Mary Schindler (4:11)

For the first two, two or three weeks, I never moved from the ICU unit.

Lynn Vincent (4:16)

Terry's attending physician, Dr. Samir Shah, hasn't been practicing medicine long. He was first licensed in 1998. Two years later, on February 25, 1990, Terri Schiavo rolled into the ER on Dr. Shaw's shift. So far, she's a medical mystery. Her husband, Michael Schiavo, says he awakened before dawn to find her lying unresponsive in the hallway of their apartment. Go ahead and set me up a second line. It took a long time for Humana Hospital's ER team to stabilize Terry even enough to move her to intensive Care. Now they're running more tests, trying to figure out what happened.

Mary Schindler (5:02)

The neurologist came out and talking about Dr. D'Souza was his name.

Bobby Schindler (5:08)

I do remember he painted a very grim prognosis.

Mary Schindler (5:11)

Right. Exactly. I don't remember his words. All I know is that he said that it was not good.

Lynn Vincent (5:17)

Dr. Shah notes in his report that Terry has suffered cardiopulmonary arrest. That's not the same thing as a heart attack. In a heart attack, blood flow to the heart stops. In a cardiac arrest, the heart stops beating for some unexpected reason, or for an expected one. The truth is, we all suffer cardiac arrest in the end. For hours, the case remains an enigma, like something you'd see on the show house. Then Dr. Shaw gets the results of Terry's blood tests. And one value really gets his Terry's potassium level. Potassium is a critical electrolyte. Even a minor imbalance can lead to serious health problems. The low range of normal is 3.6 millimoles of potassium per liter of blood. Terry's blood work shows a potassium level of 2.0. Dr. Shaw heads out into the waiting room to ask Michael some questions. Was Terry dieting, taking any diuretics or laxatives? Michael says no, but she did drink a lot of iced tea, as much as a gallon a day. Caffeinated beverages are diuretics. Dr. Shah says that, combined with her severely low potassium level, could indicate that Terry was suffering from bulimia. Here's Teri's brother, Bobby.

Bobby Schindler (6:52)

Then they started wondering what might have caused the low potassium. And that's when it came up that Perhaps it was an eating disorder which could have caused her heart to go into some type of arrhythmia.

Lynn Vincent (7:05)

This is the first hint at a diagnosis, the first time a doctor suggests a reason why a healthy 26 might collapse in the middle of the night. Did Terri suffer from a secret battle with bulimia? Some doctors said yes. Others say probably not. More on that later. Terry's family wasn't sure when it came up.

Bobby Schindler (7:39)

I guess at the time I thought, sure, it's a possibility. I mean, everything I know about eating disorders, that people do it in secret, that you don't always know.

Lynn Vincent (7:48)

Bulimia nervosa is an eating disorder that mainly affects women. The name comes from a Greek word that means ravenous hunger. Bulimics often have a poor body image and are overly conscious of their weight. A war rages inside them. The desire to control their weight clashes with sporadic bingeing and purging, usually throwing up food. This triggers shame, and in about half of bulimics, also mood or anxiety disorders. Doctors had ruled out other causes for Terri's sudden anoxic brain injury. In fact, the only abnormality came in that blood work. Remember, Terri was overweight from elementary school through high school until she took it off with Nutrisystem. That was 1982. Could Terry's childhood struggle with weight have triggered a secret battle that lasted into adulthood? Maybe. But no one had ever seen Terri binge eating. No one suspected she was throwing up her food, and she didn't have the overdeveloped neck muscles associated with purging.

Bobby Schindler (9:01)

She lost weight, but at one point it stabilized. I don't even think her weight was a topic of discussion after she had lost the initial weight. I thought she looked fabulous. I was spending a lot of time with her because Michael. Because they had offsetting schedules. I don't know if it's an exaggeration to say that I was seeing Terry more than Michael for a particular period of time.

Lynn Vincent (9:32)

But Dr. Shaw tells Michael that bulimics often hide things. So Michael and his brother Brian head back to the Schiavo's apartment. Together, the brothers go through Terry's belongings, searching for signs of a secret. They go through her clothes, her pockets, her purses, even her shoes, and they find nothing. It's Dan Greco, Michael's boss and friend, who first raises the possibility of a medical malpractice. Dan is also an attorney. Terry had been seeing OBGYN Dr. Steven Igel. Greco says that Dr. Igel never checked Terry's potassium levels, never asked about any Eating disorders. She went to him because of the problem and his analysis did not go to something simple like potassium levels because she was not, not totally forthcoming about her eating habits or something with Dr. Eigel. Michael and Mary say Greco brought up the lawsuit subject while Terry was still in the icu. Greco told me it was several months after Terry's collapse. Either way, Greco argues that if Dr. Igel had done his job, Michael wouldn't be looking at the potential loss of his wife and a life altering landslide of Medical. Though Dr. Shah's diagnosis of bulimia is preliminary, it's a place to start. Michael Schiavo and Terry Schindler got their start in a college psychology class in 1983. Michael was tall, handsome, charismatic. Terry's aunt CB tomorrow noticed how Terri lit up as she fell in love.

Mary Schindler (11:39)

She started to date Michael and I'm telling you she just was blossoming. She was so excited and so happy. She was very eager to get home. I clearly remember sitting at your mom and dad's in the living room and her talking about she had a boyfriend and dating Michael and you could, she was just radiating joy.

Lynn Vincent (12:04)

As shy and reserved as she had been in high school, Terry fit right in with Michael's raucous family. Here's Michael's brother, Scott. I was just amazed. I was like, where do you find this girl?

Bobby Schindler (12:16)

You know, she was just so giddy.

Lynn Vincent (12:18)

And so lovable and laugh and laughing, cheerful. She didn't, I don't think she stopped smiling once and it wasn't a fake smile. Terry became good friends with Michael's sister in law Joan. After a year of dating, Michael asked Bob Schindler for his blessing to marry Terry. Bob was cautious at first. Terry was so young, not even 21 years old. He didn't want her to rush into anything. But eventually he gave his blessing. The couple got married on November 10, 1984. They were married in the Catholic church. Michael wasn't religious, but he got a special dispensation to be married in Terry's parish. The video of the wedding day is hazy, full of 80s mustaches and oversized wire frame glasses. The audio is from 1984. So it's not great. It's terrible in fact. But the wedding video is a rare recording of Terri's voice.

Mary Schindler (13:20)

I, Tracy, taking Michael to be my husband.

Lynn Vincent (13:23)

Standing next to Michael, Terry looked serene as she spoke her vows.

Mary Schindler (13:27)

In good times and in bad, in sickness and in health.

Lynn Vincent (13:31)

Terry's dress was beautiful, high necked with puffy sleeves and a full skirt. Her white hat was wrapped in a halo of tulle. I, Michael, take you, Theresa, to be my wife. I promise to be true to you in good times and in death, in sickness and in health. I will love you and honor you.

Mary Schindler (13:54)

All the days of my life.

Lynn Vincent (14:06)

At the reception, Terry and Michael Green, guests in a receiving line. Shaking hands, kissing cheeks, giving hugs. Partway through the line, Terry greets a shorter man in a navy suit. He's in his 50s, handsome, dark hair, just beginning to silver. This is Terry's Uncle Fred, Bob Schindler's older brother. Uncle Fred smiles and congratulates Terry. Then as he moves toward the right hand side of the video frame, he shakes Michael's hand. After that, he moves off, already chatting with another guest. It isn't until this point in the video that you really notice he limps a little and walks with a cane. Don't forget Uncle Fred. He'll be an important figure later on.

Mary Schindler (14:56)

I'd like to thank my mom and dad and like his mom and and dad, we had a really good time. I hope everybody else had a good time. And what else?

Lynn Vincent (15:05)

We love you both very much.

Mary Schindler (15:07)

Yeah.

Lynn Vincent (15:08)

Thank you. Back at Humana Northside, Terry Smith, 44 days in the ICU. Then she opens her eyes. Terry wakes from her coma. Michael remembers being over the moon. But she doesn't awaken as the same old Terry. Instead, she's severely disabled, can't speak, barely responds to her family. Still, Michael, Michael and Mary don't give up hope. They start documenting her progress in a journal they keep at her bedside. Here's an entry Michael wrote. It's block printed in all caps.

Bobby Schindler (16:02)

April 16th, 6pm Teresa became very excited. Heart raced to 170bpm. Terry also started to cry. Facial expressions, tears, whining.

Lynn Vincent (16:21)

That's attorney Tom Broderson. He and his wife, attorney Pat Anderson, got involved in the schiavo case in 2001. Broderson and Anderson still have boxes and boxes of documents from the case, including photocopied entries from Michael and Mary's journal at their law office in St. Pete Beach. Bertison projects a few entries up on the wall. Not many people have seen this journal, but last year Bobby Schindler dug it out of storage for me. It's one of several that Mary kept. It has a cloth cover, blue and burgundy paisley written on the overleaf. An encouraging inscription from a friend. Here's an entry from April 17th at 3:30pm it's written in Mary's flowing cursive.

Bobby Schindler (17:09)

4:17, Tuesday, 3:30. Terry been sitting in the chair holding.

Lynn Vincent (17:16)

Her legs together, holding her own head.

Bobby Schindler (17:19)

Up seems to get her nights and days mixed up.

Lynn Vincent (17:24)

Responsive to every noise, noise she hears.

Bobby Schindler (17:31)

10:30Am Harriet, the speech therapist, was in. She did very well. She tasted and swallowed.

Lynn Vincent (17:43)

There are just a handful of entries in total, and they cover only about a month between April and May of 1990. Here's one from Thursday, April 19th. This one in red ink, seems to be more alert. Here's every noise. April 22, 7pm crying spell again. This time it looked as though she was trying to mouth some words. She also followed my fingers back and forth. This went on for about three minutes or longer. Monday, April 23, 1990. Michael, writing, seems to follow voices and stares when she finds the point of location. Has been doing this for a few weeks. In the journal, Michael also documents the morning of April 25, 1990. He writes that Terry was sitting in a chair in her hospital room. Before putting her back in bed, Michael tells her that he plans to take her outside the next day. And this is what he writes. She then lifted her head off and away from the chair. I asked her if she wanted to get up. She nodded. I asked her. A minute later, she did the same motion. That was 1990. Fifteen years later, in 2005, Michael would write a book. He called it Terry the Truth. In his book, Michael says Terry's early responses filled him with hope. Looking back on it, though, he says his hope was really just wishful thinking. At this point, doctors recommend that Terry be moved to Bayfront Rehab Center. David Barris, a doctor who specializes in rehabilitative medicine, thinks she's a good candidate for cognitive and physical rehab at Bayfront. But Terry's cognition seems bad. Balanced on a knife's edge, her actions waver between purposeful responses and random reflexes. Dr. Baris gives Terry a physical exam. He finds that she startles easily when he says her name. And when the bed rail falls down, 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. These responses would seem to indicate consciousness. But Dr. D'Souza, the neurologist, doesn't think so. He diagnoses Terry as being in a persistent vegetative state or pbs.

Mary Schindler (20:38)

I was standing right by her bed and he came in to me. He was a very nice person. He felt really bad, and he told me that he didn't think she would get any better. This is where she was going to be, you know, she was in pvs and that's where he thinks that she would. She's going to stay.

Lynn Vincent (20:54)

I asked Mary how she felt about that.

Mary Schindler (20:57)

I didn't care as long as she was alive, really, it didn't make any difference to. All I remember was if I could just bring her home or maybe we'll try rehab, you know, and see if it works.

Lynn Vincent (21:09)

Back in 1990, persistent vegetative state was a pretty new diagnosis. It had been around for less than a decade. The first time it was used was in 1983 to describe another brain injured woman, Karen Ann Quinlan. At the time, John Fuller was an associate professor of medicine at the Boston University School of Medicine. But in pvs, the midbrain and the brain stem are still surviving. And so we have the regular regulatory functions of blood pressure, temperature, respiratory and cardiac control. Those are happening. So if we can feed someone and hydrate them, then this body will go on and go on and go on. As we know, a patient in PBS has no awareness of themselves or of their environment. Their eyes are open and they have a sleep wake cycle. PVS patients do not have the capacity to experience pain or suffering. Those are attributes of consciousness that require the cerebral cortex to be functioning. And these patients who are permanently unconscious can't experience those symptoms. Put a pin in that one. We'll come back to it later. In the 1990s, PBS patients were considered permanently unconscious. They were given little more than custodial care, most often in nursing homes. But time and medical research would reveal that this was a grave error because PVS isn't a simple diagnosis. And nestled within the vegetative state was the minimally conscious state, which didn't become a category until 2002. That's Dr. Joseph Finns, a professor of medicine and medical ethics at at Weill Cornell Medical Center. For 35 years, PBS existed as kind of a diagnostic catchall for the severely brain injured. But as often happens in medicine, advancing research would upend the existing orthodoxy. Tragically, what we've discovered is that we've been neglecting this population, conflating them with the vegetative state. They're misdiagnosed, that are still staggeringly high rate. When Terry's former employer, Prudential Insurance, learns about her PBS diagnosis, the company refuses to pay for rehab. Here's Dan Greco. And they had paid, you know, the emergency room and, you know, whatever else, health insurance wise. But early on, which was only maybe three or four months, Prudential made a determination upon actual physical examinations of Terry and The records that it was irreversible brain damage and that they would not be paying for any, you know, treatments. And the potential cost of Terry's future care, skilled nursing rehabilitation, is astronomical. The Schindlers have some savings, time tucked away and some equity in their home. But Bob has recently come off a failed business, and that's taken a financial toll. And Michael, he doesn't have any money. And now instead of working, he's spending all his time at the hospital with Terry. How high could the cost of Terry's care go? Into the millions. And that brings us back to the medical malpractice suit. After the disappointment with Prudential, we had no money. So at some point, I suggested to Mike that we'll take a long shot to prepare for it. Michael Schiavo made his first official legal move. He filed a petition in probate court to become Terry's guardian. If that seems obvious, just a boring check in the legal box, it isn't. And Terry's guardianship would become a flashpoint in the Schiavo case, lighting off bitter litigation that lasted for a dozen years. By the fall of 1990, Terry has progressed enough that Michael and the Schindlers think they can finally take her home. Bob and Mary rent a house on Vina del Mar, one of those little freeway connected islands that dot Tampa Bay. The house is on Hermecita Street, a waterside neighborhood lush with birdsong and palm trees. Michael gives up the Schiabo's apartment and moves in with Bob and Mary. Bobby and Suzanne are also living in the house on her. The whole family plans to take care of Terry together.

Bobby Schindler (25:57)

The relationship between Michael and my parents was. Was fine. They were working in harmony together, trying to get Terry the best care and even looking to find her continued regressive rehabilitation.

Lynn Vincent (26:10)

But at least one person wasn't optimistic about the arrangement. Michael's mother, Claire Scheibo. That's according to Fran Kastler, a. A close friend who spent a lot of time with the Schindlers and Schiavos. I do remember going out with Michael's parents, and Claire was next to me, and she leans over and she says, don't say anything. But Michael is not gonna let Bob and Mary take care of Terry.

Mary Schindler (26:39)

She said, I can see trouble coming.

Lynn Vincent (26:43)

Claire Schiavo passed away in 1997. In the wake of their own tragedy, Bob and Mary are trying to keep their family together. But it definitely wasn't where they pictured themselves winding up after 28 years of marriage. It was 1962 when Mary Tomorrow met Robert in Corning, New York. She was working at a bar. He was a mechanical draftsman. Bob was short and funny. A terrible tease with a big heart. They married exactly six months later, in January 1963.

Mary Schindler (27:29)

He was a character. He is funny. He used to make me laugh.

Lynn Vincent (27:33)

Anytime Bob met someone new, he gave in his personal litmus. He asked them if they liked John Wayne. Get down off them horses.

Mary Schindler (27:42)

I don't favor looking up to the likes of you. I think he saw his pictures 800 times.

Lynn Vincent (27:48)

If people said they liked John Wayne, they got Bob Schindler's stamp of approval. Mary grew up in a big, boisterous Italian family, Catholic to the core. I first met Mary in person at the Villages, that famous retirement community near Orlando, Florida. She was visiting a friend who had just lost her husband. Mary, of course, knows loss. It showed the day I met her. Even in what she was wearing, a necklace ringed with silver charms showing the images of Catholic saints. Mary lifted one charm from the chain and showed it to me.

Mary Schindler (28:28)

This one is. Well, that's her. Saint Teresa. That's Saint Teresa. Patron saint. Saint Teresa. And that's her right there. It's called Saint Teresa. The little flowers. She's got a bouquet of flowers. See them there?

Lynn Vincent (28:43)

Terry's stay on Hermecita street doesn't last long. Caring for her is difficult, physically and emotionally. Much harder than Michael and the four Schindlers had anticipated. This is when the first family fractures appeared. Cracks in the Kumbaya. Michael and I never got along just from the get go. That's Terry's sister, Suzanne Schindler. I never liked him, and I think he couldn't bully me, so he didn't like me either. And increasingly, Bob is getting on Michael's nerves. Here's Fran Cassler, because he used to joke about my going kind of boo. Belittle him because Michael used to watch soap operas. The thing is, Bob never quite got past the fact that Michael failed his John Wayne test. Way back in 1983, when Terry first brought him home to meet her dad. Bob was macho man, you know. And, you know, when Michael used to come home and just watch the soaps, Bob just, you know, he would just tease them and make fun of them and everything, so. And as the stress mounts at the house in Vina del Mar, tempers flare. One day in the kitchen, Michael and Suzanne get into an argument. I didn't like the way Michael treated my parents. So I was always the one jumping in and saying something. This time, when Suzanne says Something. Michael gets angry. He stands up, comes at her. But Bob Schindler jumps in between them. Suzanne says, bob stops Michael from getting any closer. And Michael backs off. And my dad handed me a hammer and said, you sleep with this tonight. It's not the first time Michael Schiavo has almost come to blows with a member of the Schindler family. Bobby remembers one time back in 1983 when Michael and Terry were dating. Bobby was 18 then.

Bobby Schindler (30:41)

We were in our living room, and I must have said something and hit a button. And he exploded in anger and grabbed me with his hand around the throat and threw me down on the sofa in our living room. He had his right hand up in the air, cocked and ready to punch me.

Lynn Vincent (30:57)

According to Bobby, his girlfriend and Terry were begging Michael not to do it.

Bobby Schindler (31:02)

Yelling at him to stop, don't hit him. He let me go, didn't hit me. And I was shaking. And I was shaking in fear, really. I had never seen that side of him. It scared me.

Lynn Vincent (31:14)

Back on Hermecita street, caring for Terry becomes impossible. Michael moves her to a nursing home called College Harbor. But Terry's care is expensive. Michael does some fundraising, selling hot dogs on a beach. And Terry's co workers at Prudential, the Schindlers, too, are running out of money. They can't keep this up forever. But there's hope on the horizon. That malpractice suit. Together, Michael and Mary go to see a friend of Dan Greco's, an incredible malpractice lawyer. The best in the county or in the Bay Area. I would say he means Glenn Woodworth, a former attorney for Allstate Insurance. Woodworth now specializes in medical malpractice. At first, Woodworth doesn't think Michael has much of a case, Greco says. But he calls in a heavy hitter. Gary Fox, a superstar malpractice lawyer from Miami. And Fox, well, he sees potential. In November 1990, Woodworth filed suit against not one, but two doctors. Stephen Igel, Terry's OBGYN, and Dr. Joel Prower, her family physician. The value of the suit, $20 million. It was an enormous sum in today's dollars. 40 million. And you know what they say about money. It changes everything. Next time on Lawless.

Mary Schindler (32:57)

He took his books and threw them against the wall and pushed the chair away. And I got up. Michael went outside and he said, you're going to regret this.

Lynn Vincent (33:10)

Lawless is a production of World Radio. Our executive producer is Paul Butler. Our production assistant is Lillian Hammond. Music by Will Sheehan. Lawless is reported and written by Anna Johansen Brown, Bonnie Pritchett and me, Lynn Vinson. For a list of additional audio sources in this episode, visit lawlesspodcast.com thank you for join.