Another teen endangered by “alternative medicine,” part 2

I have to be honest here. I don’t know for sure what I think of the latest developments in the Mazeratti Mitchell case.

As you may recall from a couple of days ago, Mazeratti Mitchell is a 16 year old wrestler in Philadelphia who suffered a spinal cord injury while wrestling. Fortunately, given his subsequent course in which he has been recovering function, it was clearly not a complete transection of the spinal cord, but it was severe. His doctors recommended surgery to stabilize his spine and allow his injured spinal cord to heal. Having had extensive experience in trauma during my training, that I agree with. The physicians also apparently wanted to use steroids, which are, as I pointed out before, not really indicated anymore in spinal cord trauma, a victim of the “decline effect,” where a promising initial study gave way to negative studies later.

Unfortunately for Mazeratti, his mother Vermell Mitchell is a naturopath and thinks that she can heal her son’s spine with herbal remedies, (one of which whose name she can’t even remember!). So, while I don’t find her unreasonable for not wanting her son to receive steroids, given how poor the evidence is to support their use in this sort of situation, I do find her extremely unreasonable for refusing to authorize surgery for her son and wanting to take him home to use her herbal woo on him to “heal” him. Such a course would be extremely dangerous. Hospitals have skilled personnel who can more patients with spinal cord injuries and an unstable spine. Somehow, I doubt that Mrs. Mitchell has the skill set to be able to move her son around without putting him at high risk for re-injuring his spinal cord, with the attendant risk of paralysis up to and including permanent quadriplegia. Fortunately, the court awarded temporary custody of Mazeratti to Delaware County, where he lives. Unfortunately, as of yesterday, Mazeratti still hadn’t undergone surgery.

That might change soon:

A Delaware County judge has ruled an injured teen wrestler in the Philadelphia area must have spinal surgery, against the wishes of the teen and his parents.

Fox 29 just spoke with Vermell Mitchell, the mother of 16-year-old Mazzerati Mitchell.

She confirmed that Judge Mary Alice Brennan told Thomas Jefferson University Hospital the surgery must happen.

It is now up to the hospital to decide when and where it will happen.

The Philadelphia Inquirer reports that a lawyer for the Mitchell family will appeal the decision.

Vermell Mitchell appeared on Fox 29 on Thursday and gave us a video that shows Mazzerati Mitchell moving around. Vermell Mitchell says the video supports her claim that local government doesn’t have the right to take parental rights away in a medical case.

Delaware County took custody of the 16-year-old athlete after his parents refused spinal surgery for their son.

As I described for Abraham Cherrix and chemotherapy, these sorts of decisions are always difficult, and no judge wants to have to make them. For one thing, in this country, as I’ve complained time and time again, parental rights tend to be viewed as near absolute–or even absolute. If you don’t believe me, all it takes is to look at the number of cases of faith healing that endanger children and how rare it is for any of these parents to be prosecuted. In cases where parents choose quackery instead of effective science-based medicine to treat their children, in fact the courts bend over backward not to take parental rights away, even on a temporary basis. They only tend to do so when all negotiations have failed and the danger to the child is acute. Think Katie Wernecke. Think Abraham Cherrix. Think Daniel Hauser.

And now think Mazeratti Mitchell.

Personally, I find the video that Mazeratti’s mother released to be offensive in the extreme. No, it’s not because there’s something disturbing about it, at least not to someone with medical training. Basically, all it shows is Mazeratti moving each of his limbs. That’s great! It means he’s recovering in spite of his mother’s interference with his receiving effective medical care. As long as the injury is not too severe, the spinal cord can actually heal pretty well. The key is simply not to re-injure it, which is catastrophic when it happens. One of the reasons to surgically stabilize the spine is to minimize the chance of re-injury. Without knowing the full extent of Mazeratti’s injuries, I can only make an educated speculation, but my guess is that the surgeons would not want to stabilize his spine surgically if there wasn’t a reason. There must be some injury or instability there that the surgeons believe needs to be corrected to maximize Mazeratti’s chances of a full functional recovery. It’s all a matter of risks. If Mazeratti’s spine is still unstable, it might well heal on its own with just the cervical collar, but I’d be very, very worried about his spine being inadvertently injured again, just from moving around or from caregivers moving him around. Worse, because he can’t be moved around vigorously, he’ll spend more time in bed, with the resultant higher risk of bed sores, blood clots, pulmonary emboli, and pneumonia. With is spine immobilized with pins and plates, possibly also with a temporary halo brace, Mazeratti would be able get up and undergo much more intensive physical therapy.

Is it possible that he will regain all of his function without surgery? Sure. Is it possible that he might be paralyzed by the surgery? Sure. Again, it’s a matter of risk versus benefit. What is the risk of doing nothing versus the risk of surgery? What I find disgusting, however, is how Mrs. Mitchell is displaying her son to the world, Foley catheter and all, all in order to make a point and to prove that she’s right. Never mind that Mazeratti’s ability to move his arms and legs is more indicative that he is healing in spite of his mother’s interference than it is that her herbal woo is working.

Even though I am happy that Mazeratti is getting the treatment he needs in spite of his mother’s interference, that doesn’t mean I’m fully comfortable with what has had to happen. A few years ago, back when Abraham Cherrix was fighting having to undergo chemotherapy, even though I agreed that he needed it, I saw a huge difficulty with the judge ordering him to undergo treatment. The problem, of course, is that for the hospital to do this would require doctors and other medical personnel to use force to subject a teenager to medical care that he needs. First off, no physician that I’m aware of became a physician to force patients to undergo treatment against resistance. Second, doing so in essence crosses the line into battery. Once again, age matters. Pretty much every surgery performed on very young children is performed against the child’s will and requires either subterfuge or even force to make the child submit. Howver, somewhere between 14 and 18, it starts becoming a gray area, where the child is old enough to be not only much more aware but is starting to develop enough mentally to be capable of making more and more decisions for himself. Unfortunately, Mazeratti, being 16, ir right in that gray area.

It never ceases to depress me to read about cases like this. The power of irrationality is strong, and it can just as easily infect the child as the mother. Sometimes when it does so we can morally justify not only abrogating parental rights but even compelling treatment in an almost adult, but that doesn’t mean we have to like it or that it isn’t a horrible decision. It’s a decision that has consequences that can haunt the child and family forever. Unfortunately, quackery sometimes leaves reasonable people little choice.