When Jahi McMath was declared brain-dead by the hospital, her family disagreed. Her case challenges the very nature of existence.
Jahi had begged not to get the surgery, but her mother promised that it would give her a better life. Jahi had sleep apnea, which left her increasingly fatigued and unable to focus at school. She snored so loudly that she was too embarrassed to go to slumber parties. Nailah had brought up four children on her own, and Jahi, her second, was her most cautious. When she saw news on television about wars in other countries, she would quietly ask, “Is it going to come here?” Her classmates made fun of her for being “chunky,” and she absorbed the insults without protest. A few times, Nailah went to the school and asked the teachers to control the other students.
The operation, at Oakland’s Children’s Hospital, took four hours. When Jahi awoke, at around 7 p.m. on December 9, 2013, the nurses gave her a grape Popsicle to soothe her throat. About an hour later, Jahi began spitting up blood. The nurses told her not to worry and gave her a plastic basin to catch it in. A nurse wrote in her medical records that she encouraged Jahi to “relax and not cough if possible.” By nine that night, the bandages packing Jahi’s nose had become bloody, too. Nailah’s husband, Marvin, a truck driver, repeatedly demanded that a doctor help them. A nurse told him that only one family member was allowed in the room at a time. He agreed to leave.
Nailah, who worked in contractor sales at Home Depot, said, “No one was listening to us, and I can’t prove it, but I really feel in my heart: if Jahi was a little white girl, I feel we would have gotten a little more help and attention.” Crying, she called her mother, Sandra Chatman, who had been a nurse for thirty years and who worked in a surgery clinic at Kaiser Permanente, in Oakland.
Sandra, who is warm and calm and often wears a flower tucked into her hair, arrived at the hospital at ten o’clock. When she saw that Jahi had already filled a two-hundred-millilitre basin with blood, she told a nurse, “I don’t find this to be normal. Do you find this to be normal?” A nurse wrote in her notes that the physicians on duty were “notified several times over course of shift” that Jahi was bleeding. Another nurse wrote that the doctors were “aware of this post op bleeding” but said “there would be no immediate intervention from ENT or Surgery.” Rosen had left the hospital for the day. In his medical records, he had written that Jahi’s right carotid artery appeared abnormally close to the pharynx, a congenital condition that can potentially raise the risk of hemorrhaging. But the nurses responsible for her recovery seemed unaware of the condition and didn’t mention it in their notes. (Rosen’s attorney said that Rosen could not speak about Jahi; the hospital couldn’t comment, either, because of medical-privacy laws, but a lawyer said that the hospital is satisfied that Jahi’s nursing care was appropriate.)
There were twenty-three beds in the intensive-care unit, spread over three rooms. A doctor was standing on the other side of Jahi’s room, and Sandra asked him, “Why aren’t you guys seeing about my granddaughter?” The doctor instructed the nurse on duty not to change Jahi’s hospital gown, so that he could assess how much blood she was losing, and to spray Afrin in her nose. Sandra, who teaches a workshop at Kaiser Permanente on the “four-habits model,” a method for improving empathy with patients, told me she was surprised that the doctor never introduced himself. “He was all frowned up with his arms crossed,” she said. “It was like he thought we were dirt.”
At twelve-thirty in the morning, Sandra saw on Jahi’s monitor that her oxygen-saturation levels had fallen to seventy-nine per cent. She yelled to the medical staff, and several nurses and doctors ran toward Jahi and began working to intubate her. Sandra said that she heard one doctor say, “Oh, shit, her heart stopped.” It took two and a half hours to restore Jahi’s heartbeat and to stabilize her breathing. Sandra said that when she saw Rosen early the next morning he looked as if he’d been crying.
Two days later, Jahi was declared brain-dead. With the help of a ventilator, she was breathing, but her pupils did not react to light, she did not have a gag reflex, and her eyes remained still when ice water was dripped in each ear. She was briefly disconnected from the ventilator, as a test, but her lungs filled with carbon dioxide. On an EEG test, no brain-wave activity could be seen.
Like all states, California follows a version of the 1981 Uniform Determination of Death Act, which says that someone who has sustained the “irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” California law requires that hospitals permit “a reasonably brief period of accommodation” before disconnecting a ventilator—long enough to allow family to gather, but not so long that hospitals neglect the “needs of other patients and prospective patients in urgent need of care.”
No comments:
Post a Comment