Ep. 8: Goodbye to Love

0:06 Welcome to M4 Medicine, mystery, mayhem, and sometimes murder. I'm Andrea Marciano and RN with 35 years of experience across various fields. From direct patient care in hospitals to home health, geriatrics, and injury medicine, I face life, death, and everything in between. And I'm Crystal Miller and RN with 13 1/2 years of experience. My work spans home health, Hospice, emergency care, geriatrics, and occupational health. From the chaos of trauma based quiet moments with patients, I've seen stories that defy explanations. We've been friends for over 25 years and as nurses we've shared countless stories that have left us and our families speechless. Now we're bringing those stories and many more to you in medicine, mystery, mayhem, and sometimes murder.

0:51 Each week, we'll uncover cases that challenge the boundaries of medicine, sharing the human stories behind the science. From puzzling medical mysteries to shocking real life crimes, we'll bring you stories that'll leave you questioning everything you thought you knew. While we're both experienced nurses, we want to make make it clear we're not here to give medical advice. This podcast is about storytelling, education and exploration, not diagnosing or treating medical conditions. This is medicine, mystery, mayhem and sometimes murder. Let's dive in. Hey Crystal, how are you doing? I'm doing pretty great. How are you? I am well, thank you. Went from like chilly with thunderstorms to heat wave warnings. Like it feels like overnight. I think it was over a few days, but still it was pretty quick.

1:32 So but I I mean, I enjoy it. I don't like this super super duper thunderstorms that scare me. They're going to flood my house. But. Yeah, whenever anyone says anything about weather with something, I always think meatball, chance of meatballs. Yeah. Cloudy with a chance of meatball, rainy with a chance of meatballs, right? Yeah. I always think that is ridiculous too, but that's what always crosses my mind. So anything interesting going on with you or your family? Yeah, my two daughters, my silly daughters are going this evening to go get matching tattoos, and I don't think there's a story behind it, but Teddy's get giggling, so I'm guessing there's not a story behind it. But the tattoos they're getting are matching geese, so each of them is getting a goose.

2:13 Keddie's has a knife and Odyssey's has a cowboy hat. That's all I know. It'll be interesting to see there'll be a story. I have a funny Yeah, there will. I have a peripheral, A peripheral funny story. We were talking to Keddie about the tattoos. And at the time, me leaving, me and Holly, Sue and Cedar. And at the time they hadn't really decided what they we were gonna get. I think they'd already decided Geese, but that was it. And so we were just talking about possibilities. And then Holly said, Kenny, I think you should get a tattoo that says F you Odyssey. Oh no. And then be surprised. Surprise her later. That's right. Oh, all I want is a tattoo now that says F you Odyssey.

2:55 That's. Funny. And as the tech is cleaning it off, you're like, oh look how pretty it is. What? That's actually funny. If it weren't permanent, that would be. They could do it with a magic marker or something first. But anyway, that's awesome fun. I look forward to hear about their exciting stories when they return. Because getting tattoos is a thing, and it's interesting, and sometimes more unpleasant or less unpleasant than one might think. Yeah, I'm thinking I want to get a sleeve. I'm trying to decide if I want to get it on my just start on my forearm and go crazy from the get go or build down from my tattoo that you know my Blue Jays. Yeah, I think I've always liked the ones in that start from the shoulder and go down because it looks less odd to me.

3:35 Yeah. And also, if you start from your shoulder and go down and you decide you just don't want a whole sleeve, then you still have something good. Yeah. True. Yeah. Because to me, since it is permanent, I have the one on my back that's in memory of our granddaughter who passed Giuliana. Her mother was looking at it today and noticed that the yellow was really light and asked if I was going to get it redone. And that's what the the tattoo artist did say is that the yellow would fade fast. Yeah, I, I don't know, I haven't really looked at it closely myself for a while because it's on my back, so I don't really see it. I probably won't, mostly because it's not necessarily a fashion statement. It just means what it means to me. Sure, sure. So but I don't know if it looks too weird, then maybe I will, but I, I never see it so.

4:17 And mostly anyone who does see it sees the part that still has good color because. It's. Above. Above it, sure. I mean, I don't go topless very often, so T-shirts or bathing suits even I don't think show the part that's faded and it's only faded just because it was yellow to start. Actually, I saw a really interesting picture on an Instagram thing. It's called creepy, creepy medical pictures. And one was someone who had a probably a third degree sunburn and the skin was peeling off and the underlying color on their tattoo was so bright. And I know, and I didn't look into it. I don't know if it's real nowadays. I mean, for heaven's sakes, everything's AI, but it looked real. And I thought, I don't understand how that worked. I didn't look into it at all, but I thought, well, maybe I just need to, you know, peel my skin off, which I don't think is really a great strategy.

5:08 All right, well, cool, tattoo away. I never thought it'd be the tattoo grandma, but apparently that's me these days. I did not either. I thought, I thought, well, I thought I'd never get tattoos. One time I was offered to be paid $250 plus my tattoo paid for and I was like, yeah, no thanks. And oh, now you wish. Yeah, yeah, exactly. Now I wish. Like, OK, I'll do it. You can pay me. And even just having a tattoo for free would be fun. Yeah. No kidding. For sure. Yeah. My my big one on my chest was free because it was for covering scars from my cancer experience. And so there were practitioners of a variety of type. I was one of them as a massage therapist that offer free tattoo or excuse me no ioffer free massage people.

5:52 Like I'll give you tattoo, it might suck, it might hurt more than it should. Right, I can draw a stick figure. What more do you want? I actually as a massage practitioner would give that. But these tattoo artists donate their time for cancer survivors, for people with scars even this group covered people who did self harm scars and wanted them covered for free. So people would donate to the cause and the money would be used. The artists would volunteer their time. The money would just go to supplies for massage. If I had done a bunch, I probably could have gotten some money for more massage, lotion or whatever. But I did only did a few because that's just all that they needed for when I was involved. So anyway, good, good times. So today I have a story that has always been something I've considered.

6:39 It's it's a fascinating story to me and has a lot to do with end of life decisions. The case today is about Terry Chavo and my sources are a Time magazine article, Terry Chavo impact on right to die movement, Terry Chavo case. Just generally there were a lot of sources. One was Wikipedia, and I really take Wikipedia a little bit of a grain of salt, but they had a really good article on it and it was very clear. But this is a case that has been around for a long time and has a lot of information about it. Another source was the Death in the family reflections on the Terry Chavo case, and that was also New York Times and it was a book created by New York Times. And then the Mayo Clinic had some different writings on it was called Mayo Clinic Proceedings and it had a variety of articles about it stating the title was Terry Chavo Saga, The Making of a Tragedy, Tragedy and Lessons Learned. To talk a little bit about Terry, I'll just call her by her first name from now on.

7:36 But to talk about Terry, she was born in 1963 in Pennsylvania. And then her date of death, I almost said final date of death, and that's kind of true, but her date of death was March 31st, 2005. She was 41 years old and she was in Florida. She was married to Michael Chavo and they got married in 1984. That is relevant. The fact that she was married to a lot of this stuff went along this case, the Terry Chavo case was in and out of court for from 1998 to 2005 because we'll go into more detail this. But because of what her husband said and what her parents said, which put things in a bad a bad place because they said different things. Her husband had we'll find said what what Terry had told people about her end of life decisions.

8:25 But that was that was fought by her parents. So anyway, the way this story worked is that on February 25th in 1990, Teri Shava was 26, She suffered A cardiac arrest which was caused by hypokalemia induced by an eating disorder. She had had bulimia for a long time because of the hypokalemia and which is low potassium. So she had an anoxic event which meant no blood supply or oxygen supply to the brain. And then she, several months after the incident, had a CT scan which revealed severe atrophy of both hemispheres of the brain. And what was really interesting is I saw later a picture of her brain and part of it looked like it was liquid. It wasn't even brain matter anymore. A few months afterwards, she stabilized into a persistent vegetative state.

9:18 And that if a person hasn't seen it before, can look a little bit like consciousness, but it's the state of eyes open unconsciousness. People in a persistent vegetative state still have sleep and wake cycles. They look to be awake and conscious, but they really seem to be through testing, unaware of their environment and the things that happen around them. Which I think makes this case even a little bit more confusing because it wasn't just totally clear. She wasn't just out, you know, like no response, nothing. She, she was, her eyes were open. There were times that we'll talk about that. She looked like she could sort of eat, but she wasn't eating in a conscious way.

10:01 And that's still one of the things that made it difficult. They did some standard care for her, but even though she had a very poor prognosis for getting any better, they did experimentation therapies for three years and there were no effects. She never got any benefit from any of the therapies that they did. And like I say, all of them were therapeutic. I mean, excuse me, experimental. And her husband said, you know, here she's been three years. She's being kept alive and she doesn't want that. It's showing that she's not getting better. And she had said statements several times saying, quote, I don't want to be kept alive on a machine. And they had talked about it before. And he said that that is what she said. And he really didn't want her to have any more life sustaining measures because she just didn't. She had never wanted that.

10:51 But her parents, Bob and Mary Schindler, never believed that she was really in a persistent vegetative state. And I think part of the reason is because she had her eyes open. She had some signs that kind of looked like she was doing doing stuff, but she wasn't. There have been a couple of times I've been on in on final neurological exams and they can look like they're doing something, but there's still no great activity. Bob and Mary just didn't want anything to stop. They didn't want her to die. And they were in litigation for seven years that generated 30 legal opinions. Ultimately, they all supported Mike Chavo for his decision on her behalf. So that's kind of the big picture of it all. One of the things that was difficult is that when she was found initially, she probably had been anoxic for some large period of time.

11:48 It could have been up to hours off and on to some level before she was found. In this case, unfortunately, probably the fact that she was resuscitated was not a good thing. And that's another whole question is when? When is it not a good thing? It's hard to tell. We just, there's so many variables and it comes to a point we'll talk about a little bit later on what we feel about this and how how these decisions should be made. In 1999, the first time Michael petitioned the court of Florida removed her feeding tube along Florida law had a ruling, A ruling that they could remove a fooding tube if a person was in persistent vegetative state. And now she had been in this condition for quite a while.

12:30 Her parents opposed, like I said, the court determined at that first time that Terry would not have wished to continue life prolonging measures. So this ruling was made in February and in April her feeding tube was removed for the first time because her parents were pushing back. It was reinserted several days later. So she had it removed and several days later, which to me is the beginning of her suffering, if it had, she hadn't already had suffering. And then you may say, well, if she was vegetative, maybe she didn't know, but I don't. It's just the back and forth that we'll hear about is just so heartbreaking to me. And then just again, went back and forth and back and forth on federal cases, federal appeals.

13:11 Ultimately, I believe there was something it had said there were 30 rulings that happened that went through all of this, was involved in 14 appeals because of all of the different things that Michael said, her parents said. And in the meantime, the medical staff is going, well, what do we do? They didn't know anymore. They didn't know if they were supposed to to listen to him. They didn't know if they were supposed to listen to her parents thing. And in the meantime, Terry is not getting any better. What's interesting about this case is that at a time President Bush, George Bush was involved because Florida State governor was Jeb Bush and then President George Bush got involved. Jeb and George both were pushing for her not to be have her life ended, right.

13:58 And there's some argument that it was related to voting times. I didn't look into that a lot to find out what effect that had. But there were some things that looked like it could have probably been related to elections. There were a lot of books that were written. There were a lot of movements that were started for pro-life and right to die and disability, right? And we'll find out later, though, that this case, Terry Chavo, was not the first case that brought these things to light, but it's probably one of the best known. I think the cardiac arrest, as we mentioned, was related to bulimia would be at the overall diagnosis probably. But one of the notes said she apparently has been trying to keep her weight down with dieting by herself, drinking liquids most of the time during the day and drinking about 10 to 15 glasses of iced tea. That was kind of her thing.

14:46 And then she had been admitted for bulimia and other eating disorder behavior a few times through her life already and again had her potassium level at the time of admission to the hospital was a 2 .0 and the normal range is 3.5 to 5. So she was just off the chart. Her other levels were more normal. They said that in the research I read is that other electrolyte imbalance would be caused by drinking excessive fluids, which some people will do to sort of filter everything out really fast. She did not appear to have done that. She did appear to have had sudden abnormal arrhythmia because of the hypokalemia and the potassium has such.

15:30 A huge, by the way, I the reason I paused from it is because when I was in nursing school, they taught us hyperkalemia. And I think that was, I didn't, they didn't tell us this, but I think that was a audio clue to remember that it was K so vitamin K, not vitamin K, but you know, element of K, which is potassium. So anyway that I just, I was thinking about that. So yeah. So I learned hyperkalemia anyway. Because we emphasized the K, Yeah. And that's how I remember it, too. Is the K always meant well, Potassium. That's right. And some of those clues are really helpful, but we both overthought ourselves, I think. Yeah, exactly. A doctor Sosa was a board certified neurologist in St. Petersburg, FL and he had previously treated Shavo. And he said that upon exam that he and Victor Gambo, which which was an internist for the family, made the diagnosis of the persistent vegetative state within approximately a year after a sudden cardiac arrest.

16:29 So what I find interesting is that Doctor Sousa had previously treated Terry, the family doctor had been treating Terry and both of them said that she was in the persistent vegetative state. But the family, her parents still didn't believe it. And that was really obviously a problem. There were some dynamics, of course, as there always are with the family. Terry and her parents seem to have a really good relationship. And when she and Michael got married, they lived rent free in their condominium for several months. And so that just talks about the fact that they were close and they have been involved. But once Michael started saying this is not what Terry would have wanted, their relationship, which is probably not surprising, did start to fail. And those rehabilitative efforts from 1990 to 93 were there in the middle of all of their stress and stuff. One of the things that they they did for Terry is in 1990, she went to the University of California in San Francisco and they did some experimental nerve stimulation. And actually there's a lot of nerve stimulation now going on for quads and paraplegics having a lot of good results. But in this case she was, she really gained nothing and she was, they worked with her for speech and occupational therapy, which I think the speech therapy is interesting because she clearly wasn't speaking.

17:48 But maybe then in this case, it was more for swallowing because speech therapies does a lot with swallowing therapy. Yeah. And, and that might have been when they were able to sort of get her to eat a little bit of something at that point when things weren't moving along. In 199093, Mike said, please do a do not resuscitate order because she had gotten a really severe urinary tract infection and she was having a lot of difficulties and problems. And he said, we, I really want the do not resuscitate order for her at this point. They put it there, but that's when some of the things started happening where the parents then came in and said, no, we don't want that back and forth. And again, the staff is going, we don't know who we're supposed to listen to. And depending on the state, depends on who it is too. Some states it's the parents, some states it's the spouse. I think more often it's the spouse than the parents, but not always.

18:40 And then in 1992, Michael filed A malpractice suit against the gynecologist because they have been trying to get pregnant. Gynecologist did not talk about the bulimia as a cause for her infertility. They basically just didn't even talk about it. And Terry gone to the doctor because she had stopped menstruating. The doctor never even talked about her medical history, which so apparently he knew, but they didn't talk about it. And during the case, one of Terry's friends testified that the doctor did know about the the bulimia and her resulting difficulties. And Terry had stopped menstruating, like I said, because of bulimia and that that messes with every single system in the body. Yeah. Mike had felt that if it had been addressed, then she wouldn't have gotten to this place where she was now a vegetative state.

19:29 Michael did win the case and got 6 point $1,000,000 by the jury was later reduced to 2 million because at appeal the court said Terry was partially at fault though, because she was the one creating the condition, right? And after everything, the attorneys fees, blah, blah, blah, blah blah. Michael received 300,000 and then 750,000 was also awarded to put into the trust fund Terry's care. And one of the things that started being a difficulty for Michael and Terry's parents is that apparently they. Demanded that he share the malpractice money with him with them. Oh interesting. Yeah, that made things stressful and. And it just kept getting worse and worse.

20:10 We're backtracking a little bit now, but the first petition that Mike had made was in June of 1990 because he wanted to be the guardian, legal guardian for Terry It was not disputed by the parents at the time so they said yes, you can go ahead and be the guardian. Of course, we find out later that that changes in 1998 they but listeners Crystal has a cat all in the all in the. Up in my business. Going everywhere. Oh my goodness. OK. Sorry, but after things started getting rough between Michael and the parents, there was a guardian ad litem that was assigned. And that can be good because it can take someone who is neutral and put them in the position of assisting with decisions that make neutral sense, not emotional sense or nonsense.

21:00 As you, as you the guardian ad litem really was looking at stuff a lot and realized that with the diagnosis and everything of persistent vegetative state, the shava was legally defined by the florist statutes to be in that state. That there was an ability and a law that said that the feeding tube and other methods could be stopped. However, still, as I say, the parents have gone back and forth. But the biggest problem in this whole scenario that could have been really changed is that Terry had no living will. And that's why I, I tell everyone I know to get a living will. And if all you say is about whether you want to be resuscitated and you want to be in a, if you're in a vegetative state, you want anything extenuating done to you, those are huge pieces and it takes a lot of stress off the piece of people around. The Guardian of Litem was saying that he felt that there was some issues with Michael's credibility, but they didn't really say what that was.

21:56 And I don't know if they felt like he had some sort of secondary gain potential where if she dies, then I get the rest of the 750,000 or something, I don't know. The parents had said they wanted Michael to divorce Terry. He said, no, I don't want to do that. And the parents also said the Guardian Lion thought that maybe it was because the parents would have inherited the remainder of Terry's estate upon her death. So at a point, it looked like there was some concern about whether people are making decisions based on getting money. No idea. That's speculation by a lot of people. And obviously I wasn't there and haven't read enough stuff about that. So we're going to move on to the things that are known.

22:37 There was a judge, George Greer was the one who heard most of the things about Terry, about the appeals and back and forth and back and forth. But the first court date was the week of January 24th in 2000. That was to determine what Terry had wanted, if anyone could tell what she had wanted regarding life prolonging procedure. Michael was there. He had an attorney called George Phalos. George Phalos had already won a landmark right to die case before the Florida Supreme Court in 1990s. That probably was a good thing in Michael's view. And this trial included testimony from 18 witnesses relating to her medical condition at end of life wishes.

23:19 And Michael, as we know, claimed that she didn't want to be kept alive when her chance of recovery was minuscule. And her parents claimed she was about Roman Catholic who would not wish to violate the church teachings on euthanasia or refusing nutrition and hydration. In this case, the judge had to listen to those two things, which were obviously very diverse, and the other testimonies. And he issued an order granting the petition for authorizing to discontinue life support. So even after hearing everything judge said, yeah, discontinue. It sounds like that's what she would want because she was in the persistent vegetative state and she had made reliable, his judgment said she had made reliable oral declarations that she would not have wanted the feeding tube.

24:03 They could go ahead and be suspended. Dinner the Catholic Church Church also back her and say that removing the feeding tube was within the the beliefs or whatever of the Catholic Church. I did not see anything about that, but it's possible and that makes sense considering everything going on. So that was the first ruling. And then in March of the same year, the Schindler's, the parents filed a motion to permit assisted feeding of Terry. Remember, she was really not able to eat on her own. But assisted feeding is not considered a life prolonging procedure under flora. In a law. Feeding tube is, but assisted feeding is not. They wanted that to happen and they filed a motion for it. But clinical records has shown that Terry was not responsive to swallowing tests and requiring feeding tube.

24:48 Terry could not safely eat. Judge gurrilled that she wasn't capable of orally ingesting sufficient nutrition and hydration to sustain life. So he said no, you can't have the feeding tube in and she can't take food from an external source. So he upheld the request to take the feeding tube out. OK, so this is just remember this is still in 2000 and. Phenomenal because 10 years after her heart attack, like holy shit this is taking a long time but I know it takes longer but jeez Louise. I know, I know. And what's interesting to note at this point is in the medical examiner when he did the post mortem report was more definitive and reaffirmed that she could not have swallowed and post mortem.

25:33 So I think about this, Terry, they were trying to feed her but she couldn't swallow, which seems to me sort of torturous in itself. And how that went on. Oh my goodness. In the meantime, obviously her feeding tube has to have been in because she couldn't live all this time with no feeding tube and no anything. But again, they challenged the guardianship of Michael and suggesting that he was wasting the assets within the guardianship account by transferring Terry to a Hospice care after she was clear she was not terminal within Medicare guidelines. So she's she can't survive without feeding, but she's not terminal because she's getting feedings. She was still legally married to Michael. There was a compounding event, which is not unreasonable, I don't think in any way, but he was in a relationship with a woman and they had a child together. Michael said he chose not to divorce his wife and relinquish guardianship because he wanted to ensure her final wishes. So he did not divorce her.

26:31 Her parents kept saying just divorce her and basically get out of our lives. He said no and the court denied the motion to remove him as guardian because there wasn't sufficient evidence that he was doing anything wrong. There wasn't evidence that he wasn't taking care of her and all of that. It said the date the court set, the date is April 24th, 2001, and the date which the tube was to be removed. So they have a date. And then in April of 2001, the parents filed a motion for relief from judgement. Now, citing new evidence of Shabbos wishes, Judge Greer had the motion brought to him. And he said no, it's not. Not only is it untimely because we're supposed to discontinue the feeding tube this month, but there's no evidence of that. And so he said, no, you can't.

27:15 However, they were given an opportunity to file a new motion, but not that motion. So they kept trying to say the same motion. So he gave them an option to fire and file another motion. And then like say on April 24th in 2001, her speeding tube was removed for the first time. Emphasis of the first time. OK, let. Me just say real quick, this is this is being recorded. I do have a living will, but I'll just for all of posterity, if I'm in a persistent persistent, please do not do anything to extend my life. Pretty, pretty, pretty, pretty please pretty please, pretty please do not. I Ditto that. Today is July 21st, 2025.

27:57 That's right. On the date of recording, Date of release will be later. Still valid. I'm sure that's legal for us. And so, OK, so the date of April 24th was the date set for in 2001. And first time it was removed, as I say, and the parents filed a civil suit against Michael alleging perjury and it was sent to a different court, not judge, Judge Greer. So Judge Quisada issued an injunction against the removal of the feeding tube until this was settled. I think that's kind of hanky panky because they went to another judge because they knew what Greer thought. They went to another judge and the judge wouldn't make this decision immediately because he had to look at all the stuff.

28:40 So it got put back in on April 26th, as I mentioned. So that's almost 5 day. No, I'm sorry, it's only it's only two days, but still two days. She had no feeding tube and then she got put back on a feeding tube. That doesn't seem very nice to me. Michael appealed and they reversed Judge Casada's order and Michael filed a motion to make him enforce the mandate of the guardianship court and that was that the feeding tube be removed. The Second District Court denied the motion that the feeding tube be removed, so they didn't stay the course on keeping the the feeding tube out. It gets very confusing because one court says this, one court says that, and that's not that uncommon. But still when you've got somebody's life on the line here, that seems just cruel and unusual really to extend things. But that's if we take the perspective that that's what she wanted is to be stopped.

29:37 And so from our perspective, that's cruel and unusual, maybe from the perspective of someone like her parents, is it? That's what she deserves. She deserves to be kept alive and all of that. These three decisions all back they were published in a single order at the Court of Appeal came to be known by the court as Shavo 2 in this later's rulings, probably because it was getting very confusing. Anyways, in August, on August 10th of 2, 2001, Second District Court of Appeal had Judge Greer hear a motion from the Schindler's claiming that new medical treatment could restore sufficient cognitive ability so that Terry would herself be able to decide to continue life prolonging measures. I'm like, what the heck is that going to be?

30:18 Because three years she had rehab and it didn't do anything. But anyway, the court also heard motions from Michael. I'm excuse me, the Schindler's to remove Michael again as the Guardian, and they also wanted Judge Greer to recuse himself. Oh, that's convenient. Right. So now, because they don't agree with him, he's got to get out because he keeps saying the same thing, which to me, I'm very proud of Judge Greer because he did keep saying the same thing. And I don't think it was because he was being difficult. I think it's because that's what the evidence showed and that's what a judge is supposed to do. And Judge Greer said no, no, you can't have those motions. He denied the motions. Then the Schindler's appealed to the Court of Appeals.

30:58 And then October 7th, 17th and 2001, the Court of Appeals affirm the denials of the motions to remove and refuse. So basically the Court of Appeals said, no, Judge Greer is right, you can't have those. The denials don't happen. The the motion to remove the judge isn't going to happen. Everything's everything's good. The Court of Appeals did make a statement here, and this is the gist of it, is that the Court of Appeals acknowledge that their opinion misled the trial court and they remanded the question of Terry Shabbos wishes back to the trial court, which was Judge Greer and an evidentiary hearing to be held. And they said in this Court of Appeals letter that five board certified neurologists were to testify. The Schindler's were able to choose two of the doctors to present findings at an evidentiary hearing while Shavo could introduce 2 rebuttal experts. Those are the four.

31:48 So 2 for the Schindler's, 2 from Shavo. And finally, the court would appoint a new independent physician to evaluate Kelly's, Kelly's, Terry's condition. So was the neutral 1. You know, it's nice. It would be nice if they were all neutral, but in that case, they wanted to be sure. And the biggest question was, would this new therapy help Terry have any cognitive function? So they did the new CT scan, which is the one I mentioned, is that it showed severe cerebral atrophy. The picture literally, like I said, looked like she had some brain matter. They did her pre. No, I'm sorry. They did a normal brain under ACT scan and they did hers and there was some what I could tell there was some front, some brain matter in the frontal cortex area, but everything else was either gone or look liquefied. It looked like there was just just not, not right. Then an EEG showed no measurable brain activity. They mentioned the five doctors.

32:50 I'm not going to mention that, but the doctors all examined the record records, brain scans, videos and Terry herself. And then a few judges, including Judge Greer, testified that Terry Chavo was in a persistent vegetative state. Now, the judge obviously isn't going to have a medical opinion, but he had read the records as well and everything has really mentioned that. So that was three of the witnesses that were supposed to testify and said there's she was a persistent vegetative state or PVS. The other two doctors said she was in minimally conscious state for six hours of video of Terry, and they were taped and filed in the courthouse. The tape included Sherry with her mother and neurologist William Hammersprar and the judge. Greer looked at it and he said Terry clearly does not consistently respond to her mother. I mean, she doesn't.

33:44 There's no, there's no consistent video. And there were video clips that were given by the Schindler's that were supposed to support their case totalling less than 6 minutes. And they released those clips to a public website and hoping to get some sort of traction on people saying, no, she's alive. And and yes, I guess she was alive, but she was vegetative. So ultimately Judge Greer ruled that she was in Apbs permanent vegetative state and was beyond hope of significant improvement. So this trial thing that they wanted to do, this test run of stimulation was denied because it just doesn't doesn't make any sense.

34:28 It's not going to they wanted the Schindler's wanted it, the feeding tube removal postponed for this event to happen. They said it doesn't, it doesn't make sense. And what Judge Greer said is that it's just it's not going to make enough difference. And one of the doctors claimed positive results in similar cases using BIOS vasodilation therapy, but there was no support of that actually having really worked and being successful in any of the literature. Well, and when you consider that the brain runs on electrical activity and the fact that the EEG showed no activity opening up the veins, vasodilation is not going to bring back electrical activity.

35:08 Right. I mean, that doesn't even really make sense, right? What do you? What are you electrifying? Water, right? Like what? Fat. Maybe there's some fat in there still going on, but the neurons that were happening and there weren't doing enough anyway. This goes back and forth and back and forth. In 2003, the Schindler's began to create more publicity for this, for lobbying their case to keep their daughter alive. On September 7th of 2003, they petitioned the court again to forestall the removal of the feeding tube in order to provide for eight weeks therapy. And there were also 4 affidavits in there from the family and one from a doctor Alexander Gaiman to prolong her life and have these therapies and the hearings. At the hearing, the council, their attorneys read an additional affidavit for speech professionals and two nurses. They had all of that.

35:59 One, a nurse said she was able to to feed Terry orally, but that Michael characterized any such interaction as therapy and told her not to feed Terry. Now remember in the post mortem, the doctor said there's no way she could have swallowed. Something was in her mouth. I mean, I guess it's not. There is some involuntary swallow response if there's something in the mouth, but she wasn't doing it. She wasn't eating. No way, right? It's not like she had a hamburger and fries. But it went back and forth and you know, there was he said this, she said that that all of that sort of thing. Ultimately September 17th in 2003, Judge Greer denied the petition for the 8 weeks more of therapy.

36:41 He said in his letter, Judge Greer said, quote, the petition is attempt by Mr. and Missus Schindler to re litigate the entire case. It's not even a veiled or disguised attempt. The exhibits rely upon the by them clearly demonstrate this to be true. And he said, Judge Greer said that this is kind of interesting. Judge Greer, it says here, Judge Greer wrote that they were incredible, to say the least. The nurse who said that Terry wouldn't eat heard the details amount to a 15 month cover up from April 1995 through July 1996, which includes the staff of Palm Garden of Largo Convalescence Center and some other people.

37:25 Mr. and Mr. Schindler that they were just throwing allegations around trying to stop all of this. He, he listed a lot of people. That was his basically his final ruling in September of 2003 at that point and said, yeah, the feeding tube gets come out. So on October 15th of 2003, her feeding tube was removed. At that point, all of the repeal appeals that could happen were exhausted. And the state Representative Frank Atkinson in Florida legislature passed Terry's law in an emergency session, giving Governor Jeb Bush the authority to intervene on the case. Governor Yes. So her feeding tube was removed October 15th, 2003. Governor Bush immediately ordered the feeding tube to be reinserted and he sent the Florida Department of Law Enforcement to remove Michael Chavo from the hospital. And.

38:22 Politicians practicing medicine and sarcasm. Right. And then Terry was then taken to Morton Plant Rehabilitation Hospital in Clearwater, FL and her tube, her feeding tube was surgically reinserted and then she was returned to Hospice. And I don't understand that because she was had been taken off the Hospice, then she had a feeding tube and was returned to Hospice. Part of the legislation required another guardian on litem. And this was someone named Jay Wolfson to quote, deduce and represent the best wishes and best interests of Cherry Shavo and then report them to Governor Bush. Oh, brother. Yeah. So crony put in place to do Governor Bush's bidding.

39:04 Yeah. The good news is that this report did not change Michael's rollers or legal guardian and did not otherwise obstruct him. Legally it is. However, it's just so hard because Michael obviously opposed the governor's intervention in the case because, First off, what the heck? I mean, governor probably doesn't be belong in this case and it's been ruled on by a whole variety of courts. The ACLU assisted Michael in part of this trial because they felt like it was wrong too. And then Terry's parents had gotten had attempted to intervene and participate in the Terry's law case. But they actually the good news on this is they were denied by the judge to be able to participate in the case at all in Terry's law goes back and forth. Some more stuff happened.

39:52 Several judges said no, you can't intervene to the Schindler's. They tried to get appeals based on some representation by the American Center for Law and Justice. Finally, on May 5th, 1004, Teach, Baird said. This Terry's Law is unconstitutional, and he struck it down so right, Like, OK, great. Jocking. I know. And then Bush appealed this order to the second quarter of District appeal. But on May 12th, 2004, the court issued an order relinquishing case. This is the quote order relinquishing case for final judgement and order to show cause why this proceeding should not be certified to the Supreme Court is requiring immediate resolution.

40:34 They wanted it to go to the Supreme Court because the Supreme Court invoked the jurisdiction and I'm not totally sure what that means, but the the Supreme Court over the law is unconstitutional. And so Theresa law it held it got the feeding tube reinserted. But Florida Supreme Court that that's not right. And so the Florida Supreme Court spleen tube could happen or could happen and things can just tie up at that point. So on February 23rd, 2005, so here she is. How many eight years out of her accident or her cardiac arrest and now they want to do some stimulation to see if she can swallow and then get this.

41:19 Though the motion company by 33 affidavits from doctors and specialties, speech language pathologists, therapists, neuropsychologists, all urging that the new tests being undertaken. And they still held the Schindler still held that hope that Terry might be able to take nourishment orally even though she hasn't been able to do it in the past. And, and you know, the perspective of a parent, to not lose hope is one thing, but to be blind to reality is is another thing. And. Carried on for 15 years. I don't think it was 15 years, was it? Yeah. But anyway. 1990 to 2005.

41:59 No, that's not she didn't. She didn't go down in 90, I don't think. I thought it was 93 nonetheless, nonetheless, it was a long time. You can if you want to look back, that's fine. But Judge Greer said no. He denied the motion and ordered the removal of nutrition and hydration from from Terry and the time and date set was 1:00 PM on Friday, March 13th, 2005. The Schindler's tried a few other things but it just it was over. Finally her feeding tube was removed and she was, she was able to to go and it was 15 years. By the way, was it 2005? Yeah, well, I'm only telling the story and I forgot the dates. Thank you.

42:46 So once she finally got released, I'm going to say they actually had police there at the hospital because they were worried that there were going to be riots and things like that. And there were a few times throughout all of this that some police presence had to be there because there were so much agitation, especially back in 2003 when the parents had tried to do publicity stunts, really as it were, to get more going on it. People were getting pretty agitated. And, you know, when we hear things on the news or from sources that have agendas, which all of us do, I mean, none of us have no agenda.

43:26 But when things are swayed in a way that it looks like that she's just being abused and stuff like that, it, it can get pretty rough. Fortunately, I, I don't, I didn't read anything about there ever being any really big events, but they were a little bit worried about it now. After Terry had died, her body was taken to the medical examiner. The autopsy was conducted on April 1st in 2005 revealed extensive brain damage, which is not surprising at all. What's interesting is the manner of diverified is undetermined, probably because there wasn't an active event at that moment. But in addition to the chief medical examiner was John or Thor Martin, and he had a consultation with a neuropathologist, Doctor Nelson.

44:10 They did specialized cardiac and genetic examinations. They said that it didn't look like they're actually been a heart issue, but they did say the brain weighed. The brain weighed 21.7 oz, which is only half the weight expected for a female of her age, height and weight due to loss of a passive number neurons. And so yeah, it was half the size, which is what the CT scan did. The microscopic examination revealed extensive damage to nearly all her brain regions. So, I mean, it was obvious that she was she was brain dead, as it were. They said that there the brain was precisely the type of damage seen in patients who enter persistent vegetative state following a cardiac arrest. Now, let me backtrack.

44:56 The one there was a doctor that said there was no cardiac damage. And I'm sorry, I misstated that just now. These doctors saw that there was, but there was another Doctor Who had said that he didn't think there was, and I'm not. You had. A freaking heart attack. There's no cardiac damage. Yeah, I had. I had misstated that because I had read it before that he had said that, but that was sort of a secondary opinion later. And they keep talking about how much brain functioning was just gone because the so 70% of the cerebral cortex was gone. And they said there's just no way there he even with any of the treatments or anything like that, there was no way that she could have recovered. Dr. Thorke Martin said the brain damage was irreversible and no amount of therapy or treatment, whatever we generated the massive loss of neurons.

45:47 Wait, I'm. Really curious, is it Throckmorton or Thorkemorton? It's Thorg Martin. Thorg Martin. OK, got. It not related to the people we know. Not related to my relatives, I guess would be related. To me, right. So given all of that, for heaven's sakes, it brings up a lot of issues, least of which is at what point does a person have a right to die, you know? What? Well, in my opinion, whenever they want. But that's me. Right. And I did some research and there are a variety of states that currently have some people call it right to die. But there is a website that's called Death with Dignity. And as of July 14th and 2025, which is, you know, just about now, it shows to the states that have where death with dignity is legal.

46:39 Now I know you may not be surprised, but mostly Western states have death dignity things there. Or Washington State, where I live. Oregon, California, Montana, Nevada and Arizona are the ones that. Currently happening Montana is a very red state. Yeah, it is I that surprised me too. Those are the ones that currently have legislation. There are many other states, probably about half the other states that are considering death with dignity this year. And there's some states that have pending elections. Now, here's the trouble. About half the other states are considering death with dignity this year, but there's some legislation coming right now that is threatening some of these death with dignity legislations. The biggest one under threat right now is 1 in New Jersey. Now, I didn't go into a lot of detail about why that's where it is, and there's some things that I can think about, but I won't talk about that right now because this is not a political podcast that's right in my state. I'm very grateful that it is the case. And as an aside, I have a stepmother who had Lou Gehrig's disease, and she lived in California. And fortunately, she had a right to die. And she didn't want to be in a position where she was on a ventilator or anything like that, and she wanted to make the decision.

48:02 Most states have. This decision has to be made while this person is conscious. I mean they have to pre planned and living will and that sort of thing. You can't just suddenly say they also. Have to be residents. They have to be established residents in some way. That is changing. There is legislation right now in action in a few states that are saying that you don't have to. Oregon is the biggest one right now that I saw that you don't have to be a resident of Oregon to be able to use the right to left or right to die. But that's pending because there are some concerns with that too, because they may not have established care providers that can testify and blah, blah, blah, blah, blah. So it has to, in the way I understand it. And this is how it was working in California. I, I haven't looked at it in Washington as much, but in California, there had to have been at least one doctor saying, yes, this is terminal, yes, this is the course. Yes, they're capable of making this decision. This is what they've decided.

49:00 And in some cases, the states will will allow prescriptions to be written to be given at the time the family thinks is appropriate or the person sometime. But in many states, the person still has to be conscious enough to be able to take it themselves. They have to be able to make the decision. And some states they can be given medication at a lower level of consciousness. So it just depends. So whatever state you're in, you probably would be served to look to see what your rights are. But my stepmother was able to have this administered to her by the Hospice care provider so that she could pass when she was ready and didn't have to be ventilated. Thank. God, every one of us knew that's what she wanted.

49:42 She had been abundantly clear and she was abundantly clear because she didn't want anyone to think that she had been well killed and and she wanted everyone to know this was a conscious decision. She did not allow anyone to be there with her except for her husband, my biological father. But she, she actually didn't allow most of us to even see her at that point because she didn't want to be remembered that way. So, yeah, it was, it was a big thing. But we were all grateful that she could go. I know my biological father was prepared for that as well. He ended up dying for other reasons and it was much faster than that. But I know he was prepared. That's, that's the Terry Shavo. And and there were many, many legislations made based on this and some other cases.

50:26 And we may go into some of the other, but it was it's always been important to me because I think that we all should have a right to die that we agree, have our living wills honored and that sort of thing. It's pretty intense case. And there were others that were really big Landmark and Carrie Anne Quinton Quinlan you've probably heard and Nancy Crewson. I had not heard, but those were their Landmark right to die cases. And again, we may go ahead and talk about that later, but not in this case because we just it would take another hour and a half to. Right, very interesting. Thank you. I'd love to hear our listeners comments on this because it's it's a very thought provoking topic. Yeah, well, and honestly, me too. And honestly, it's a little scary to think that I might not, might not have a choice.

51:18 I'm again grateful I live in a state that does. All right. Well, thanks. We'll talk again soon. All right. Thank you. All right, if you've made it this far, clearly you like a little mayhem with your medicine. Or you just enjoy hearing us ramble about weird medical mysteries. Either way, we'd love you for it. So hit that follow or subscribe button wherever you're listening. And toss us a rating or review while you're at it. Helps other curious weirdos find the show. And we know there are a lot of you out there. Oh so many. Come join the chaos. Thanks for listening to Medicine, Mystery, mayhem, and sometimes Murder. Do you have an idea for an episode of this podcast? Just want to say hi? You can get in touch with us at our M4 pod. That's OURM the #4pod@gmail.com.

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