Okay, more questions. A commentor at one of my posts is a brain doctor. He has raised the issue of the fact that the autopsy report points out that the “larger pyramidal neurons were globally absent” in the cerebral cortex. A doctor blogger points out in his comments that the “relative preservation” of the frontal and temporal lobe means preservation compared to the massive damage elsewhere—but that those locations were still severely damaged.

The report says that the granular neurons of the cerebral cortex were relatively preserved—though damaged since the report speaks to global damage. I know that we have to accept that Terri had severe brain damage. I think that we still have to ask whether or not these findings unequivocably rule out any level of consciousness.

Granted, I do not believe that PVS justifies withdrawal of nutrients and hydration—so I wouldn’t concede that what was done to Terri was right under any circumstances. Given that, I do not want to just concede that because some doctors say so—that the autopsy unequivocably and with certainty shows that she had absolutely no level of consciousness whatsoever—without asking every question possible.

It is certain that she had a badly damaged brain. Yet the part of the brain where IQ and personality reside—though badly damaged—is not as damaged as the rest.

• Does this, without doubt prove that she was 100% unconscious? What were the neurons that she had left doing?
• I found an article about THE SINGLE-NEURON THEORY OF CONSCIOUSNESS. Do some doctors and researchers think that if there is a neuron there is a chance of consciousness?
• If the pyramidal neurons are gone, do the granular neurons (stellate cells) fill in and support consciousness in any way?
• Fr. Johansen spoke to other neurologists who stated that loss of tissue found upon autopsy cannot diagnose PVS or clincial status—does that mean that as long as she had tissue that was intact to a degree and some neurons—she may have had some degree of consciousness?

Brain Doc believes that: The anterior and medial thalamus had less than the massive damage reported in the cortex and basal ganglia. This is buried in the report of the microscopic H+E slides. In simple terms, it(the antero-medial thalamus) coordinates emotion/ drives by communicating to the cortex, but only if activated by the rest of the thalamus,which I doubt it could be. It is interesting for me, but it changes little.

I found this article about the thalamus which suggests that there are competing theories about its role in consciousness. So, another question—is there disagreement in the medical community about its role and how it works?

Dr. Rangel at RangelMD answered some questions in his comments. The report talks about the LARGER pyramidal neurons being globally absent. I asked does that mean there were other pyramidal neurons present? He believes that the term LARGER was used to distinguish between the granular—or stellate—neurons (cells) and the pyramidal. So I thought there was no such thing as larger and smaller pyramidal neurons. Then I find this source that talks about larger and and smaller pyramidal neurons.

So, another question: If there were smaller pyramidal cells present—what does that mean in terms of the possibility of consciousness? And, if there were smaller pyramidal’s present were they interconnecting with the granular or stellate neurons? And could this yield some degree of consciousness?

When people say that the autopsy proves that she was PVS or unconscious, I have to question that. To me, that would be an opinion based on some degree of subjectivity.

No doubt there are objective findings recounted in the report. But the meaning of those findings is based on the expert’s subjective opinion. Even his observations of the brain at the microscopic level involve some degree of subjectivity because he is perceiving the results and then reporting based on his opinion of what the slides show. So, there is an element of the subjective contained in every medical report.

I believe that only God knows with certainty whether or not Terri was conscious. In the meantime, I think that it is appropriate for us to question and argue about what the findings recounted in the autopsy really mean.

Update:

Dr. Rangel said this in his post:

The optic nerves were atrophied and the visual centers of the brain, which interpret signals from the eyes and optic nerves and allow for conscious awareness of visual stimuli were completely destroyed.

He believes that there was complete destruction because the report said that the most damage was done to the occipital region.

Obviously, she was completely blind or visually impaired to a severe degree. But—does that rule out all consciousness? Here is a medical article that says:

Many patients who are misdiagnosed as being in the vegetative state are blind or have severe visual handicap; thus lack of eye blink to threat or absence of visual tracking are not reliable signs for diagnosing the vegetative state.

The article states that PVS is a clinical diagnosis requiring many steps. Did Cranford take all of the steps?