The Story of Jahi Continues

Horseshoe, BSN, RN · Dec 28, 2014

If Jahi's mother and lawyer are telling us the truth, Jahi is more PVS than brain dead, especially since she has not rotted in the bed.

I would think a nurse would know that the fact that Jahi hasn't "rotted in the bed" has not ONE IOTA to do with her being brain dead or not. She is on a ventilator, which is keeping her heart beating. That beating heart is distributing oxygen rich blood to her entire body. There would be no reason for her body to "rot" while her healthy heart continues to nourish her other tissues.

And yes I've cared for patients in that particular state. The family is CERTAIN that the patient communicates, and capable of some rather complex interactions that are simply NOT possible.

That's not really that surprising. Terri Schiavo's family insisted that their PVS daughter was tracking her with their eyes and was interacting with them. However, the autopsy showed that her brain had atrophied to a little lump. She was blind, thus totally incapable of tracking anything with her eyes as they INSISTED over and over. They were in denial because they loved her and didn't want to let her go. The autopsy proved they were wrong about almost everything they said about her. You are right, what Jahi's family says she is doing is impossible. I don't think they are lying as much as wanting to believe it very badly, just as the Schiavos did.

But they are as dedicated to keep their loved one bed-sore free and comfortable as I've ever seen, they go to an extreme you don't see in healthier cases. It's all they have left, and they ain't letting go without a fight, for whatever personal reasons. I've often thought the family is 'animating' the patient far more than is actually happening. I've not felt distaste or disgust, but I have felt very sorry for them, and the poor patient who might rather die but has no say.

I think that Jahi's family, particularly her mother, loves her deeply. The stuff about the spending and other unwise uses of donated money may also be true, but I think that NW has a fierce love for her daughter that has contributed to her refusal to face the facts here.

It's a far stretch to me to see a picture of a name brand hand bag and assume it was purchased directly from donations meant for Jahi's medical needs. Maybe you're right. But we don't KNOW. No one knows but the family. I suppose Jahi's family are not required to explain every nice thing they accumulate to the public. I don't suppose they should all wear black and cover the mirrors and never laugh again either.

It takes some heavy denial to think that these purchases are being made with anything other than donated funds or government benefits intended for necessities. How one judges these purchases may be another matter, but NW doesn't have a job, and last I heard, neither did her husband.

scaredsilly, BSN, RN · Dec 28, 2014

We don't know if she is rotting in the bed or not. You are correct that the vent is keeping her from completely decomposing, but there is an article submitted to the court by a Dr. who examined her prior to her release from Children's in Oakland that stated she was sloughing her intestines even at that early point in the case. Best guess is that she is slowly "rotting" and that photos we see are quite old.

NM probably does love Jahi, but I don't think this is about love at all. Nor do I believe they are in denial. NM spent a year by her child's bed, no doubt with a multitude of med professionals explain the Lazarus syndrome to her. She KNOWS her child is dead, but she can't get rich enough with a dead child. Gofundme raised over 60k and people still donate. there is another fundraiser online with a goal of 500k. Cali law caps malpractice suits in peds cases at under a million, but malpractice that leaves a child profoundly disabled has no cap and the dirty uncle actually said in a new conference early on that the cap was bogus and they were going after the big money. This is about money, plain and simple. They want to emerge as multimillionaires by their own admission and they have no chance at that if they bury their dead.

Horseshoe, BSN, RN · Dec 28, 2014

We don't know if she is rotting in the bed or not. You are correct that the vent is keeping her from completely decomposing, but there is an article submitted to the court by a Dr. who examined her prior to her release from Children's in Oakland that stated she was sloughing her intestines even at that early point in the case. Best guess is that she is slowly "rotting" and that photos we see are quite old.
NM probably does love Jahi, but I don't think this is about love at all. Nor do I believe they are in denial. NM spent a year by her child's bed, no doubt with a multitude of med professionals explain the Lazarus syndrome to her. She KNOWS her child is dead, but she can't get rich enough with a dead child. Gofundme raised over 60k and people still donate. there is another fundraiser online with a goal of 500k. Cali law caps malpractice suits in peds cases at under a million, but malpractice that leaves a child profoundly disabled has no cap and the dirty uncle actually said in a new conference early on that the cap was bogus and they were going after the big money. This is about money, plain and simple. They want to emerge as multimillionaires by their own admission and they have no chance at that if they bury their dead.

I do remember the bowel sloughing, but that seemed to be more about the initial hypoxic injury rather than long term decomposing.

It may be that money has become the driving factor here, but I really can't say that with any authority. I personally believe NW loves that girl fiercely, and don't discount denial in the face of what SHOULD be very convincing arguments. People can be very adept at seeing what they want to see.

scaredsilly, BSN, RN · Dec 28, 2014

I do remember the bowel sloughing, but that seemed to be more about the initial hypoxic injury rather than long term decomposing.
It may be that money has become the driving factor here, but I really can't say that with any authority. I personally believe NW loves that girl fiercely, and don't discount denial in the face of what SHOULD be very convincing arguments. People can be very adept at seeing what they want to see.

You may be right about the sloughing, but I don't believe that she is still the morbidly obese child with perfect skin in the pictures. I would like to see a certified recent photo, but not much chance of that happening. I understand denial, but this is about money. They have basically admitted that.

Ruas61, BSN, RN · Dec 28, 2014

There best move on their part, as of late, has been staying out of the public domain.

In our electronic, instant world things fly around so fast and there are so many things that come and go.

They invited this scrutiny and public talk (everywhere worldwide) when they went public and asked for support particularly when they sought financial contributions.

You may not always like what you get or hear when you do this but that is reality of the situation.

I think there was a lot of poor decisions made and presentation of things to the general public.

You can't erase those mistakes.

More than just Jahi was lost that day.

elkpark · Dec 28, 2014

It may be that money has become the driving factor here, but I really can't say that with any authority. I personally believe NW loves that girl fiercely, and don't discount denial in the face of what SHOULD be very convincing arguments. People can be very adept at seeing what they want to see.

Not just love and denial; don't forget about guilt -- the mother has to live for the rest of her life with the knowledge that she might still have her daughter if the family hadn't ignored the physician's orders and fed her fast food right after her surgery.

TriciaJ, RN · Dec 28, 2014

The family's public behaviour has made it very difficult to give them the benefit of the doubt. I've seen many people in denial; it's very sad but at some point everyone comes to terms with the terrible truth. It seems very judgmental to assume the family is only interested in the money, but we're not assuming. They have been very blatant about it.

I don't need the book to come out before I can empathize with Jahi's caregivers. As a nurse I can empathize with them right now, even if I've not been in their particular circumstances. I can empathize with parents who have lost children, even though I've never had any. But over the past year, my empathy for Jahi's family has eroded greatly, because I just can't get my head around their public behaviour.

scaredsilly, BSN, RN · Dec 28, 2014

Not just love and denial; don't forget about guilt -- the mother has to live for the rest of her life with the knowledge that she might still have her daughter if the family hadn't ignored the physician's orders and fed her fast food right after her surgery.

Don't forget the suctioning! That had a lot to do with the bleeding that killed Jahi. Oh and all of the laughing and talking that the family initiated after being specifically told that she needed to be quiet for the first 24 hours.

Horseshoe, BSN, RN · Dec 29, 2014

Don't forget the suctioning! That had a lot to do with the bleeding that killed Jahi. Oh and all of the laughing and talking that the family initiated after being specifically told that she needed to be quiet for the first 24 hours.

For that matter, just having the surgery to begin with. I think it was NW who acknowledged that Jahi had verbalized fears that she wouldn't wake up after her surgery. Knowing that this was an elective procedure and that other options had been presented to her, I would think that alone would be extremely likely to produce a whole hell of a lot of guilt feelings.

Horseshoe, BSN, RN · Dec 29, 2014

Not just love and denial; don't forget about guilt -- the mother has to live for the rest of her life with the knowledge that she might still have her daughter if the family hadn't ignored the physician's orders and fed her fast food right after her surgery.

As far as I know, this is a rumor which has been floated about quite a lot but absolutely never confirmed by any credible source. Or has that changed?

Horseshoe, BSN, RN · Dec 29, 2014

The family's public behaviour has made it very difficult to give them the benefit of the doubt. I've seen many people in denial; it's very sad but at some point everyone comes to terms with the terrible truth. It seems very judgmental to assume the family is only interested in the money, but we're not assuming. They have been very blatant about it.

Not everyone comes to terms with the truth in only a year's time.

There was even one mother who never did allow her four year old brain dead son to be taken off life support. He lived 20 years after becoming brain dead, and if memory serves, was only taken off it when his heart stopped. Autopsy showed nothing but a small amount of calcified matter with absolutely no discernible or identifiable brain structures.

That's pretty strong denial.

That said, I'm not really defending the family's actions/behavior. I just don't believe that NW has no love for her child and is simply using her brain dead body in some kind of gross money grab. I think her funding is running low and she needs money to pay for Jahi's continued treatment. It seems that in addition to that, she is not averse to spending some of it on herself. I believe that love and greed can co-exist in the same person.

Gooselady, BSN, RN · Dec 29, 2014

How else does she get the funds? Where does the money come from when she doesn't work? The magical money tree in the backyard? If so, I want one.
So then the 5 independent neurologist who tested Jahi were wrong. Did you see the recent MRI of Jahi's brain?
If she was in PVS would she be able to thermoregulate?
You know you won't be able to hear from direct caregivers due to HIPPA.

I sure did see the MRI. Her midbrain, pons and brainstem in general are toast. She appears to have intact areas primarily in the cerebrum and a little bit in the cerebellum. This MRI is a picture of ONE SLICE of hundreds and no matter what it shows, it's missing 98% of the necessary context to make any statements.

The five independent neurologists who declared Jahi brain dead used evidence-based parameters to declare brain death, and that was their conclusion. I don't doubt their expertise at all. What's in question -- maybe -- is the value of the parameters of brain death. We are always improving on pre-existing knowledge. The improvements that get made happen when the old tried and true fails and then further investigation happens.

You don't know if she can thermoregulate or not. I have read 90% of the Jahi threads. Blankets on Jahi, no matter how many or few are not clinical indications of thermoregulation, and we shouldn't assume they are as nurses who know better about human physiology.