"The truth is incontrovertible. Malice may attack it, ignorance may deride it, but in the end, there it is"
Winston Churchill
I wonder if Richard Speights in his vast "wisdom" will make the decision to "correct" the words spoke by Winston Churchill as he did with the anonymous quote? What Winston Churchill stated is so true. Ignorance tried to deride medical fact - but in the end all one has to do is some simple research and they will find the truth.
CAUTION - THIS ARTICLE IS FILLED WITH IMPROPER GRAMMAR AND MISSPELLED WORDS (SOME INTENTIONALLY)
Richard Speigths has presented a rebuttal in response to my debunking of his sinus theory. I must have struck a nerve with my dear Mr. Speights because he has had a sudden emotional outburst and went on a rampage. This rampage is evident in the number of comments he has posted on this blog. It shows that he is a man obsessed and can't handle it when he has been proven wrong. But, most curiously, is his chosen method used to refute the fact that he was proven wrong. Instead of presenting clear concise scientific fact to support his sinus theory and other claims, he went on the attack in regards to my writing style. He just does not seem to like my tendency for run-on sentences. (Oh well, I guess I should say A Farewell to Arms). Maybe his obsession with grammar is all he can offer in rebuttal because it appears via his writing and statements that he lacks the medical knowledge to support his statements.
Mr. Speights has bragged about his prowess as an army medic who had earned an associated badge to imply that he is qualified to make the claims that he has. However, his writing shows that he lacks an understanding of basic human cardiac vessel anatomy and his statements do not support medical knowledge.
Mr. Speights has bragged about his prowess as an army medic who had earned an associated badge to imply that he is qualified to make the claims that he has. However, his writing shows that he lacks an understanding of basic human cardiac vessel anatomy and his statements do not support medical knowledge.
For example, consider this snip from Mr. Speights's "Innocence Essay Report"
One cannot expect any one person associated with medical studies to know everything in the medical community about pathophysiology. That is why they make specialist. However, what can be expected of any person of medicine is the understanding of basic anatomy, which seems to have escaped Speights when it comes to the heart and her vessels. He shows his ignorance of the cardiac vessels with the statement in his innocence essay "..... the superior vena cava, the major artery between the heart and lungs". Anyone who has been introduced to a medical dictionary knows vena means vein - however Speight calls the vessel an artery. In addition, the superior vena cava does NOT connect the heart and the lungs. The major artery which connects the heart and the lungs is called the pulmonary artery. Almost all arteries and veins are quite different in structure and function (exception is the function of the pulmonary artery and veins). Most people with a medical background know that.
The superior vena cava is a major vein that returns deoxygenated blood to the heart from the upper circulatory system -- hence the "superior" in the title. It is a much thinner walled vessel than an artery and damage to this vessel results in quick and severe bleeding. In fact, people who have penetration to their superior vena cava rarely live long enough for help to arrive.
Even though he mislabeled this vein, in his rebuttal essay Speights implies that people should believe and trust that his medical facts are correct. He has based this on his use of grammar. However, I suggest that you base your decision of what information to believe by doing your own fact checking. No matter what people claim, the true facts will always be out there. I strongly urge you to look up the superior vena cava and see if it is:
A. Speights's claim that it is the major artery between the lungs and heart, or
B. A major vein that returns deoxygenated blood from the upper circulatory system.
http://en.wikipedia.org/wiki/Superior_vena_cava
http://en.wikipedia.org/wiki/Pulmonary_artery
.
A matter of non-importance....
Mr. Speights has made the claim that the two times in my very lengthy article I used the word 'infer' it was incorrect. He further claims the word should be 'imply". However, he is only partially correct and that is the word infer was used incorrectly once - which was in relation to Speightz claim.
But before that is discussed we need to look at the definition of each word in the Oxford dictionary.
The Oxford dictionary defines the word imply as "to strongly SUGGEST the truth of something not explicitly stated"
And infer as "deduce or CONCLUDE from EVIDENCE and reasoning that something is true rather from explicit statements.
THUS MY STATEMENT " ......the ME was inferring the brain was autolyzed" is a correct use of the word as the statement is based on the evidence presented to the ME. Dr Horn did not suggest his conclusion was true --- he determined it to be a FACT.
I used the term "infer" in relation to Spieghtz statement because he claimed the "ear blood" could have only come from a gunshot wound to a victim that was alive. However, his statement was based on very little evidence --- one picture of an ear. An inference is a conclusion based on a well informed educated guess and his "evidence" does not meet the criteria. So I stand corrected because the correct term should have been "surmise". Surmise means a person is offering an idea based on very scanty evidence -- such as what Speights did via the one picture of the ear.
The fact is one can't fault Speigts or anyone for making the mistake between infer and imply. The interchange is so frequent in the English language that some sites are even listing imply as a synonym for infer. Perhaps Speghts is under the impression that a person can only infer after being told something by another? It seems that he decided to forgo definitions for the easy out explanation of the sender-receiver method of determining when to use which. One can infer a fact based on research -- its a common term used in scientific articles. It seems that the main reason Speights has decided to focus on one of the most common misused words in the English language was out of spite because he lacked the ability to refute the medical evidence.
Here are some more examples using infer from some well published media:
- I suppose that Speights might want to write the New York times and correct them as well in regards to the fact that they have used infer to indicate a situation was based on fact (inferred) and not a mere suggestion.The fact of the matter is that the word infer was used to indicate that a conclusion based on evidence was formed and not that the claimant was only suggesting it was true (Implying). But maybe Speights believed he knew more of my intention with the use of the word then I did when I wrote it? Nonetheless, it still is a matter of non-importance. The important part is that the reader understood the article and it was able to be easily followed. RS's focus on two simple words in a lengthy article seems to indicate a pettiness -- such as making mountains out of molehills.Speight's Rebuttal Defenses
Herr Spieths plays multiple defenses but forgets the one that would be the most effective -- the one that has verifiable facts.
Speights has presented the often used immature facebook defense of "you can't spell, incorrect grammar". This is a technique that is often used by an opposing view when they lack the evidence and facts to support their claim. It is used as a method of distraction from the case at hand. They use it to say "I am better then you" which is actually only a self serving act. It makes the person using it feel a little better about their lack of evidence to support their claim. However, the thing is that it is no replacement for facts because the true truth seekers will always seek out those facts to make their own determinations -- such as researching what the superior vena cava is to see who really holds the medical knowledge and who does not.
Another defense that Speights uses is the "Poor me, pity me" defense. Again, it is just another distraction attempt from the matter at hand. He has pulled up past events that are long over and not even linked to this writer. He has linked them to her to say "Oh, she is picking on me for no reason at all. See how mean she is". These events are linked to a comment that a third party posted on a blog belonging to Justda Truth. Mr Speights seems very focused on Justda Truth which is quite an interesting case to study for clinic.
Then we have Speights "I'll sue you defense" which he likes to use often. He implies that there will be some legal recourse for the critique of his non-factual article. I have noticed him use this defense before: He claimed copyright infringement via the posting of his "property" from his site - once again associated with Justda Truth. However, given the fact the item Speights claimed ownership of is a creation by another artist that he altered slightly, Speights is the one who is guilty of the crime unless he obtained permission from the artist to claim the piece as his own. In addition, his "I'll sue you defense" has been stated to have been used against ever another as noted in the reader comments.
Last, RS presents the "I am gonna call you names " defense. This really shows his emotional immaturity and true colors. This defense is in response to a photograph that I used from his site to demonstrate how good he is at one part of his job -- altering pictures. I took the time to block out much of the picture so anonymity could be maintained and only said nice things about the work. But, Speights's response was to remove that anonymity by naming the woman in the picture and direct the following comment towards me: "you creepy, ignorant, knuckle-dragging troglodyte". From my experience, such actions say so much more about the character of the writer than the one they are writing about. People like Speights end up giving themselves a bad rep with such actions. However, the sad, immature, and emotional outburst from Speights holds little meaning to me... it only makes me aware of the fact that the truth of his incorrect medical findings being brought to light is really getting to him.
What is an Army Medic?
Speights likes to use the fact he was an army medic to support that his medical information should be believed. From my experience it is not what a person claims to be that should support belief but if the facts they offer are true. Again, I urge you to research the superior vena cava.
So, what is an army medic? What training does it include?
An army medic is someone in the military who has been trained to at least the civilian equivalent --- EMT-basic level. They are responsible for first aide in the field and front line trauma care. They will provide basic life saving care until the injured person can be turned over to more capable hands. However, due to their limited medical education, the army medic will always have to follow the directions of the medical professional with superior knowledge such as the physician. Don't get me wrong, army medics are very important to the troops they provide care for. My only point is that the medical knowledge they have is basic and not in depth. It takes a lot more time and education to reach such a level.
The term "medic" can be misleading - it's not a synonym for a doctor. It is a military person who has been trained to give basic medical assistance and provide care in emergency situations when the physician or nurse is not available.
Speights has posted on his page about his achievement of winning the Expert Field Medical badge. So, what is it? What requirements does a person have to meet to earn the badge?
From: http://www.armystudyguide.com/content/EFMB/EFMB_Information/efmb-information-paper.shtml
.Critical performance areas:
(1)Written Test--100 performance-oriented multiple choice questions of which 75 must be passed.
(2)Army Physical Fitness Test (APFT)--The events are push-ups, sit-ups, and a two-mile run. A minimum of 60 points in each event with a composite score of 180 points must be achieved for those candidates not APFT certified by their commander. No alternate event authorized.
(3)Land Navigation Courses--Both day and night courses will be navigated individually.
(4)Weapon Qualification--Marksman or above within 12 months preceding the EFMB test start date.
*(5)Litter Obstacle Course--Candidates form into four-person litter squads to negotiate eight obstacles: low obstacle,high obstacle, gully or trench obstacle,barbed wire obstacle, uphill/upstairs carry, downhill/downstairs carry, rough terrain, and narrow obstacle (Candidates are graded individually).
(6)Forced Road March--A 12-mile forced road march must be accomplished within three hours.
*(7)Communication--Candidates must demonstrate competency on use of field radios and radio techniques. "Prepare and transmit a MEDEVAC request" must be performed correctly, and be one of the three of four tasks passed in order to receive an overall "GO" for the Communication Lane.
*(8)Survival--Candidates must demonstrate knowledge of survival skills in a Nuclear,Biological and Chemical environment and in combat situations requiring the use of the M16 series rifle.
*(9)Emergency Medical Treatment--Candidates must demonstrate knowledge in treatment of various wounds similar to those encountered in a combat situation.
*(10)Evacuation of Sick and Wounded--Candidates must demonstrate evacuation techniques utilizing a variety of vehicles and manual carries.
(11)Cardiopulmonary Resuscitation(CPR)--Candidates must demonstrate proficiency in CPR using the one-person method.
I don't have military experience so I can only go by the information that is presented on sites on the Internet. However, it seems that the EFMB is highly based on the ability of the applicant to physically function in a combat zone while performing basic EMT skills and the rescue and removal of those injured. From my understanding, it does not indicate that the medic is being recognized for his or her expertise in the knowledge of the field of medicine but his or her expertise to perform those basic EMT duties in a dangerous and physically demanding environment.
So what are some of those basic EMT duties that need to be performed?
- Tactical Combat Casualty Care Tasks
- Perform a TCCC patient assessment
- Triage casualties
- Control bleeding using a tourniquet, hemostatic device, and dressings
- Initiate a saline lock and IV
- Initiate treatment for hypovolemic shock & prevent hypothermia
- Insert nasopharyngeal airway
- Treat a penetrating chest wound
- Perform needle chest decompression
- Treat an open abdominal wound
- Treat a casualty with an open head injury
- Immobilize a suspected fracture of the arm
- Treat eye lacerations/contusions/extrusions
These are all tasks and duties that can be learned without the need to have a greater understanding of the pathophysiology of the process because the focus is acute short term care to maintain life and/or prevent further damage to tissue. It is not a focus on the completion of healing of the injury which requires quite a bit more medical knowledge.
X-RAY ISSUES
One thing an EMT
or the army medic does not do is to interpret x-rays to form a diagnoses. Most understand that such a skill can only be mastered via training and experience doing so. And then there are the few that violate their scope of practice by making claims that they are qualified to interpret the x-ray. So, it makes one
have to wonder why Speights claims that he can interpret a poor copy of
an x-ray without the use of a lighted view box and lack of examination of the body. He continues to insist that his untrained eye looking at a
poor image of an x-ray is more accurate than the doctor who viewed the
actual film in the appropriate manner using the lighted x-ray view box. I guess the trained radiologist or MD doesn't realize he had wasted all his time in medical school because according to what Speights suggests, all it takes is a few weeks spent learning the profession of an EMT to be competent to interpret x-rays of any quality.
On the poor quality film, Speights
continues to claim that the area of higher attenuation
(lighter area) on the forehead area of the skull is a bullet fragment.
However, the truth is that from only a poor quality image without a correlating
exam one just cannot make such a definitive diagnoses.
So
what is it then? It just not possible to tell given the photo we have access to. My whole point is that there
is no way of telling without viewing an actual film showing details on a lighted view
box which is a concept that has forever escaped Speights. One still has
to wonder why he felt the need to make the image brighter if the photo presented is claimed to be usable for diagnostic purposes. The fact that Speights had to alter the copy of the x-ray to prove his point shows how unreliable that the copy is. But he just does not get it.
To support his use of a poor quality copy to diagnose, Spiegths states that x-rays are expensive. This is to imply that the ME settled for poor quality films and what we got to see is the same view the ME used. However, what RS fails to understand is the fact that a major portion of the cost of the x-ray is related to the radiologist who reads it. The process and the films really make up just a small portion of the cost. Because of that reason, when the radiology tech shoots the x-ray, it is reviewed for quality prior to determining it fit to be sent off for reading. If the quality is subpar, the x-ray is shot again prior to sending for that read. That is how it works.
Foreign Objects
In his rebuttal, Speights makes the claim that if the bullet went through the forehead into the brain, the bullet would have sent those bone fragments through the brain. He claims that the doctor was specifically looking for bone fragments when he wrote "foreign objects". Actually, I do believe that the doctor was looking for ANY type of foreign objects including both bone fragments and bullet fragments. It is common sense that such a procedure is a normal part of autopsy when a projectile injury reaches the brain.
The search for those foreign bodies starts with the x-ray. In fact, one of the main purposes of obtaining an x-ray of a dead body in a criminal case is to look for any type of foreign body within the victim. Those images must be detailed enough to locate any foreign body and if the quality is poor, that x-ray is shot again. Getting a clear image is not only important in the investigation of a crime, it is very important for the safety of the examiner. The examiner will closely inspect the image and note any foreign bodies. For his own safety, those foreign bodies are removed prior to the cutting, removal, and examination of the organs. This is a necessity. Foreign bodies have the potential of having sharp edges that could cut the gloves or hands of the examiner and put him at risk for contact with hazardous bodily fluids - I believe such a statement was included in testimony. To find those foreign bodies, Dr. Horn had the benefit of seeing the real x-ray on a lighted view box. For both his safety and the retrieval of evidence, the films Horn would have used would be ones with details far beyond the copy Speights used for his "interpretation and diagnoses". If the area of higher attenuation was present on the films Horn viewed, he would have investigated it further to see if it was a foreign object. I am guessing that if it was a bullet fragment, he would have removed it for his own safety and it would have been entered into evidence.
Below are a comparison of x-rays and the copies of Travis's films.
From http://mcadams.posc.mu.edu/xray/reading/reading.htm
Below are a comparison of x-rays and the copies of Travis's films.
Reading the X-ray
"X-Ray Reproductions – Why Books aren’t the Best Way to View X-rays"
"A radiologist needs to see the full range of densities, that is, shades of gray from white to black, to make a proper diagnosis"
"X-rays are transparent like photographic slides rather than prints. Radiologists read X-rays on a lighted view box. This way of displaying the image presents a much greater contrast and tonal range "
"An X-ray that has been copied and published in a book will have to sacrifice many of the gray levels that are in the original X-ray. Certain features will be undetectable."
" A ray that passes through bone and tissue records a brighter image than a ray that passes through just bone"
The issue with a copy of an x-ray is that it loses much of it's contrast - thus making using a copy to form a diagnoses a foolish thing for anyone to do. One must use the original image on a lighted view box. A copy will interpret the areas of shades of black and white on a smaller contrast ratio and items that may have been slightly darker in shade can be reproduced in the copy as white.
So -- given this information and looking at the comparison of the copies of Travis's films with that of more detailed films... whose diagnoses does a person believe? Is it the interpretation of the trained medical doctor who had the benefit of viewing the actual film in the appropriate manner using a lighted view box and did not find a bullet fragment? Or is it the interpretation of the ex-army medic who lacks the education and experience in reading x-rays so he used a contrast-poor COPY of the x-ray to deduce a bullet fragment is present?
For most, the answer is obvious.
The False Impression
In my other article I presented a demonstration as to how the "proof" in Speight's line up of Travis's skull with Speights model is flawed. In rebuttal, RS describes how he altered the "perfect skull" to match up with Travis's by sizing it and overlaying it to the original. However, in the end his attempt fell short. Speights manipulation of the image does not line up with the size of Travis's skull and does not account for the structure of TA's jaw. Thus, in the end it just does not scientifically work to support his claim. The result only ends up giving the false impression that the bullet is further up in Travis's jaw which is necessary to make the trajectory sort of work. However, nothing can beat the empirical method that the ME used when he took and recorded measurements of the entry and resting point of the bullet. Nor can it beat the actual photos of the base of the skull along with the other photos which were entered into evidence that we did not get a close look at. However, the jury did get to see ALL those photos and these pieces will forever be in evidence and will forever prove Speights's trajectory is wrong.
I have demonstrated the true trajectory using an anatomically correct model of a skull and the measurements from the autopsy report. I have also used a male model roughly the same height and weight of Travis Alexander in placing the key points. Of course it will not be exact because skull shapes differ, but I can ensure it is a lot more accurate than that of the "eyeball-it guess" method used by Speights. This first image is one that shows the trajectory using the measurements from the autopsy. It demonstrates a straight trajectory entering the forehead at 1.5 inches to the right of mid line and 3 inches inferior to the crown, passing through and blowing away the entire cribriform plate, and coming to rest at 4.5 inches to the left of mid line and 6 inches inferior to the crown
Depth refers to the area starting at the forehead moving in towards the back of the head.
A. This is the level of depth where the bullet entry point is. It is CLOSEST to the forehead.
B. This is the level of depth where the bullet hole in the base of the skull is. It is SECOND CLOSEST to the forehead.
C. This is the level of depth where the bullet came to rest. It is FURTHEST from the forehead.
D. This is the area where the wound track "transverses the right anterior fossa" as stated on the autopsy report. The anterior fossa is INSIDE the skull where the brain is.
E. This is the area after the bullet "RE-entered the facial skeleton" near mid line as stated on the autopsy report. It is outside the skull.
However, if we take a look at Speights trajectory following the sinuses, we can see how it would not work -- a major fact Speights chose to ignore in his rebuttal in lieu to present his defense of his medical knowledge based on composition skills.
The heavy black line indicates how the bullet would have had to move forward first and abruptly turn to end up in the resting spot in the cheek.
The yellow area indicates the depth of the sinuses superior to the anterior fossa. This area very slowly and slightly increases in depth prior to reaching the skull base.
The pink area indicates the depth to which the sinuses extend posterior to the skull base.
This pathway does not permit the bullet to stay within the sinuses and end up at the resting spot at point C using a realistic trajectory, especially if "the bullet glances off the posterior sinus wall".
What I did not include in the picture is the abrupt turn the bullet would have made to come in contact with the inferior skull base to break that hole from underneath. It would have had to come in direct contact with the skull from underneath to break that hole in the base. This is another fact that Speights decided to forgo in his rebuttal and offered his composition skills instead to support his medical knowledge. As stated in the previous article, the perpendicular plate of the ethmoid bone will not pull off a large chunk of the skull base if it is struck of fractured. It's too thin and too weak to do so. This bone makes up the upper portion of the nasal septum. Nasal fractures are the most common fractured bone. A fracture involving the nasal septum can cause a fracture that extends into the skull base but it just does not pull away a large chunk of the skull base. Once again, if I am wrong, show it to me Speights. And show me something beyond your speculation of "it happens".
One more thing that Speights decided to just "ignore" in his rebuttal is information that supports the dura mater being intact was a typo. While the picture of TA's skull base was on the overhead, the ME stated the bullet blew away the entire cribriform plate. If this statement was not true, it would have been noted by the ED nurse juror or the juror who asked about how the dura mater could be intact if it was not the nurse who asked the question. The fact the statement was made while the photo in view confirms the plate was blown away. The topmost portion of the cribriform plate is the crista gali which attaches the falx cerebri to the skull. If the cribriform plate was gone, the falx cerebri would no longer be intact to the skull. This fact has been brought up to Speights before and he tried to argue it by changing the facts of the entire cribriform plate being blown away to just a portion of it. However, it's not what the evidence and testimony indicated.
Speights has made the statement that the entire report supports that the bullet did not pass through the brain. However, what has been constantly ignored is the fact that the ME stated that the bullet passed through the area that houses the brain when he stated "transverses the right anterior fossa".
Perhaps Speights does not understand that the anterior fossa is a term to label the area within the brain vault:
Maybe this will help:
"The Anterior Cranial fossa is a depression in the floor of the cranial vault which houses the projecting frontal lobes of the brain"
The Meninges Mater
Speights (keep counting again ;) ) writes:
"The
brain is covered with meninges, the dura mater the outermost layer.
This dura mater is easily pealed away from the brain during an autopsy.
But the leptomeninges (the arachnoid and pia mater) are more closely
associated with the brain, following every fold, attached directly to
the surface of the brain.
Dr. Horn wrote about these meninges, noting the color and character associated with decomposition"
The original quote was copied and pasted directly from his site -- put it seems that Mr. Speights had went back and proof read for his mistakes after posting out of his fear of the stone hitting his own glass house and had thus changed the word to the appropriate "peeled". I just was a little too late with the snip to catch this. Lesson learned.....
The original quote was copied and pasted directly from his site -- put it seems that Mr. Speights had went back and proof read for his mistakes after posting out of his fear of the stone hitting his own glass house and had thus changed the word to the appropriate "peeled". I just was a little too late with the snip to catch this. Lesson learned.....
I am really at a lost in regards to Speights's statement that Dr. Horn wrote about the meninges. If we take a look at Horn's autopsy report, the meninges are not mentioned beyond the standard. I don't know if it is an issue of reading comprehension on Speights's part, the fact that Speights does not understand the anatomy of the meninges, or if the statement was purposely written at an attempt to make the reader infer that the Horn actually inspected the meninges in depth. However, I will let you make that decision by presenting a snip from the actual autopsy report to display that Horn did not write about those meninges beyond a slight mention.
Dr. Horn's autopsy report:
There is no description of the leptomeninges as to color and character. However, I suspect that Speights is referring to the phrase in the report which states "green-gray softening of the parenchyma" and he thinks it means the meninges. Someone with true medical knowledge knows and understands the term parenchyma is in reference to the FUNCTIONAL tissue of an organ.... ie the actual brain tissue. This just happens to be another example of Speights's lack of knowledge in regards to A+P.
Speights implied that the ME was describing the thin delicate meninges that cover the brain. Maybe Speights just does not realize that it is possible to see the brain after cutting through the dura mater and the subarachnoid mater because NEITHER are attached to the brain. Maybe he doesn't realize that when it comes to the arachnoid mater and pia mater that these layers are so thin that they are pretty much transparent? Maybe he does not understand that the pia mater is thin, delicate, and full of holes and it is very likely that after 5 days it is possible to have decayed right along with the brain.
Speights statement about the brain and the meninges just gives further proof of his lack of understanding of the medical field beyond the skills of an EMT. Speights writes, "But the leptomeninges (the arachnoid and pia mater) are more closely
associated with the brain, following every fold, attached directly to
the surface of the brain"
So, let us take a lesson (oh groan all you want) as to the make up of the brain in relation to the meninges.
The dura mater is the meningeal layer right up against the skull. The next layer is the arachnoid mater. It is a very thin, clear, fibrous membrane which is NOT attached to the brain. The shape of this membrane does not follow the folds (gyri) of the brain as Speights mistakenly suggested. It is more like a big loose fitting sack around the brain. In between the arachnoid mater and the pia mater is a space filled with cerebral spinal fluid called the subarachnoid space. Extending from the arachnoid mater is a network of very fine filaments that pass through this space and attach to the pia mater. This does not have an effect on the arachnoid mater in shape by pulling it tight up against the brain like the pia mater. The arachnoid mater simply does not follow every fold nor is it attached to the brain surface as Speights claims in his statement. Once again, he shows his lack of education in regards to medical studies.
After the arachnoid mater, the next layer is the pia mater. The pia mater is attached to the brain surface. The pia mater is a very thin and delicate membrane:
"Pia mater is the thin, translucent, mesh-like meningeal envelope, spanning nearly the entire surface of the brain"
The pia mater includes a rich supply of blood vessels passing through it to nourish the brain. All those vessels passing through help to speed up decay by creating that mesh-like envelope. Thin, delicate, and full of holes is a recipe for quick breakdown of biological material. However, given the fact that it is so thin and clear, it would be very difficult to distinguish pia mater breakdown from brain tissue mush.
If Speights knew his brain business, he would have included the fact that the very label, leptomeninges indicate the nature of these membranes. It means "thin meninges"
So how thin are they?
The size of the dura mater is 0.3 to 0.8 mm or .01 to .03 inches or .03 to .08 cm. Pretty damn thin, correct? NOW.... imagine this, the pia mater is much much thinner. Below is a blown up artist rendition of the meninges.... so just imagine how incredibly thin and delicate that the pia mater has to be if the area indicated as dura mater on the picture is only 0.3-0.8 mm/ .01-.03inch/.03-.08 cm.
To help you visualize a little better a MM is about the size of this dash mark -. The dura mater is smaller. At Travis's age, probably about 1/2 of that dash mark. Now, imagine how small the pia mater would be in relation to 1/2 that dash mark using the comparison in size of the dura mater to the pia mater in the picture above. Actually, studies show the pia mater to be 5-15 micrometers in size -- which would be .005 to .015mm or .0005 to .0015 cm. I guess what I am saying is it's pretty damn small and delicate. Add to that all the holes from the vessels forming that mesh-like appearance and there really would no way of distinguishing a gunshot hole in the pia from that of decay, even if a gunshot hole in the meninges would be something a ME would note on report.
Still the Weakest Claim Ever
Speights makes the statement "A hole punched through these meninges would be “grossly apparent” (visible to the naked eye), especially the “exit” hole" to imply that since the ME didn't note it in autopsy that there was no hole.
In my previous article I had a section called "The Weakest Claim Ever". This was regarding Mr. Speights's statement that if there was a hole in the dura mater the ME would have described it. So I challenged readers to please show me one autopsy of a gunshot wound to the the brain that described the holes in the dura mater after describing the entry wound. Examination of the meningeal layers next to a bullet hole holds not value as evidence, thus it is not a common occurrence on autopsy reports. So the question is, even if the pia mater was still intact and could be easily seen at the size of .005-.015 mm, what purpose would it serve for the ME to have described it? All Speights did is take his unfounded claim that if a hole in the dura existed the ME would have described it and substituted a much thinner and more delicate membrane. I asked for autopsy reports to support his claim that it is a common occurrence and in rebuttal I only get more speculation. That shows that his claim cannot be supported. It's a failure to perform on Speights part so thus he went to something much smaller and he still could not hold it up. Speights's insistence that the layers of the meninges would have been described in a gunshot wound is like stating even though a bullet hole in a mans head is found it never occurred because the ME did not describe how it passed through each layer of the skin - the epidermis, the dermis, and the subcutaneous fat.
The New York Daily News Tale
Speights tells a story about a gunshot to the head victim which is alleged to be reported in The New York Daily News. He claims an eyewitness rendered aide and reported the victim was bleeding from his mouth and ears. He even tries to support with a link to the New York Daily News website.... but does not provide the link to the actual article. I don't understand that method at all because if one is trying to prove a point, they link the actual article. Speights's method of saying "This is what was said" and not linking the article makes it just about impossible to verify what he claims and to see if any information was omitted. Thus, this leaves lots of questions. Who was this witness? Was there any elaboration? Who was the victim? What was the bullet trajectory? Was there a basilar skull fracture involved and if so, where did it extend to? Was it a louder firearm that caused the ear drums to rupture from the decibels? Lots of questions that just cannot be answered. I for one, will take medical research over a claim of an article which was never produced and has many missing details
Speights has further shown his lack of medical knowledge with the statement "Medical knowledge 101: Bleeding from the ear or ears is a symptom of and treated as head trauma—always."
However, if one does a search as to "Ear bleeding" they will learn that the number one cause of ear bleeding is a ruptured ear drum and not that of head trauma. If Richard had the medical knowledge that he states, he would realize this. Rupture of the tympanic membrane can occur from a number of things. The mayo clinic provides a list with infection being at the top of that list:
Middle ear infection (otitis media)
Barotrauma
Loud sounds or blasts (acoustic trauma)
Foreign objects in your ear
Severe head trauma. Severe injury, such as skull fracture, may cause the dislocation or damage to middle and inner ear structures, including your eardrum.
The Mayo clinic indicates the head trauma as SEVERE and relates it to a skull fracture that involves the ear structure. This would be a temporal bone injury and NOT a frontal bone injury.
http://www.facialtraumamd.com/sinus-fracture/
A severe head injury also DEFINITELY involves injury to the brain and an inability to function. Given his statement about his time spent as an army medic, one would expect Mr. Speights to be well aware of this.... yet he claims that the gunshot would caused ear bleeding and Travis was up and walking. It's a nonsense statement.
The Glascow coma scale used to classify head injuries:
A mild head injury is a GCS of 14-15
A moderate head injury is a GCS of 9-13
And a severe head injury is a GCS of 3-8
Using the GCS, if Travis's condition was listed under any of the below numbers, he would not be upright:
Motor response 1-3 is a person that is comatose and non-responsive.
Motor response 4 is semi-comatose
Eye opening 1-2 is a person that is comatose to semi-comatose and not functional. .
Verbal response 1-2 is a person that is semi comatose and not functional
Using the rest of the available scores, there is just not any way for Travis to be classified as a "Severe head injury" and be up and functional after receiving it.
Basically, what research shows is that if an impact to the head is strong enough to blow the ear drums, then it is strong enough to cause a severe head injury. Speights does not seem to comprehend that fact.
How the falx cerebri remained intact after the cribriform plate was blown away
Speights's tale shows his imagination but it has many far-fetched ideas. One such idea is that a horny Travis wanting to have sex would take the time to burn the ends of a rope that was only going to be used for sex. And, the rope burning was done without Arias seeing or smelling it.
Another far-fetched idea is that Travis could see enough to reach out and grab Jodi in a way that he had partial control over her for a period of time while at the same time having too blurry of vision to be able to see her enough to punch her in the face. That far-fetched imagination gets even crazier with a suggestion that a raging mad Travis might have even attempted to choke Arias yet did it gently enough to not leave a mark for Ryan to see when they were macking the next day.
I think the most unrealistic detail starts with Speights's description of how the chest wound occurred. The "breakdown" is really quite all over the place and not at all in a linear sense. It appears that what Speights is attempting to say is that when the two reached the end of the hall TA had Arias pinned with his hands. She stabbed TA's hands and he let her go. Next, TA held his arms wide open to his sides to give Jodi, who he knew had a knife, better access to his organs. At this point, even though he was not attacking anymore and Jodi was free to run she decided to stab him three times in the chest instead. The stab in the chest caused Travis to perform the aggressive act of covering his wound and Jodi took that opportunity to slash his throat. So, it seems that even per Speights's scenario Jodi had plenty of opportunity to run away. And, not only when Travis left her go the first time but when she gave him that mortal chest wound -- yet she did not.
The point of the neck wound is where Speights really hits the horror movie fiction realm. Speights would like the reader to believe that even though Travis had lost enough blood that within 5 seconds after the throat wound he would have passed out that Travis participated in the following events:
Because of the fact so many bacteria can live for such an extended period of time outside the body, there is a a high focus on preventative measures. One such measure is instructing people on PROPER hand washing techniques. These techniques are learned at the most basic level of medical teaching, yet Speights does not demonstrate that he is aware of the importance. He leaves out two important factors - when hand washing is a must and the proper way to do it to ensure the destruction of bacteria.
* Before, during, and after preparing food.
* Before and after eating
* Before and after caring for the ill
* Before and after treating a cut or a wound
* After using the toilet or coming into contact toileting issues (diapers)
* After coughing, sneezing, blowing your nose or touching your face
* After dealing with an animal
* After touching waste
* Any time the hands are visibly soiled.
He is incorrect in that statement too. It is the hydrophobic molecules of the soap that "lift off" the dirt and bacteria. The molecules combine with those of the dirt and bacteria and the water rinses it away. That is the reason that even with a good frictional scrub to break that water tension, water alone just is not effective.
I decided to focus on the fault within Speights's article about hand washing because hand washing really is medicine 101. A person of non-medical origin would not be expected to know that there is a right way and a wrong way to wash the hands for infection control purposes, but a medical person should. I am really quite concerned that Speights does not demonstrate this fact in his hand washing article.
Proper hand washing techniques are a big focus in the health care environment to prevent infection thus time is taken to ensure that health care workers understand the process.
But first, let me tell you the story of Josie Doe. Josie Doe was a person I got to know who ended up having a large portion of her foot amputated from what is called "Bathroom surgery". It seems that Josie Doe had a thick callous on her foot that she no longer wanted. So Josie Doe decided to perform bathroom surgery and slice away the callous using a razor blade -- AKA "Bathroom surgery". Josie Doe efficiently broke through that first layer of defense - the skin - which allowed bacteria to enter which caused a major infection in the foot. The bacterial infection was pretty aggressive and to save the limb, a large portion of Josie Doe's foot had to be amputated to get rid of the infection.
In his "advice column" Speights discusses blister care and the prevention of. He makes this statement:
The Cleveland Clinic is a top hospital in the nation and they strongly advise against this act as well. For full information: http://my.clevelandclinic.org/orthopaedics-rheumatology/diseases-conditions/calluses.aspx
"You should never use sharp objects to cut calluses since injuries can occur and are particularly dangerous in patients with diabetes. This "bathroom surgery" is strongly discouraged and can lead to serious problems. "
.Mr. Speights is putting people at SEVERE RISK by suggesting such a thing. He needs to remove this dangerous advice from his blog at once. If anyone is in doubt of Mr. Speights's lack of medical knowledge, this should do it. He is not only giving incorrect advice, he is giving DANGEROUS advice.
Multiple MEDICAL sites caution against this type of "bathroom" surgery.
MAYO CLINIC - http://www.mayoclinic.org/diseases-conditions/corns-and-calluses/basics/lifestyle-home-remedies/con-20014462
"Don't use a sharp object to trim the skin. "
http://universitypodiatryassociates.com/corns.htm
http://eriepodiatrists.com/files/BayCity%20-%20January%202010%20Newsletter.pdf
http://www.profootcare.ca/corns-calluses.php
ADDENDUM -
I have a question -- Is there both criminal and civil legal ramifications if someone implies that they are competent to give medical advice by saying they were an army medic, and then instructs people to do a dangerous act?
ADDENDUM, 7/22/14 - Richard Speights posted a comment today. This indicates that he is aware of his dangerous advice on his blog about cutting off calluses. However, the information still remains.
So -- what does this mean? Is he too arrogant that he just does not care about the safety of others? Is he not capable of learning or doing his own research? He has been alerted several times under his "comments" about his grave error, yet he allows it to remain.... should anyone trust the medical knowledge and advice of a man who does such a thing? Let's just hope that he just decided to not read the statements. I like to give people the benefit of the doubt, but as he has read the blog it kind of hints to the fact he knows.
Speights implies that when describing the parenchyma of the brain the ME was talking about the lepomeninges - FALSE, parenchyma is a medical term used to describe the functional tissue of an organ.
Eye opening 1-2 is a person that is comatose to semi-comatose and not functional. .
Verbal response 1-2 is a person that is semi comatose and not functional
Using the rest of the available scores, there is just not any way for Travis to be classified as a "Severe head injury" and be up and functional after receiving it.
Basically, what research shows is that if an impact to the head is strong enough to blow the ear drums, then it is strong enough to cause a severe head injury. Speights does not seem to comprehend that fact.
The "weakness" of a .25
I would encourage that Speights takes on the experiment to see if a .25 can really pierce the skull and enter the brain but I am afraid he just might -- SO PLEASE DON'T.
Speights continues to claim that a .25 just cannot pierce the skull. The claim is ridiculous because there is a big ol' hole in both the forehead and the base of the skull that indicates something different. In fact, Speights own "theory" argues against his own claim. He continuously REFUSES to address the fact that the area he claims the bullet to have broken through, is the most difficult to fracture in the facial skeleton. He can imply "Well I meant it was thinner thus easier to go through" all he wants but the fact still remains -- the bone over the frontal sinus is harder, tougher, and more durable. This fact makes it harder for something to break through at that point than other areas of the forehead. Per Speights's logic, a person can more easily hammer a nail through 3 inches of steel then they could through 4 inches of plywood - and we know that isn't true.
Speights seems to play with the facts but ends up damaging his theory even more. He wants to claim that the bullet was too weak to pass through the weaker part of the forehead where it did. In fact, he wants people to believe that not even a fracture resulted at the site from the initial impact of the bullet. But at the same time he needs you to believe this "too weak" bullet did all of these things:
Hit the skull at over 400 MPH and did not leave as much as a fracture at the impact site.
The bullet then lost velocity and kinetic energy after the initial impact but still busted a hole in the hardest bone to fracture in the facial skeleton
Hit the skull at over 400 MPH and did not leave as much as a fracture at the impact site.
The bullet then lost velocity and kinetic energy after the initial impact but still busted a hole in the hardest bone to fracture in the facial skeleton
Punched another hole in the rear sinus wall
Fractured the frontal sinus as it exited to continue on to the ethmoid sinuses.
After passing through all that bone and tissue this "too weak" bullet still had enough kinetic energy to hit the upper portion of the nasal septum with enough force to tear a huge hole in the skull base.
This "too weak" bullet kept going and it busted it's way into the maxiallary sinus.
And finally, after busting through multiple sections of bone and tissue, this "Too weak to fracture the weaker portion of the forehead" bullet managed to punch a hole in the maxillary sinus and find it's way to the check.
Wow... an amazing feat for a "too weak to break through the weaker portion of the forehead" bullet. It's silly to think that this bullet could not pass through the forehead bone where it struck at full energy but went on to break through harder bone and pass through multiple areas of bone.
The thing is, these people like Speights must prove that the bullet did not pass through the brain because it is their only way out to explain the continued attack by Arias with no attempt to escape. This is because they know and understand that any shock to the brain will incapacitate in some manner. Travis would not have simply stated "FKYB" and continue his attempt to take Arias down. In fact, he would have been knocked to his knees and incapacitated for a time as that shock wave from the bullet passed through his brain and caused the soft tissue to bounce off the inside of the skull. This shock wave would have interrupted the motor strip, basically turning his muscles to jelly. Stating "FKYB" is not an immediate response to the situation - dropping to one's knees is. This gives Jodi time to run away if she is so scared of Travis that she had to pull a gun on him.
Mr. Speights, I urge you to please point out the following in the medical evidence to support your sinus theory:
The fracture in the forehead where the bullet traveling over 400 MPH hit Travis's head on the weaker portion of the forehead.
The FIRST hole in the frontal sinus where the bullet passed through the stronger bone.
The second hole created in the rear sinus wall from a bullet moving at a sideways down trajectory and thus the holes would not line up.
The multiple sinus bone fractures and the associated bruising as the bullet passed in and out of the sinus tissue
That hole in the maxillary sinus where the bullet exited to rest in the cheek
How the falx cerebri remained intact after the cribriform plate was blown away
Please present those autopsy reports that show the standard procedure of noting injuries to the dura mater in a gunshot case and injuries to the thin and delicate pia mater.
Please present a case in which a nasal fracture results in a big hole tore out of the skull base.
Please present the full article from the New York times indicating the bleeding from the ears and mouth so a full consideration can be made.
CAN YOU?
CAN YOU?
The Man Throwing Stones From His Glass House
The only fight Speights could muster up was to attack grammar. However, a review of Speights's articles indicate that he is not quite the expert writer he believes.
In this snip from his site, Speights seems to not understand the correct use of the word "detour". A detour is when one takes the long roundabout route. I believe Speights means "deter" which means to prevent. Plus, it seems that he has dressed microbes up for a ball... Perhaps he meant to use the word "growth" and not "gown"?
Conjunction junction it's our function. It seems that RS must not have had the pleasure of School House Rock.
"No matter how wild the situation, how deep in the wood, bring a civilized attitude with you and maintain a higher standard for healthy living".
OR
"No matter how wild the situation or how deep in the wood, bring a civilized attitude with you and maintain a higher standard for healthy living".
"No matter how wild the situation, how deep in the wood, bring a civilized attitude with you and maintain a higher standard for healthy living".
OR
"No matter how wild the situation or how deep in the wood, bring a civilized attitude with you and maintain a higher standard for healthy living".
However, as stated before - these mistakes are of non-importance as the article is just a blog. The fact of the matter at hand is in relation to medical FACT and the attempts of grammar name calling if just a distraction from the fact that Speights cannot perform with facts.
A Choppy Essay
Speights writes an essay about Innocence. However, once a person gets to his "breakdown of events" the essay becomes very choppy and difficult to follow at times.
There are parts of that breakdown that are easy to follow but others that suddenly jump to another idea. Speights forgets the need to link with transitions - ie He writes about anger from a gunshot wound and then jumps to a sex scene with a rope and right back to where he left off with the gunshot wound. Speights most likely was trying to add a little flair but his attempt fell short.
Speights's tale shows his imagination but it has many far-fetched ideas. One such idea is that a horny Travis wanting to have sex would take the time to burn the ends of a rope that was only going to be used for sex. And, the rope burning was done without Arias seeing or smelling it.
Another far-fetched idea is that Travis could see enough to reach out and grab Jodi in a way that he had partial control over her for a period of time while at the same time having too blurry of vision to be able to see her enough to punch her in the face. That far-fetched imagination gets even crazier with a suggestion that a raging mad Travis might have even attempted to choke Arias yet did it gently enough to not leave a mark for Ryan to see when they were macking the next day.
I think the most unrealistic detail starts with Speights's description of how the chest wound occurred. The "breakdown" is really quite all over the place and not at all in a linear sense. It appears that what Speights is attempting to say is that when the two reached the end of the hall TA had Arias pinned with his hands. She stabbed TA's hands and he let her go. Next, TA held his arms wide open to his sides to give Jodi, who he knew had a knife, better access to his organs. At this point, even though he was not attacking anymore and Jodi was free to run she decided to stab him three times in the chest instead. The stab in the chest caused Travis to perform the aggressive act of covering his wound and Jodi took that opportunity to slash his throat. So, it seems that even per Speights's scenario Jodi had plenty of opportunity to run away. And, not only when Travis left her go the first time but when she gave him that mortal chest wound -- yet she did not.
The point of the neck wound is where Speights really hits the horror movie fiction realm. Speights would like the reader to believe that even though Travis had lost enough blood that within 5 seconds after the throat wound he would have passed out that Travis participated in the following events:
Think about what to do next
Bend over, charge Arias, take her by the waist, and pin her against the wall.
Continue to stand on his own two legs and keep Arias pinned against the wall while allowing her to stab him 9 times in his back.
Back up some from Arias while keeping his grip on her and allowing her to stab him 4 more times in the head and neck -- he must have waited while she switched hands or stabbed him at a very awkward angle to get the opposite direction right - left upper head wounds.
And then he finally fell.
Methinks that Speights has been watching too many movies.
Let's use medical science and examine what would have REALLY happened in his scenario.
The adrenaline from Travis's heightened emotional state elevates his heart rate to about 110 BPM
Jodi shoots him, the pain response and shock of the gunshot wound elevates his heart more - 125 BPM
Travis starts to pour blood out of his nose and mouth. He becomes angrier. The emotional response increases his heart rate even more - 135 BPM
The blood loss is now about 250 ML.
Travis grabs at Arias and she stabs him. This pisses him off even further - heart rate 150 BPM
The large hole in the base of his skull causes the cerebral spinal fluid to leak out giving him an immediate agonizing postural headache. The result is more pain and a more rapid heart rate - 165
Jodi shoots him, the pain response and shock of the gunshot wound elevates his heart more - 125 BPM
Travis starts to pour blood out of his nose and mouth. He becomes angrier. The emotional response increases his heart rate even more - 135 BPM
The blood loss is now about 250 ML.
Travis grabs at Arias and she stabs him. This pisses him off even further - heart rate 150 BPM
The large hole in the base of his skull causes the cerebral spinal fluid to leak out giving him an immediate agonizing postural headache. The result is more pain and a more rapid heart rate - 165
The rapid heart rate of 165 from the combination of pain and a heightened emotional state make Travis bleed more. Prior to the stab to the vena cava his heart is pumping blood at 206 ML per second. The time to move from the first point of bleeding, the gunshot, to the end of the hall is about 25 seconds. At this point it's safe to state Travis has lost at least 1000 ML of blood.
The sudden loss of blood makes his BP start to drop. To compensate and ensure cerebral profusion, Travis's heart rate increases even more. His body is sensing the sudden blood loss and his heart is now pumping at 180 BPM.
Travis is stabbed in the superior vena cava. This thin walled vein begins to bleed profusely. As blood pours out the tear becomes even larger from the force of the blood pumping as is common with superior vena cava tears. Travis's continued movement causes this vessel to tear even more.
Travis is moving 225 ml of blood throughout his body per second prior to the throat slash. At least a third of that is coming out his wounds.
It takes Jodi at least 5 seconds to get the knife out of the ribs. At this point Travis has lost at least a total of 1500 ML of blood due to the expanding S. vena cava injury.
Travis's hands are on his chest to stop the bleeding, but this only causes the blood from the vessel to stay in his mediastinum.
Jodi takes this opportunity to cut Travis's throat. She cuts one of the major arteries supplying oxygenated blood to the brain in 1/2. This leaves the artery wide open thus as each second passes, Travis is losing a total of 225 ML out of the carotid. The brain is now only getting a portion of the blood and oxygen that it needs.
Jodi severed the trachea which impaired Travis's ability to breathe. This is NOT because of the open trachea but because of the blood that would be pouring down the wide open airway filling the bronchial tubes with thick sticky fluid. In just two seconds Travis has so much blood in his lungs they are no longer able to function to oxygenate blood cells.
Travis's brain is now getting no oxygen and only a portion of blood flow.
Within 4 seconds Travis has lost another 900 out the wide open carotid alone. He would have lost about another
300 ML via his vena cava injury and about 150 ML via the other wounds. That would mean total of 1350 ML within 4 seconds from after the neck wound.
Prior to the neck wound Travis had already lost 1500 ML.
1500 ml + 1350 ML = 2850 ML of total blood loss 4 seconds after the throat slash. Compound that with the severely low BP, the severe headache from the loss of CSF in the brain, and the lack of oxygen and Travis would have lost consciousness less than 4 seconds after his throat was slashed.
There is no way that he was functioning enough to pin Arias and receive those 13 extra stabs as Speights claims.
However, I am guessing that Speights will try to tell some story to show it is possible. He will most likely tell the story of hockey player Clint Marlachuk. In order to ensure the full story is given, I will tell it first.
The sudden loss of blood makes his BP start to drop. To compensate and ensure cerebral profusion, Travis's heart rate increases even more. His body is sensing the sudden blood loss and his heart is now pumping at 180 BPM.
Travis is stabbed in the superior vena cava. This thin walled vein begins to bleed profusely. As blood pours out the tear becomes even larger from the force of the blood pumping as is common with superior vena cava tears. Travis's continued movement causes this vessel to tear even more.
Travis is moving 225 ml of blood throughout his body per second prior to the throat slash. At least a third of that is coming out his wounds.
It takes Jodi at least 5 seconds to get the knife out of the ribs. At this point Travis has lost at least a total of 1500 ML of blood due to the expanding S. vena cava injury.
Travis's hands are on his chest to stop the bleeding, but this only causes the blood from the vessel to stay in his mediastinum.
Jodi takes this opportunity to cut Travis's throat. She cuts one of the major arteries supplying oxygenated blood to the brain in 1/2. This leaves the artery wide open thus as each second passes, Travis is losing a total of 225 ML out of the carotid. The brain is now only getting a portion of the blood and oxygen that it needs.
Jodi severed the trachea which impaired Travis's ability to breathe. This is NOT because of the open trachea but because of the blood that would be pouring down the wide open airway filling the bronchial tubes with thick sticky fluid. In just two seconds Travis has so much blood in his lungs they are no longer able to function to oxygenate blood cells.
Travis's brain is now getting no oxygen and only a portion of blood flow.
Within 4 seconds Travis has lost another 900 out the wide open carotid alone. He would have lost about another
300 ML via his vena cava injury and about 150 ML via the other wounds. That would mean total of 1350 ML within 4 seconds from after the neck wound.
Prior to the neck wound Travis had already lost 1500 ML.
1500 ml + 1350 ML = 2850 ML of total blood loss 4 seconds after the throat slash. Compound that with the severely low BP, the severe headache from the loss of CSF in the brain, and the lack of oxygen and Travis would have lost consciousness less than 4 seconds after his throat was slashed.
There is no way that he was functioning enough to pin Arias and receive those 13 extra stabs as Speights claims.
However, I am guessing that Speights will try to tell some story to show it is possible. He will most likely tell the story of hockey player Clint Marlachuk. In order to ensure the full story is given, I will tell it first.
Hockey player Clint Marlachcuk suffered a skate slice to his carotid artery, walked off the ice, and managed to live to tell about it. It seems amazing at first, but there is much more to the story that paints a picture as to why this was possible.
Clint's injury occurred very close in proximity to the team's trainer, Jim Pizzutelli. It just happened to be that Jim was an ex-army medic that recognized the gravity of the injury immediately. Jim knew that without immediate intervention Clint would die from extravasation. This lead Jim to meeting Clint on the ice and instantly reaching inside Clint's neck to pinch off the artery, thus greatly slowing down the bleeding. It is said that if the injury had occurred at the opposite end of the ice, Clint would have died.
However, the story does not end there. Jim held on tight to that artery as he assisted Clint off the ice. He refused to let go of that artery until the appropriate doctors took over. As the story goes, it is written that while waiting for help to arrive, the team doctor recognized that there was still a need to slow down the bleeding. He put an intense amount of pressure on Clint's collarbone inducing a reduction in his breathing and metabolic rate thus slowing the heart rate as well. Due to the actions of these two men, Clint survived. Travis was not so lucky. He had more injuries that caused him to pass out within seconds.
MORE EXAMPLES OF SPEIGHTS LACK OF MEDICAL KNOWLEDGE
Speights has a section on his prepper page titled "Medical knowledge". One would expect that given his history as an army medic, the articles presented would reflect a higher level of learning.
NO.
The subject of the only three articles:
Spitting
Hand Washing
Blisters
Even with subjects that are learned at the most basic level of medical education, he still does NOT get it correct.
Hand washing
Speights makes statements that suggest the idea that microbes cannot live long enough on a surface to infect a person.
Speights has a section on his prepper page titled "Medical knowledge". One would expect that given his history as an army medic, the articles presented would reflect a higher level of learning.
NO.
The subject of the only three articles:
Spitting
Hand Washing
Blisters
Even with subjects that are learned at the most basic level of medical education, he still does NOT get it correct.
Hand washing
Speights makes statements that suggest the idea that microbes cannot live long enough on a surface to infect a person.
Even though the most common method of transmission of microbes is person to person - microbes CAN and DO live long enough on non-porous surfaces to cause infection.
Avian Flu - up to 6 weeks
Swine Flu (H1N1) up to 8 hours
Common cold up to 3 hours
Samonella up to 4 hours
Avian Flu - up to 6 weeks
Swine Flu (H1N1) up to 8 hours
Common cold up to 3 hours
Samonella up to 4 hours
C-difficile (extreme diarrhea) up to 5 month
Norovirus (stomach 'bug') - "weeks"
MRSA - Weeks
Streptococcus pnuemonia (ear infections, pnuemonia, bacterial meningitis) weeks to months
Strepococcus pyogenes (strep throat, impetigo) weeks to months
MRSA - Weeks
Streptococcus pnuemonia (ear infections, pnuemonia, bacterial meningitis) weeks to months
Strepococcus pyogenes (strep throat, impetigo) weeks to months
TB : http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/tuber-eng.php
"SURVIVAL OUTSIDE HOST: M. tuberculosis can survive for months on dry inanimate surfaces (
18). M. bovis can survive on dry surfaces at 4oC (19). M. tuberculosis can survive in cockroach feces for 8 weeks, sputum on carpet (19 days) and wood (over 88 days), moist and dry soil (4 weeks), and in the environment for more than 74 days if protected from light (possibly longer if in feces) (20-23)"Because of the fact so many bacteria can live for such an extended period of time outside the body, there is a a high focus on preventative measures. One such measure is instructing people on PROPER hand washing techniques. These techniques are learned at the most basic level of medical teaching, yet Speights does not demonstrate that he is aware of the importance. He leaves out two important factors - when hand washing is a must and the proper way to do it to ensure the destruction of bacteria.
WHEN
* Before and after eating
* Before and after caring for the ill
* Before and after treating a cut or a wound
* After using the toilet or coming into contact toileting issues (diapers)
* After coughing, sneezing, blowing your nose or touching your face
* After dealing with an animal
* After touching waste
* Any time the hands are visibly soiled.
AND HOW:
* wet your hands with water FIRST
* wet your hands with water FIRST
* Add soap and lather every aspect of the hand including the front, back, between fingers, and the finger nails for AT LEAST 20 SECONDS. We teach to the tune of "Twinkle Twinkle Little Star".
* Rinse your hands well
* Dry using a clean towel or air dry them.
Speights adds that water should be as hot as one can stand for proper hand washing. This is not true. The recommendation is warm water. This is because of two reasons - 1: comfort, and 2: most soaps are designed to function best in warm water, although they still function adequately in cold.
Speights instruction on using hot water actually can increase the risk of infection. The skin is the first line of defense against infection, thus the idea is to keep it intact. The use of hot water removes too many of the skins natural oils. Without this natural oil, the skin dries and cracks. Those cracks open the body up to infection.
Speights writes:
* Rinse your hands well
* Dry using a clean towel or air dry them.
Speights adds that water should be as hot as one can stand for proper hand washing. This is not true. The recommendation is warm water. This is because of two reasons - 1: comfort, and 2: most soaps are designed to function best in warm water, although they still function adequately in cold.
Speights instruction on using hot water actually can increase the risk of infection. The skin is the first line of defense against infection, thus the idea is to keep it intact. The use of hot water removes too many of the skins natural oils. Without this natural oil, the skin dries and cracks. Those cracks open the body up to infection.
Speights writes:
He is incorrect in that statement too. It is the hydrophobic molecules of the soap that "lift off" the dirt and bacteria. The molecules combine with those of the dirt and bacteria and the water rinses it away. That is the reason that even with a good frictional scrub to break that water tension, water alone just is not effective.
I decided to focus on the fault within Speights's article about hand washing because hand washing really is medicine 101. A person of non-medical origin would not be expected to know that there is a right way and a wrong way to wash the hands for infection control purposes, but a medical person should. I am really quite concerned that Speights does not demonstrate this fact in his hand washing article.
Proper hand washing techniques are a big focus in the health care environment to prevent infection thus time is taken to ensure that health care workers understand the process.
It is engraved in a health care workers brain - water - soap every spot of the hands, front, back, sides, and nails- at least 20 seconds - rinse well - dry with clean towel. I just don't understand why such a basic procedure would be left out of Speights's article since he stated he used to be an army medic.
ADDENDUM: While working on another blog that is going to feature the multiple grammar and spelling mistakes Speights had made in his articles, I came upon something that made me gasp and turned my eyes to saucers. Speights has instructed his readers to do something that is VERY dangerous.
SPEIGHTS'S DANGEROUS ADVICE
But first, let me tell you the story of Josie Doe. Josie Doe was a person I got to know who ended up having a large portion of her foot amputated from what is called "Bathroom surgery". It seems that Josie Doe had a thick callous on her foot that she no longer wanted. So Josie Doe decided to perform bathroom surgery and slice away the callous using a razor blade -- AKA "Bathroom surgery". Josie Doe efficiently broke through that first layer of defense - the skin - which allowed bacteria to enter which caused a major infection in the foot. The bacterial infection was pretty aggressive and to save the limb, a large portion of Josie Doe's foot had to be amputated to get rid of the infection.
In his "advice column" Speights discusses blister care and the prevention of. He makes this statement:
PLEASE! I IMPLORE YOU! DO NOT LISTEN TO SPEIGHTS WHEN HE INSTRUCTS TO DO THIS!
The Cleveland Clinic is a top hospital in the nation and they strongly advise against this act as well. For full information: http://my.clevelandclinic.org/orthopaedics-rheumatology/diseases-conditions/calluses.aspx
.Mr. Speights is putting people at SEVERE RISK by suggesting such a thing. He needs to remove this dangerous advice from his blog at once. If anyone is in doubt of Mr. Speights's lack of medical knowledge, this should do it. He is not only giving incorrect advice, he is giving DANGEROUS advice.
Multiple MEDICAL sites caution against this type of "bathroom" surgery.
MAYO CLINIC - http://www.mayoclinic.org/diseases-conditions/corns-and-calluses/basics/lifestyle-home-remedies/con-20014462
"Don't use a sharp object to trim the skin. "
http://universitypodiatryassociates.com/corns.htm
"But don't cut corns or callus with a razor blade! Such bathroom surgery lets to serious cuts or infections"
http://eriepodiatrists.com/files/BayCity%20-%20January%202010%20Newsletter.pdf
“Bathroom surgery,” using a
razor or knife to “trim” or
remove the corn or callus is
dangerous and may lead to
additional problems.
"Cutting corns and calluses yourself (bathroom surgery) is not without it's dangers, especially if you cut yourself. In the warm and moist environment of enclosed shoes, infection can easily develop into a serious wound"
http://www.footfix.co.uk/callus.html
"This is not something to try with your handy razor blade at home. This type of “bathroom surgery” is likely to be ineffective at best and may even cause a serious infection."
It is quite obvious that a NUMBER of medical sites throughout the country and even in the UK say DO NOT CUT THE CALLUS OFF YOURSELF. I have been giving Mr. Speights the benefit of the doubt as to his proficiency as an army medic. However, with this latest discover of this dangerous advice, I am having strong doubts to that fact. It greatly concerns me that this man is giving such advice while saying he is an army medic. The wrong person is going to listen to him and end up with a serious infection. No one should ever follow that bit of dangerous advice presented by Speights --- but if that person happens to have diabetes.... SMH.... I am SICK... just sick that he is telling people to do such a potentially harmful and dangerous thing as an "army-medic". Those credentials have the potential of giving someone a false sense of security and may cause them to proceed with such a dangerous action.
PLEASE MR SPEIGHTS - REMOVE THAT DANGEROUS BIT OF ADVICE FROM YOUR SITE!!!!!!!
Speight makes this statement in regards to something he read about medical care:
" If it did happen, shame on anyone who dreamed it up, and shame on those who performed this procedure." I say shame on Speights for instructing people to do bathroom surgery!
I encourage ALL of you to read his article on blisters: http://www.herrspeightsventures.com/Blisters.php
This way you can see with your own eyes his dangerous advice:
I suggest this because I just don't know how else he can save face and remove it at the same time besides insisting that I made it all up.
I have a question -- Is there both criminal and civil legal ramifications if someone implies that they are competent to give medical advice by saying they were an army medic, and then instructs people to do a dangerous act?
A scenario for you.
One of Rich's readers takes a hiking trip. Let's call him Bob B. Bob B. is hiking and after two days he notices that even though he followed Rich's instructions on prevention, his boots are causing him discomfort. So, Bob B. examines his feet and believes it is related to a callus on his foot. The hiker decides the callus must come off so he takes that razor like Rich suggested and cuts off the callus. However, because Bob B. cannot see through the skin he goes just a little deep in one area of the large callus and causes an inch in diameter round open area in the skin. Bob B. slaps on some antibiotic ointment that day and decides to progress with the "once-in-awhile" dressing changes as suggested by Rich, the army medic.
Over the course of the following week, Bob B.'s foot has come into contact with multiple surfaces during the short intervals he has taken off his boots to give his feet a break from his boots. He continues to only change that dressing "once-in-a-while", which to Bob B. does not mean daily. At the end of the week, his foot with the cut of callus is red, hot, swollen and painful. Bob B. goes home and decides that he needs to stay off his foot for a couple of days, continue to use the antibiotic ointment, and change the dressing at least twice daily now.
Bob B. does this for two days and the infection is only getting worse. He decides it is time to see the doctor. The doctor takes one look at Bob B.'s foot and immediately recognizes a severe infection of the foot, suspects MRSA, and swabs the foot. She is concerned about the wound so admits Bob B. to the hospital for a course of IV vancomycin prior to getting the culture results.
The preliminary culture results come in the next day and show gram positive cocci in clusters, so the team treating Bob B. are pretty sure that they are on the right track with the antibiotic use. However, they have great concerns about the wound so they consult the infectious disease doctor to see Bob B. The infectious disease doctor suspects that this is no longer just a soft tissue infection, but has now progressed to osteomyelitis (bone infection).
The ID doctor discusses the wound with Bob B. She needs to know the history of the wound. Bob B. tells her about cutting off the callus and the course of the week. The ID doctor suspects that he came into contact with the MRSA bacteria by picking it off one of the surfaces he came into contact with but can't understand because it's not found in the dirt. It was a mystery to her with the information Bob B. relayed. However, if the ID doctor tested Bob B.'s hiking buddy that shared his tent, the mystery would have been solved. He was a MRSA carrier but had no idea that he was. Due to the close contact via sharing the same tent, he inadvertently spread the MRSA to Bob B.
The wound on Bob B.'s foot had progressed to the point that it needed to be debrided. The podiatry team was consulted and Bob B. had to undergo surgery to remove the dead necrotic tissue that was within the wound. After a 7 day stay in the hospital, Bob B. was sent home with a PICC line, an additional week course of IV antibiotic, and a stern lecture by all those involved of the risks associated with bathroom surgery.
The number one mistake Bob B. made was breaking that initial line of defense - using that razor to remove a callus. It is not possible to see how far down the callus reaches in any given area. This procedure is sometimes completed in the physician's office but by someone who has done it before and in a sterile environment -- you just cannot get the same effect out in the public.
Second, Bob B. set up the perfect environment for bacteria growth - the warm, moist, and dark enclosed area such as a foot in a boot. By only changing the dressing "once-in-awhile" Bob B. encouraged growth of bacteria resistance to the antibiotics in the cream.
Third, Bob B. was under the impression that antibiotic ointment would protect himself against all infections. However, it does not always work against MRSA. In fact, the overuse of triple antibiotic ointment in the states is causing many strains of MRSA that are resistant to it. It really is best to clean the wound well and to use an anti-microbial or hibiclens solution such as betadine (as long as there are no allergies) prior to the starting use of an antibiotic. Then, at first sign of any infection (redness, warmth, swelling, drainage, increased pain) start the antibiotic ointment twice a day.
And fourth, Bob B. did not understand that bacteria such as MRSA could be so easily spread via surface contact..... maybe it was something he read?
.
A REVIEW OF SPEIGHTS INCORRECT MEDICAL FACTS
Speights claims the superior vena cava is a major artery between the heart and lungs -- FALSE, it is a vein returning blood from the upper circulatory system
Speights claims the arachnoid mater is firmly attached to the brain and follows all folds (gyri) - FALSE, the arachnoid mater is a loose fitting sack.
Speights claims that ear bleeding is ALWAYS a symptom of and treated as head trauma - FALSE - the most common cause is a ruptured ear drum from a variety of sources.
Speights implies the bullet would more easily pass through the bone of the frontal sinus as compared to the rest of the frontal bone - FALSE, The bone over the frontal sinus is the hardest to break in the facial skeleton.
Speights implies that when describing the parenchyma of the brain the ME was talking about the lepomeninges - FALSE, parenchyma is a medical term used to describe the functional tissue of an organ.
Speights implies that it is procedure to describe damages to the dura mater, the arachnoid mater, and the pia mater in an autopsy report - FALSE, such actions offer no value of evidence to use in a criminal case.
Spieghts claims that after a mortal wound to the superior vena cava, multiple other stab wounds, a severed carotid, a severed jugular, and a severed trachea resulting in blood filled lungs drowning the victim, that the victim could remain standing and in the position of forced physical control after all the injuries - FALSE, The combination of injuries would result in Travis being incapacitated in less than 5 seconds.
Let's hope that in his next "Rebuttal" that Speights can offer verifiable medical facts to support his claims. However I suspect just more of the usual defenses filled with veiled threats of lawsuits, name-calling, and distraction attempts via changing the focus from medical to grammar.
END
