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- [00:08]
Lynn Vincent
The Irish playwright Oscar Wilde was a quotable man. One of his most famous quotes. Life imitates art far more than art imitates life. In Lala season one, you've heard a lot of 911 calls, ambulance sirens, paramedics working. So far, they've all been for Terri schiavo. But on May 5, the day our last episode aired, the paramedics came for me. Seriously, they came for me. It started a couple of weeks ago. I felt dizzy, light headed. I tracked my blood pressure. That was normal. Was it vertigo? An inner ear virus? I'd had one of those before. This time, when I felt lightheaded, I'd lie down, put my feet up, and soon enough, the feeling would pass. Finally, though, on May 5, I felt dizzy enough to call 911. In the ER. Tests and more tests, lab work, all normal, CT scan, clear. But then, life did imitate art.
- [01:22]
Dr. Tony Pham
So first, coming into the hospital, we want to rule out a hemorrhagic stroke, like a bleeding type stroke, and see how to CT scan. The CT scan, luckily, was normal, so it very quickly tells us not a bleeding type.
- [01:33]
Lynn Vincent
Dr. Tony Pham is an internist at one of the largest hospitals in the San Diego region. He's also the doctor who admitted me to the same hospital.
- [01:43]
Dr. Tony Pham
So after that, well, you wanted an mri.
- [01:46]
Lynn Vincent
The MRI showed a glitch in my brain. A tiny dot. Think of it as a pixel. It was a stroke. An ischemic one. I didn't even know I'd had it. In the United States, someone suffers a stroke every 40 seconds and many don't know it until years down the line. As it turns out, my dizziness wasn't a sign of a stroke per se. It was a sign of where I'd had it.
- [02:15]
Dr. Tony Pham
So yours was located inside the Pons, which is about a 2 1/2 centimeter, about a 1 inch diameter structure. So it's very small. It's a part of the brain stem.
- [02:24]
Lynn Vincent
Dr. Pham calls the Pons Manhattan real estate. Tiny but valuable. The Pons relays critical data to other parts of the brain. It regulates things we do without thinking, like breathing, sensing pain and equilibrium. Which explains those dizzy spells. Ironic, isn't it? I'm in the middle of investigating the story of Terri Schiavo, a brain injured woman, when I suffer a brain injury myself. No comparison, of course. Not only was Terri's brain injury severe and life altering, but there's a very good chance that her entire state of consciousness was misdiagnosed. From World Radio and the creative team that brings you the world and everything in it. This is Lawless.
- [03:19]
Unknown Artist
I see a wicked man walking down a broken road. I see ransomed man in the storm trying not to fall for gold Devil's.
- [03:33]
Anna Johansen Brown
At the door trying to take control.
- [03:37]
Unknown Artist
But the Lord's gonna scatter his bones.
- [03:40]
Lynn Vincent
I'm New York Times best selling author and World Magazine senior writer Lynn Vincent. Lawless is a new true crime podcast that examines a frightening fact of American life, that not every crime is against the law. In season one of Lawless, we're investigating the Terri Schiavo story, a case that in 2005, shock the world. This is episode 5.5, Brain Trust. So far this season, you've heard a lot of nitty gritty details, a lot of pieces to this 15 year puzzle. In this 0.5 episode, we'll take a step back to look at some of the main threads that run through the whole story. We'll tug on some of those threads, questions we've raised and haven't yet answered. This week, my co writer, Anna Johansen Brown is taking point. Anna is a new mom and a deep thinker, an intellectual who also happens to be hilarious. Anna's been with me from the start of this podcast reporting adventure. Last May, when I went to Florida to do on site interviews with people close to the case, Anna traveled with me.
- [05:01]
Anna Johansen Brown
I'm Anna. I am carrying the mics and doing some of the sound stuff.
- [05:07]
Lynn Vincent
She was there when we drove around St. Pete in a rental car with no air conditioning. In Florida in the summer, that's just blowing hot air. Yes, it is. And Anna was there when we wandered the beach with Bobby Schindler, exploring one of Terry's favorite places.
- [05:26]
Anna Johansen Brown
The ocean at St. Pete's looks like a postcard. A long sweep of translucent green, blue waves, boardwalks running out across the dunes, black Eyed Susans, seagulls, sailboats.
- [05:38]
Bobby Schindler
Okay, so this is the Pasigril beach. It's one of our favorite beaches while we lived here.
- [05:44]
Anna Johansen Brown
Across the street is a tall Victorian style house painted, painted mint green. It's a restaurant called the Hurricane, a fixture in this area.
- [05:51]
Bobby Schindler
When we moved here, they were known for having the best group of sandwiches, if not in Florida, at least in this area.
- [05:59]
Anna Johansen Brown
It's a beautiful beach, but being here is strangely melancholy.
- [06:04]
Lynn Vincent
So I'm having the most interesting experience and I don't know if I'm just imagining things, but I just keep having these images of Terry just laughing and just, you know, having fun on this beach.
- [06:20]
Anna Johansen Brown
Bobby and Terry spent boatloads of spare time Here, back before her sudden, unforeseen, abrupt, out of the blue brain injury, back before everything changed, before Terry got the diagnosis. Persistent vegetative state. It's one of the most crucial pieces of this story. So it's the first big question we'll talk about today. That diagnosis would become the linchpin of years of litigation, which is ironic because in the 1990s, PBS was still a brand new field of study. Lots of figuring it out as we go along. Even to this day. It's a slippery, controversial thing. Here's Village Voice journalist, the late Nat Hentoff.
- [06:58]
Lynn Vincent
This vegetative state is one of the hardest things to diagnose. The last big survey in England, there's a 43% error rate. So this is very, very amorphous.
- [07:09]
Anna Johansen Brown
Experts didn't hammer out a protocol for clinical diagnoses until 1994, four years after a doctor labeled Terry as PVS. Here are the key. No awareness of self or environment. No voluntary, reproducible responses, and no evidence of language comprehension. But just days before Terri's PVS diagnosis, a doctor noted the progress she had made.
- [07:33]
Lynn Vincent
Dr. Baris gives Terry a physical exam. She closes her eyes to mock threats around her face and blinks appropriately. Terry responds to pain by moaning and moving her arms and legs. She makes eye contact with family members, and by this point, she's saying a word. No.
- [07:57]
Anna Johansen Brown
Several months after Terri's injury, Michael took her to California for an experimental treatment. Doctors implanted a brain stimulator to try to jumpstart Terry's cognition. Throughout the first month of stimulation, Dr. Eugene Alcazarin reported that Terri had increased alertness. He said she turned her head toward voices and could track things with her eyes. Speech therapists noted that Terri could follow commands like sticking out her tongue, nodding and blinking. Michael would later say that was all just wishful thinking. Here's one of Michael's lawyers, George Felos.
- [08:28]
George Felos
Michael, in the first few years of Terry, after Terry's cardiac arrest, believed the same as the parents. He misinterpreted the involuntary actions of, of Terry as, as consciousness. And he, he said, she's there and I can. I know she's there and I know she understands me, and I know she can get better. And so it was. That's a complete long time for him.
- [08:56]
Anna Johansen Brown
By the early 2000s, doctors had begun to identify a different state of cognitive awareness in severely brain injured patients. They had more awareness than some people. In pbs. Patients in this newly recognized condition drifted between a reflexive state with random movements and conscious, purposeful Responses that describes Terry.
- [09:16]
Wesley Smith
To a T. Her brain was consistent with either the minimally conscious, which is what the Schindler said she was, and what the videos that they posted up on the Internet would make it appear.
- [09:29]
Anna Johansen Brown
This is lawyer and author Wesley Smith.
- [09:31]
Wesley Smith
Where someone comes in the room and says, terry, will you lift up your eyebrows? Eventually she. She raises her eyebrows and she raises them so high her forehead wrinkles. I mean, that is a really humanizing moment for Terry. Or when she comes in and her mother says, hi, Terry, it's mommy. And Terry looks over and gets a big smile on her face. Now, you know you're not dealing with, quote, a vegetable. Close quote. You're dealing with a human being.
- [09:58]
Anna Johansen Brown
By 2002, even before Terry's case arrived on most people's radar, research had advanced enough to give this condition a name, the minimally conscious state, or mcs. But by then, Terry had already been slapped with the PVS label. After long stretches without rehab, Terry's progress slowed. But even years later, witnesses like Tom Broderson still reported a shocking level of awareness.
- [10:23]
Unknown Artist
They said, terry, I'd like you to do this. I'd like you to moan, but hold it like a note if you were singing, and it'll sound like this.
- [10:37]
George Felos
Ah.
- [10:42]
Unknown Artist
And I probably said it again. I had no idea of what intellectual level she was operating at, so I was trying to be as clear as I could be. But after I asked her to do it, she went, ah. And I was blown away.
- [11:13]
Anna Johansen Brown
We were blown away, too, Lynn and I. Bertersen's interview was stunning. I'm pretty sure my mouth was hanging open for most of it. You'll hear more of what he had to say in episode eight, and also on a future edition of the Point Five. Broderson visited Terri in 2002, one year before the media began characterizing her as comatose. Some even called her a vegetable.
- [11:36]
Wesley Smith
Will not allow a severely brain damaged.
- [11:38]
Anna Johansen Brown
Comatose woman to die who had collapsed into a coma 13 years earlier. Everybody thinks she's gonna die. She's put on full life support. She's in a coma and. But Terry definitely wasn't in a coma. And if Broderson was right, if Terry could communicate, she wasn't in PBS either. And if she wasn't in pbs, then it's not likely that Michael could remove her feeding tube, even if that was what Terry would have wanted. But before anyone started wondering about Terry's wishes, they were asking another question, a question that should have had a simple answer. What happened that night? Back in February of 1990.
- [12:17]
Lynn Vincent
Experts say that in times of extreme trauma, events often burn into the human memory with sudden and unalterable clarity.
- [12:26]
Anna Johansen Brown
We've talked a lot about what happened in those early morning hours or what may have happened. The trouble is, no one seems to know for sure.
- [12:35]
Lynn Vincent
Somehow that burning clarity of memory would become blurry. The timeline of events, who called whom and when. Even the position of Terry's body and details that should have been easy to remember would change.
- [12:55]
Anna Johansen Brown
When the homicide detectives talked to Michael that morning at the hospital, his account was straightforward. He woke that morning, heard a thud, found Terry called 911. But that simple retelling would soon become more detailed and more confused.
- [13:10]
Terry Buxtrom
There were time inconsistencies.
- [13:12]
Anna Johansen Brown
Terry Buxtrom is an investigator and security Expert. He spent 25 years as a special agent with the U.S. department of Justice.
- [13:19]
Terry Buxtrom
I guess in the different interviews that he did, he would articulate different times that he arrived home and that he woke up. And there were also time inconsistencies with what time he actually called paramedics.
- [13:36]
Anna Johansen Brown
When Michael wrote his book in 2005 chronicling the case, he says he woke up sometime after 5:30. That's when he heard a thud, went out to the hall and found Terry unconscious. But in a 1992 deposition leading up to the malpractice trial, he says he woke at 5:00. When Larry King interviews him in 2003, he says he woke up at 4:30. The 911 call came in at 5:40am.
- [14:01]
Terry Buxtrom
The problem I have with that is usually if someone is telling the truth, they're going to remember that first time articulated and they're going to keep repeating that same time. It's not a difficult thing to remember.
- [14:16]
Anna Johansen Brown
Years into the case. What time Michael woke up that morning would become a crucial but bitterly disputed fact. At first, Michael says he found Terry on her back. That's what he told lawyers in that 1992 deposition. But in 2000, on the witness stand once more, he says he found Terry on her front and turned her over. By the time he wrote his book in 2005, his story had shifted again. He says he found Terry on her left side, one arm down by her side, the other flung up over her head. I got down on my knees, he writes, rolled her over so she was facing me and scooped her into my arms. Michael says he cradled Terry three different times. But that doesn't fit with what Bobby remembers or what the paramedics reported.
- [15:05]
Lynn Vincent
The paramedic tells the cop that they found Terry face down on the floor Half in and half out of the bathroom. And how did you find her on.
- [15:14]
Bobby Schindler
The floor, on her stomach and her hands, or underneath her torso Once the.
- [15:23]
Anna Johansen Brown
Paramedics arrived on site. It's all pretty clear and documented. But before that, what caused Terry's brain injury in the first place? We've covered one theory so far. The theory that convinced a jury her.
- [15:36]
Terry Buxtrom
Nutritional levels were totally off, and that's what caused it.
- [15:42]
Lynn Vincent
It was the eating disorder, and it was bulimia.
- [15:45]
Anna Johansen Brown
But that diagnosis was based on a single piece of key data. Terry's potassium level. The problem is there's more to it than that. Let's rewind.
- [15:56]
Bobby Schindler
I knew something wasn't right because you could tell they were very, very concerned. And I think it wasn't. It was. Shortly thereafter, they hit her for the first time with the defibrillators.
- [16:07]
Anna Johansen Brown
The paramedics are desperately trying to revive Terri, trying everything they know.
- [16:12]
Bobby Schindler
They seem to be adamant that it was an overdose.
- [16:14]
Anna Johansen Brown
They hit her with Narcan, a drug that reverses the effects of narcotics. And they injected her with five doses of adrenaline. Adrenaline is a hormone the body produces in response to stress. Here's Gavin Perkins, an expert in critical care.
- [16:28]
Gavin Perkins
Adrenaline is exciting. Can you feel the rush? I mean, it's exhilarating. It gets your heart pumping, literally.
- [16:36]
Anna Johansen Brown
Adrenaline increases your heart rate and strengthens the force of its beating. That's why doctors use it to jumpstart a struggling heart. But adrenaline doesn't just affect your heartbeat. In 2018, Perkins led a group of researchers studying the effect of adrenaline on people who suffered cardiac arrest. People like Terry. Here's what the researchers found. Adrenaline helped buy time to get patients to the hospital.
- [16:59]
Gavin Perkins
There were 36 more survivors overall, but.
- [17:04]
Anna Johansen Brown
It increased the likelihood of severe brain damage. In fact, it doubled it.
- [17:09]
Gavin Perkins
27 patients more. Patients that had moderate or severe disability. In the adrenaline treated group, patients who.
- [17:18]
Anna Johansen Brown
Received adrenaline were twice as likely to have severe, severe brain damage. Why? Because adrenaline reduces blood flow to other organs, like the brain. Terry's brain was already oxygen deprived. It's possible that adrenaline made it worse. Adrenaline also messes with other systems in the body. John Thogmartin is the medical examiner in Pinellas County, Florida. He conducted an autopsy on Terry's body in 2005. We'll go through it more in a later episode.
- [17:47]
Lynn Vincent
But.
- [17:48]
Anna Johansen Brown
But part of what he said is relevant here. He notes Terry's severely low potassium level. That was what originally prompted Dr. Shaw to wonder if Terry had an eating disorder. But thog Martin says that's unlikely. Instead, he points to another cause. During that hour, the paramedics worked on Terri. They gave her dextrose solution, five 1 milligram doses of epinephrine, lidocaine, Narcan, dopamine and seven defibrillations. Thog. Martin points out that epinephrine and defibrillation are known to cause changes in electrolytes, drastic swings in potassium levels. He says flat out that Terry's potassium levels were probably low because of all the stuff the paramedics gave her, not because of any secret eating disorder. Thus, he writes, the main piece of evidence supporting a diagnosis of bulimia nervosa is suspect, or at least can be explained by her clinical condition at the time of blood draw. Here's what's important. If the bulimia theory is dismantled, a huge question remains. What happened to Terry? Next time on Lawless. I just remember somebody coming up with the idea that, you know, we need to record Terry. That's what I remember.
- [19:06]
Unknown Artist
I did it without hesitation.
- [19:09]
Anna Johansen Brown
Lawless is a production of World Radio. Our executive producer and sound engineer for this episode is Paul Butler. Our production assistant is Lillian Hammond. Music by Will Sheehan. Lawless is reported and written by Lynn Vincent, Bonnie Pritchett and me, Anna Johansson Brown. For a list of additional audio sources in this episode, visit lawlesspodcast.com thanks for joining.
- [19:38]
Lynn Vincent
Oh.