You don't neeed your cerebral cortex to run your organs, but you need your cerebral cortex to be yourself -- to be a person. I don't know how God deals with our soul, our alma, but for all practical purposes, our personhood, the part of us that lives in the material world, springs from our cerebral cortex. When that is gone, we don't function as people anymore. We can function as bundles of reflexes and respond as plants or primitive animals respond. We are not there anymore. I often fear that when people are caught in such a state, their souls are stuck in a netherworld. In Terri Schiavo's case, it is also important to remember that this is not a life that can continue on its own. When a person can never again on her own ingest and digest food, that person is dependent on extraordinary measures. The chronic use of such measures is sustaining a life that is pretty much over.
I have experience with vegetative states, two kinds. I worked over a period of years with very severely retarded people -- people who had little or no cerebral functioning. I saw them respond to heat, light, and more notably, to pain. At that time, I was responsible for seeing that programs for such people were responsibly administered. It was very depressing. Various federal guidelines insisted that these people be "habilitated." I never saw a more frustrated bunch of techs...spending weeks trying to achieve a teaching objective of tracking something for a few inches with their eyes, for instance, generally with no success. These all were people we would not think of putting to death because they were not on life support of any sort. They could swallow, though they couldn't do much of anything else: their limbs had to be moved for them, they had to have specially molded seats to keep them from discomfort while they were kept upright to look more "normal" during the day. We were most aware of them feeling, yes, pain, though they would also smile from time to time or open their eyes or appear to see you. It often took years and sometimes it never happened that families could come to accept the situation of their children, children who grew from infancy in close to but not quite a vegetative state. The people working with them came to know that there was no person inside. They were gentle with these creatures, but out of hearing of the families would call them slabs and plants. They weren't speaking cruelly, only using a bit of black humor to keep their own wits about them.
Another experience was with my mother. She had a massive stroke and was left in a persistent vegetative state for almost four years. My father, a physician, had terribly conflicted feelings about the situation. My mother had recently complained about severe and unusual headaches, but my father brushed them off. Finally she was admitted to the hospital. Nothing was found wrong, but before she was discharged, she had this stroke and was alive but was no more. My father insisted on a ventilator.
Over almost fifty years of marriage, my parents had woven a particularly complicated marriage with threads of hate as strong as those of love which were also there. They were both prickly, arrogant people who were especially unlikely to accept criticism. Over the years, my father had fallen into being the first line of comments about my mother's medical complaints. He was often not very sympathetic, though by this time they were both in their seventies and her complaints, especially since she continued to smoke heavily, were increasingly real. My father himself had had a stroke at sixty, though he had recovered. But he was the one with the history of high blood pressure, a history of high cholesterol. She was supposed to live longer than he.
So when she had her stroke, his world came crashing down around him. He blamed himself completely for not having listened to her complaints, for not having pushed testing further. He took it upon himself to care for her as he never had cared for her in life. He wove a warm-colored tapestry of a happy marriage and devoted husband. He spent his days with her, reading to her, brushing her hair, putting perfume on her. Nothing went untreated. He insisted she was there and no one else could understand.
But I saw her and she wasn't there. She lay on her back, her face looking much younger, smoothed of its wrinkles. Sometimes she smiled, but not at my father though he thought it was at him. You could get her to grip your finger the way an infant does. She would make noises, gurgles and giggles it would seem. My father would say, see, see, she's responding! But to what? With a huge stretch of the imagination I could only believe it was to some whisp of an internal image.
Finally, my father could not visit her every day. He had his own growing problems and could no longer keep a hawklike eye on her. One day at work, her doctor called me. She said, "I am sorry to have to tell you your mother has died." The first words out of my mouth, even before the thought of them, were "Thank God." The doctor's first words were, "I wish I'd known you felt this way."
The cost of my father's efforts was not simply to the insurance companies but to the network of our family and friends. People, including me, generally had mixed feelings about my mother: she was not exactly warm and snuggly. But she was smart and witty and loved art and politics and took part in the community: she was full of life, as they say. She was definitely very autonomous and couldn't have stood people poking around her body and giving her no control. If she was conscious. IF she was not there, her conscious self would have railed against the expense and would have chosen to use the money for something like the local public library -- what that money could have done! Or for art scholarships or for any number of celebrations of life.
For the Republicans and George W. to be advocating for Terri's parents is the ultimate in cynicism. They are playing into the Schiavos' pain, not helping them let go of it. Medical authorities cannot say with 100% certainty that Terri the person is no longer there, but they can probably say with as much certainty as experts could say that it was O.J. Simpson's DNA at his wife's murder site. If Terri is not there anymore, to sustain her at great expense is to keep her parents trapped in a destructive fantasy instead of letting them get on with their lives. If she is there, which is extraordinarily unlikely, can she be content?
