For those who’d know: Can an extended heart stoppage (a minute or two or three) cause brain damage not too different from a stroke? I think “yes” without researching.
EDIT: I’m also wondering if stroke-like outcomes can result from repeated cardiac “events” in short succession. A cardiac arrest, then being brought back by the EMTs in the ambulance, then another episode that evening at the hospital, etc. Chain together half a dozen of these over 24-36 hours … that can’t be great. @Qadgop_the_Mercotan ?
Right. It’s not the job of paramedics to diagnose, it’s their job to rapidly mitigate whatever seems most likely, and bring the affected person to an emergency room.
My father’s death certificate said “heart attack” based on what it looked like on the scene. The autopsy found a pulmonary embolism (and no heart involvement, except for the, "heart ran out of oxygen and died, thing.) If he’d survived, the paramedic chatter would have said cardiac arrest and attempted CPR, but the doctors would later have said it wasn’t a heart attack. (In theory, the AED wouldn’t have fired, though.)
Aha! @puzzlegal – he left out “pulmonary embolism”.
I’m in a hurry, so I asked Doctor Gemini (yes, the dread AI) to help me find citations that a pulmonary embolism can lead to stroke-like outcomes. First quick cite that, yes, yes it can (PDF of white paper):
Remember Mitch has already had a couple episodes where mid-speech he froze and just stared ahead blankly until his handlers led him away. He obviously had some neurological disorders before this latest thing.
Hypothetically – could a public figure hide advanced Parkinson’s or Lewy Body Dementia for an indefinite period? For one, I know actor Robin Williams’ struggle with Lewy Body Dementia were either completely or nearly-completely unknown to the public before his death.
I have just been living through this, with my father. Medicare will only pay for up to 100 days in a residential rehab facility. And, even then, after day 20, you pay a daily co-insurance amount, and Medicare will only continue to pay, at all, if the patient is deemed to be continuing to make progress in their rehabilitation. Medicare does not pay, at all, for residential care (e.g., assisted living, skilled nursing) beyond that in a rehab facility.
Also, I would suspect that McConnell, having both (a) money and (b) financial advisors, has a “long-term care” policy, which pays for ongoing care (either at a residential facility, or at home).
Regardless, I think it’s very clear that, of all the reasons why his Republican colleagues might be covering for him at this point, “let’s make sure poor Mitch has insurance paying for his care” is not one of them.
There’s actually a very narrow financial range where this makes sense, and Mitch’s finances lie above that range. He ought to be self-insured.
Thanks for correcting me. And i agree with your larger point that “paying for his care” is not why Republicans are covering for him. It’s possibly a motive for his family to lie, but i doubt it.
Williams was diagnosed with Parkinson’s about a year before his death:
Williams had been sober but was diagnosed with early-stage Parkinson’s disease, which he had not made public. An autopsy revealed that Williams had diffuse Lewy bodies, which had been misdiagnosed as Parkinson’s [and may have] contributed to his depression.
Further reading: A comparison of “regular” Parkinson’s motor- and non-motor symptoms against the same for Parkinson’s with the presence of Lewy bodies in the neurons.
EDIT: Tying this back into McConnell - I am trying to establish that a public figure can keep this degree of disability hidden from the public. Williams continued working until months before his suicide, filming 22 episodes of the 2013 CBS series The Crazy Ones and four movies during 2013-14 that were released posthumously.
I think the most likely explanation, and the one that fits all of the facts, is that McConnell had to do his annual service in Hades before Summer recess due to a scheduling conflict.
To strongly suspect that he can’t talk now, might or might not be able to in the future but it’s touch-&-go? How fine does the Ginsu have to slice this to yield a reasonable stance?
As an aside: Why grant the presumption that McConnell’s generally alright? His team and certainly his party haven’t earned that in recent years.
I have done nothing of the sort. In fact I have said several times that he is not well enough to go back the the Senate, just like the Office of the Attending Physician.
Guessing that Mitch is dead or brain dead or in a Coma after the evidence shows otherwise is a Conspiracy theory. Especially when there is absolutely no evidence that any of those tree things are true.
A conspiracy theory is an explanation for an event or situation that asserts the existence of a conspiracy (generally by powerful sinister groups, often political in motivation),[3][4][5] when other explanations are more probable.[3][6][7]
Note that there are many things outside Dead, brain dead or Coma. Maybe he will never be able to return to the Senate. Maybe a small stroke did occur.
I accept the following statement-
The statement from the Office of the Attending Physician said physicians are meeting with McConnell daily to discuss “all aspects of his rehabilitation care.”
“Since his discharge from hospital care, he has maintained a strenuous course of physical therapy and rehabilitation, including multiple sessions a day designed to rebuild strength and reduce the risk of future falls,” the release said. "His bout with childhood polio continues to be a significant factor in his mobility. He is not yet medically cleared to leave the rehab facility and return to the office.”
No, brain death is defined as the total cessation of all brain activity, including the brain stem. If you’re breathing on your own without a ventilator, you’re not brain dead:
From the NIH website: What Is the Ideal Brain Criterion of Death? Clinical and Practical Considerations: The UDDA Revision Series - PMC
" The Uniform Determination of Death Act (UDDA) defines death by neurologic criteria (i.e., brain death) as “irreversible cessation of all functions of the entire brain, including the brainstem … in accordance with accepted medical standards.”1 The American Academy of Neurology (AAN) and other professional organizations have outlined these best accepted standards,2,3 which at the least involves identification of “an established neurologic diagnosis that can lead to the complete and irreversible loss of all brain function”; confirmation that confounding conditions and mimickers are absent; and a bedside clinical examination that demonstrates coma, brainstem areflexia, and inability to breathe spontaneously".
So even a still picture of a person sitting up in a chair, with eyes open and no ventilator present, is a pretty good indication they’re not brain dead. They may have very little cognitive ability due to a stroke or other neurologic event, but that’s not the same thing at all as brain death.
Those of us you’ve been engaging with in this thread today (and I believe yesterday as well) have not advanced any of “Dead, brain dead or Coma” – there’s no cause to throw us all in a common bucket.
What’s been released publicly to date – including McConnell’s team’s second-hand account of the Attending Physician’s statement – leaves a lot of reasonable room to countenance serious, potentially permanent neurological infirmity.
I accept the following statement
The Attending Physician’s statement – again reported second-hand – fundamentally says little. At least not with any precision. That statement can credibly and honestly cover a wide range of conditions from “He’ll drive himself home before the weekend” to “He’ll never walk, talk, or use his left arm again”.