Monday, February 10, 2014

Jahi McMath: Frequently Asked Questions, Part II

 Alleged feet of Jahi McMath, in response to ice. Source: Video 
originally posted on a Facebook Jahi McMath support page.


This is Part II, of a two part series by T&T's guest writer, KZ, a Certified Registered Nurse Anesthetist. I asked KZ to share some of her thoughts on what might be happening to Jahi's body. Part I covered questions 1 and 2. You can find Part I HERE. Sprocket

Jahi McMath: Frequently Asked Questions, Part II

3. Where is Jahi? Could she be in someone’s private home getting care?

I haven't ruled out a private home setting either. Or perhaps a church building, etc.

They have a large following of supporters. Some of them are bound to be nurses aides, LPNs, or RNs. It is possible that they have accepted donated machinery, hospital bed, and supplies, and donated volunteer nursing services. That would keep costs down. And keep things very quiet and away from the media. The grandmother is an LPN-- she probably has a lot of connections to people who know how to do physical care. A small cadre of dedicated volunteers, who agree to keep quiet, could accomplish the task for a while.

I've cared for people on ventilators in the back of transport military planes, in the back of trucks, in tents, etc. If you know how to set up some equipment, oxygen, meds, IV's, and work out the electrical and oxygen issues, etc, it wouldn't be hard to set up a place to provide custodial care to a body, especially if it were classified as a home care situation. That is essentially what the "facility" in New York was going to do. I imagined that they were going to put her in an empty office space at their main building (the one without automatic doors, lol!) if she ever arrived there.

I do think the coroner knows where they took Jahi's body. I think that was almost certainly part of the arrangement to release her body to Mrs. Winkfield. It's standard procedure when a body is released to family members for transport, or for religious/ cultural rituals, etc. Basically, the receiving person has to fill out forms and disclose what they intend to do.

I think we will continue to hear occasional social media reports of "She's doing great! She's healing every day, and responds to her mother's touch", right up until the day that it is announced that she has been called home to be with God. I expect there will be an enormous funeral, eventually, with thousands in attendance. They do have a really amazing number of supporters, whatever we may think about that. Since everything they are doing is framed within their faith, there is no way for them to lose face within their religious community of supporters, IMO. If she rises up and lives, prayer worked. And if she doesn't, then God called her home, and they will continue to praise God. Their supporters will be there for Mrs. Winkfield's emotional needs when the time for the funeral comes, I think. 

But then I think that they will immediately become immersed in the process of litigation, which will go on and on for years on end. I really hope the other kids are having their needs attended to, and have returned to some kind of regular routine. Sadly, instead of mourning their sister, I think that this atmosphere of prolonged "conflict", followed by litigation, will define their childhood. I feel like their identity has been buried in all this, with all of the adults around them focused on prolonging the "conflict". Jahi might actually BE the only one in this whole mess who is "healing". JMO.

4. What kind of care would Jahi’s body need, wherever she is? Is she just laying there like she is asleep? Does she look normal?

Just a guess, as I have no earthly idea what they really are doing, or hope to accomplish.

My best guess is that Jahi's body is not receiving the same level of care and monitoring that is "possible" in an ICU setting, or even a med surg bed in an acute care hospital. If I had to generalize, I'd say what they may be doing could be classified as "custodial care" or possibly palliative care (though palliative is an odd descriptor for a patient who is deceased).

There is an adage in palliative health care that you don't do a test if you don't want to know the answer (meaning, you don't intend to treat).

I could be wrong , but I think any labs potentially being done would probably be "bedside" labs, such as a urine dipstick, urine specific gravity, or a fingerstick blood glucose. As far as "send out" labs to monitor kidneys, liver, etc, I doubt that they are doing this. A LTC center would not have an in house lab, so would have to send out. (And may not have in house ability to draw labs into the proper tubes, etc.) If she is at a private home, same. And whose name would be put on the send-out lab tubes? The bigger question is what would be done with abnormal results? It's not like they are going to put her body on peritoneal or hemodialysis if her kidney function is wildly abnormal. I think they probably have a very limited ability to correct electrolyes. I suspect her liver function tests would be pretty abnormal at this point.

I know a body has diabetes insipidis for a "while" following brain death, but I have no idea if it continues beyond 6 weeks to 2 months duration? If she is still having DI symptoms, they might "chase" it with vasopressin to slow down how fast she is losing fluids, and try to keep her BP up, but if her kidneys are in the process of shutting down, I could also see retention of fluids and low urine output. They might be giving her thyroid hormones, but the dose wouldn't necessarily be dependent on a lab value. All this is dependent on a doc to write a prescription, and a pharmacy able to fill it.

Her heart is only 13 years old, and even with the cardiac arrest, must still be in good enough shape to pump regularly and sort of effectively without too much intervention. Pre load and after load is a big issue, as her body has lost the ability to regulate the expansion and contraction of her peripheral circulatory system. I doubt they have ability to do hemodynamic monitoring beyond external BP (blood pressure) cuff pressures. 

She may or may not have a central IV access line, but I doubt they would use it for central venous pressure monitoring. I seriously doubt she has an arterial line for BP monitoring and blood gas analysis, so any ventilator setting changes would be based, probably, just on physical symptoms, perhaps end tidal CO2, and pulse oximetry. And "guesswork". 

I suspect her body is refractory (less able to respond) to a number of vasoactive drugs at this point. She may no longer be responsive to vasopressin. Who knows? There aren't too many health care providers who are "experts" at caring for brain dead patients 2 months out from brain death.

I highly doubt she would be a candidate to receive blood products, so monitoring those labs might be kind of pointless.

I think they probably provide hygiene care, skin care, turning, bathing, mouth care, lubricating eyes, trach care, peri care, etc. All that is fairly straight forward, and doesn't require a high level of skill, except trach care. I think she probably has lots of lung issues at this point-- even with antibiotics. Lots of atelectasis (small airway collapse) fluid filled areas, "pus" and either dried out thick secretions, or soupy secretions. She has no ability to mobilize secretions, so is dependent on suctioning, aerosolized humidification and medications, and maybe lavage (fluid instilled to thin secretions). They might be dripping some tube feed solution into a PEG. They might be giving IV vitamins or hyperal (TPN), and/ or lipid solution. Who knows what their capability is?

I do know that she will progressively deteriorate. Her periphery, in particular, is vulnerable to dehydration (tip of nose, lips, ears, fingertips, toes), as well as poor circulation. Eyes are vulnerable to drying out and becoming gummy on the surface, and would need protection and frequent lubrication. Her gums and the lining of her mouth may slough. Fungal infections, like thrush, are a constant issue, and she may have a coated tongue (white patches), or it could be blackened if her mouth is open all the time, or may look sort of normal. (There is only so much you can do with a sponge on a stick and a toothbrush.) Areas of skin compression may not have circulation restored just by turning her in bed. (I don't want to think too much about perineal care issues, but things like fungal infection is a realistic issue down there, too, along with urinary tract infection, etc. She may have a urine foley catheter, or be diapered. There may, or may not be bowel issues.)

And then you also have issues of contractures from immobility. Hands and wrists would need to be splinted, in normal position, as well as have range of motion. Needs heel protectors, and foot drop splints, in addition to the sequential compression devices seen in the video. All of the physical care that would ordinarily be given to someone with PVS or comatose condition.

From CHO report, she was very unstable just with turning. I can't imagine doing upper and lower body range of motion twice a day or so, with all of the issues. She may be quite stiff in her limbs, joints, and spine. (Not rigor mortis, just stiffness from immobility.)

I would be very curious to know the date of the video posted on Facebook, then abruptly pulled. If it was recent, her feet look to be in better condition (better hydration, no foot drop) than I would expect. My strong suspicion is that the video wasn't from last week. Why would anyone go to such measures to conceal the embedded data? Almost seems like it was baiting for some kind of response, but unwilling to provide details to authenticate. They could have posted it as a private video, and given the access code to people they approved-- but didn't.

The way that video was posted, altered in the embedded data, then abruptly pulled, seems very manipulative, IMO.

Organ systems will shut down. How long that will take is any one's guess. 

The above is my best guess. I'd be interested in hearing any other health care professionals opinions, too.

5. Are there any odors because she has been dead so long? Is her body decomposing?

One thing that is a bit of a blessing about "odor control" is that Jahi's body is on a ventilator. The breathing circuit is "closed"-- meaning, both the inhalation and exhalation takes place inside of hoses that are not open to room air. The lung secretions are likely to be a dominant source of bad odors at this point, very icky and infected smelling. The circuit on her trach will somewhat contain these odors.

When someone on a ventilator has a breathing tube inserted through the mouth, or as a tracheostomy, the suction catheters can be contained within this closed circuit, with a type of sterile plastic sleeve over the catheter. This is usually the method used in a hospital situation. This way suctioning can occur without disconnecting the circuit every time, thereby the patient has decreased exposure to infection, as well as the staff having less contact with secretions.

There are also suction catheters which require the circuit to be removed from the trach every time, and a clean or sterile catheter is used. A lot of people with long term home ventilator care situations don't need to practice "strict" sterile technique, but instead use "clean" technique.

For those interested, here are some pics of suction catheters, and a guide to "home care" suctioning of pediatric trachs. The procedure is pretty much the same for kids as well as adults. There are some risks with suctioning-- and prolonged or inappropriate deep suctioning can cause low oxygen conditions, as well as serious and abrupt slowing of the heart rate, with abnormal rhythms. Jahi's body can't cough up or mobilize secretions, so she would have to have deep suctioning to get the gunk out. She also can't cough or react to suctioning, so while she may have heart slowing or oxygen issues, it wouldn't cause her distress. Long term scarring of her lungs from deep suctioning probably isn't much of a concern, since she is deceased, and we are waiting for her heart to finish.

Her PEG probably isn't all that smelly, unless the insertion site has infection. AFAIK, she has no major sources of open infection, like deep bedsores, or infected surgical wounds. Her mouth has no "breath" going in and out, so it may be somewhat smelly if you are close enough, and her mouth is open. (We have a saying in anesthesia that "bad breath is better than no breath at all".) 

We can all imagine the types of odors produced "down below". Many of the odors of the bed bound can be controlled with scrupulous hygiene of the body, prompt changing and replacing of soiled linens, prompt removal of medical equipment containing secretions and body fluids, and odor masking things like scented body lotion, air fresheners, etc. This is a great deal of work, by the way, and requires very dedicated caregivers.

In my experience, comatose patients do have a type of "sickness" odor emanating from the skin itself, but if you are motivated enough, you can manage (but not eliminate) all of the odors associated with a comatose, bed bound patient. It is a lot of work, though. (IMO!)


wonderingone said...

Thank you so much for taking the time to provide this very enlightening information! As terribly sad and wrong as I believe what they're doing to be, it is a fascinating intellectual and spiritual exercise.

I know the buzz was that UCSF did the trach and the feeding tube and we don't know who is providing the care now. Do you see any ethical problems with a licensed physician or RN being involved in her care? How about an accredited facility? And if she's not being cared for at home, how in God's name have they kept it secret this long?

Again, thank you so much for sharing your time and expertise

KZ said...

Thank you for your comments!

There is something that occurred to me a couple of weeks ago, when everyone was speculating about who may have done the trach and feeding tube placement.

Jahi is officially dead. Therefore, there is really no need, or requirement, to keep any "official" medical records anymore. That includes medical records of the trach and feeding tube placement. That also means that, if I understand the legal implications, there is no mechanism to bring any medical negligence (malpractice) complaints for care rendered after she was pronounced dead.

It is entirely possible that a currently licensed and practicing physician (or 2) performed the PEG and trach, either alone, or with a tech or nurse to help.

If that did happen, the person/s likely quietly volunteered their services (as you can't really charge for medical services for a dead patient, either.)

And if the procedures were done in a licensed facility, they wouldn't be able to charge for them, either. It does present a bigger set of circumstances, the more people who participate in the procedures (nurses, techs, etc.)

If it was done in a licensed facility, of course the hospital admin would have to know and approve. I would think that the attorneys would have to draw up something like a "consent" form and a "hold harmless" clause that says the family understands that there is no guarantee of outcomes, that they can't engage in civil actions for medical negligence, or something like that. I really have no idea what would be involved at a legal level.

One could also argue that the procedures were "post mortem rituals", and not medical care.

No matter how it was done and justified, I'm sure the coroner/ ME had to approve ahead of time.

It's also remotely possible, I suppose, that a medical examiner placed the trach and PEG. Who knows? It's interesting.

Where ever her body is, they have done a remarkable job of keeping it all quiet. I'm actually okay with that. This has been enough of a circus.

Because of the way this family has acted in the last 8 weeks, I highly doubt that they will keep silent when her heart stops. I doubt that they can conceal that from their many supporters. I think (hope) there will be a nice memorial service and funeral to honor her, eventually.

Anonymous said...

I just want to say that you have done a wonderful job with these articles. I really appreciate you taking the time to explain these things to us laypeople.

smalls777 said...

Where did you hear ucsf?? I'm in the area, and have not heard any involvement by ucsf. I also would be shocked such a reputable hospital would do this.

Thanks kz. You have stirred my brain up back to my nursing school days

Anonymous said...

I heard the UCSF rumor also and the person it came from did not sound like they knew what they were talking about. I don't think UCSF would go near this situation.

Unknown said...

Very insightful, as a mother myself, I cannot imagine how Nailah can put Jahi's body through this. But then again, we are talking about a woman who jokes about Jahi losing weight on Uncle Beast's latest Instagram post.

wonderingone said...

I think the coroner did some special "carve out" for this case. Because it was such a political hot potato the Alameda Co Coroner's Office must have. I remember years ago I worked in an East Bay hospital. It wasn't a trauma center but we would get the occasional GSW thrown out of a car on our ramp. One night they were working on a guy and the ER doc had ordered a CT right before he coded. For some reason...I can no longer remember why, they went ahead with the CT scan. Oh brother, it caused all kinds of problems. The cororner's office was angry and administration was angry and I do remember that it was because of some issue with performing a service on a dead person. Might have really had more to do with mucking up a crime scene, though, not that I remember the Alameda Coroner being particularly fastidious about "crime scenes" ugh.

Another thing: Sometimes when someone being coded died in the ED, the attending would "allow" a resident to "finish" a procedure for training purposes. Not sure this is "kosher" but it did happen. So I do know that procedures are sometimes done on the recently deceased...or at least they were years ago in the interests of training new docs and medics

Anonymous said...

Thank you very much for this series of articles, without question the best and most informative. Have followed your blog as soon as a link was provided in the comment section of mainstream news.

So two months later I'm still interested and still wondering about Jahi and her family, and following the links from your blog which I hadn't read yet. DocBastard gave a link to this study and I am quite curious. (apologies for not remembering how to hyperlink)

From my reading of it, it mentions that 9 out of 10 pregnant and brain dead women, were carrying boy fetuses. I'm wondering if part of the reason such heroic measures were taken to save the fetus, was because they were carrying boys. After all, the ratio is 9 out of 10 boys, not 50-50 as one would expect to match the standard male-female ratio. What do you think?

The other thing, is that after reading that study twice, I still can't figure out how many of the fetuses who were "born" actually lived past the infant stage. The study talked about 4 dying in the womb, and most dying after "birth"? The study also mentioned that only 2% of those that lived for any length of time, were without serious handicap.

First there's the money aspect -- is it truly reasonable to spend who knows how much, to "save" a child who has a 98% chance of a serious handicap, of the ones who even live at all? And secondly, it's just incredibly disgusting to me, that anybody thinks it's appropriate to literally use a woman's dead body as if she's nothing more than a mechanical incubator. If she's brain dead, then she's ALREADY donating the use of her organs to the fetus. If she didn't sign the organ donor card, then the fetus isn't entitled to the use of her body after she's "done with it". Call me a tin-foil hat crazy person all anybody wants, but where is this going to end? Will medical science progress to the point where any brain dead female who signs a donor card is considered fair game, and our non-pregnant uteruses at the time of our death, are used to incubate random fetuses which were created in a lab?

ALL of that creeps me out, which is most likely the primary reason which explains why I can't let this story go. Dead bodies need to be buried and left alone, not used for frankenstein experiments. Okay, I'm ranting, apologies for that, but I am wondering if you or anybody else on this knowledgeable blog has an opinion and/or a response?

CaliGirl9 said...

Wonderingone, when I was still working as an RN in the small community hospital in rural California, that very “finish the procedure” stuff happened more than I care to admit. I think the worst one was on an elderly woman who was a long-time patient who was in and out of the hospital due to heart disease. One afternoon she coded, and the ER “doc-in-a-box” came up to run the code. Most of us RNs had completed an ACLS course weeks before, so we pretty much ran the code, which included meds, defibrillation and intubation by a CRNA who was onsite.

We were not able to establish a rhythm, and the doctor pronounced her dead. Then he turned to us, laryngoscope in hand, and asked if any of us wanted to practice intubation techniques. We were all numb from losing this patient, many of us were friends with her daughter. We refused to participate.

As we were turning off the monitors, her heart started beating again. The doctor pulled the ET tube, and within 5 minutes she was talking. She did leave the hospital alive, but died for real a few weeks later.

I just have a hard time picturing any ethical RN participating in the ongoing care of Jahi’s body. I wouldn’t even consider it ethical to teach an unlicensed person how to do something as simple as change an IV bag, or empty the Foley catheter bag. But maybe that’s just me. I had a hard enough time learning how to do sutures using medical cadavers at UCSD over 20 years ago… and those were bodies who had willingly donated their remains to medical research.

I cannot imagine a facility such as UCSF or even Stanford touching this with a ten-foot pole. I prefer the idea of some rogue doctor from the Byrne school of "she's not dead" doing his or her thing, believing what is being done is "God's work."

Anonymous said...

Could it be that Jahi's body has been "donated to science" and is in New York after all?

Johnathan Fellus and others from the International Brain Research Foundation claimed in the media that they were on their way from New York to CHO to examine Jahi and have successfully "treated" others deemed "brain-dead" and in comas. (A contradiction, I know!)

Frankly, I could see that a hyperbaric oxygen chamber might help stave off necrosis for a while with a corpse, but not do a darned thing at all for a brain that has been liquifying (dead) for over two months now??? (Or any of their other so-called therapies/treatments for that matter)

I followed your wiki "quakery" link and from that, found another very interesting and informative website called "Quackwatch".

IMO...some of these "doctors" involved in Jahi's "after-care" should at the very least, have their medical licenses revoked!! (SMH)

Rest in Peace, Jahi.

KZ said...

Thanks for the comments, everyone.

I'm on the go at the moment, but wanted to leave a couple links that some readers might find interesting. This first one is an online discussion among physicians about the issues surrounding uncooperative families and the brain death of a loved one. I think it is quite illuminating, but be advised the language is very blunt among these professionals. It is a great chance to be a "fly on the wall" as they discuss.

This second article talks about continued treatment of the brain dead person, for the benefit of the family.

g kuzma said...

Dear KZ,

Thanks for the articles you posted. I read the top one beginning to end, and found it very enlightening. It really puts in perspective how utterly bombastic Nailah Winkfield's behavior was. These doctors talk as if the right and responsibility of doctor's to turn off the vent when a person is brain dead is unequivocal and well-established in the law. People who won't accept it are contraverting our legal system and the system of ethics that guides our country's medical delivery system. Jahi's family's behavior was far worse than anything described by those doctors. I am really amazed that they took it so far, and even went back on their own agreement to accept the sixth doctor's opinion. The docs in that discussion question whether two opinions are needed, and they say there comes a time when you just inform them it will be turned off and let them deal with it. How Mrs. Winkfield managed to domineer an entire hospital staff is quite beyond me.

Your Q&A articles have also renewed in my mind the question of how on earth they are paying for all this.

It will be interesting to see if/when they ever inform us about poor Jahi's interment. Can they admit they were wrong?

Unknown said...

Just finished reading the page discussing uncooperative families. Wow, what a difference. It really highlights what an odd ruling the judge in Jahi's case made to keep her on the ventilator for those extra weeks. I can see his ruling making things much more difficult for doctors in the future when faced with angry families who think they can refuse to "allow" hospitals to disconnect the vents from people who have died. What a mess this case has made.

smalls777 said...

Reading the link from kz, I really wonder why CHO didn't just turn off all equipment like other MDs mentioned in the first link. What's the worse that could happen? They sue? At least they would have lost their case, just like the shaken baby. And a judge would have followed the law and told them "they did the right thing..." End of story. This case allowed judge to change the perspective and NOT follow law. they only thing they may have gotten was the "chump change" uncle was so passionate a out. No more fighting, no lifeless body in limbo somewhere.

Anonymous said...

KZ, Great find on the link about uncooperative families. It's spot on in pinpointing how Jahi's case went off the rails.

It seems as if CHO should have just stood firm even in the face of threats of legal action since brain death is legal. I can't help but wonder if the family also used race to further manipulate the situation as one of the physicians in the article mentioned.

From what the physicians were saying and certainly as demonstrated in Jahi's case, the longer they wait the more hardened the position of the family becomes that they have to give permission to turn off the ventilator when that isn't what the law requires. I also think Jahi's case could be used as a threat by other families in the future just like the baby's case referenced in the link.

I wonder what some of the physicians commenting would say about what happened in Jahi's case?

Anonymous said...

I so hope she's not at home with her little siblings. Having a corpse in the house would be terrifying.

Sprocket said...

Dear readers:

Lets leave the Twitter crickets on Twitter.

Thank you!

Unknown said...

One question for KZ: With Jahi's systems breaking down, is there any danger to family members due to bacteria? Does the decomposition process result in any nasty germs that would be a health threat to others around her?
My suspicion is that one of the reasons we bury/creamte the dead (beyond religious or cultural reasons) is that having decomposing bodies laying around would be a threat to the public health.

Anonymous said...

Yesterday KTVU reported that anchor Frank Somerville got an update from Mrs. Winkfield about Jahi. I'd summarize or link but I'm on a virtual keyboard and can't type well on these things. Letter also reported in SF Chron and LA Times. "She is much better physically ... and I see changes that give me hope."

McLelland Family Blog said...

Thanks for your awesome FAQ. I'm a parent of a long term trached kid, so I've been following this story in total bafflement as it played out.

My son lived in a Bay Area subacute care facility until he was 9 months old, and the facility where he lived was one of the "undisclosed local facilities" that turned down Jahi for admission. The facility takes plenty of discharged kids from Oakland Childrens and the other big hospitals in the area, so the family may have even been in contact with other families from the subacute.

The subacute in question provides excellent care (to live children, of course).

Would you have any interest in a guest post addressing what trach and trach-vent kids really are? I feel like the Jahi case gave the impression that the trach is appropriate for brain dead patients (it is not) and that the rest of trached kids are somehow similar to a brain dead patient (they're not).

* for reference, my kid is not even remotely brain dead, he's trached due to craniofacial malformations, and formerly vented at night due to having sleep apnea, now fortunately resolved. He'll be totally fine, eventually, probably.

Anonymous said...

The money must be running out. Why else issue an unspecific letter with vague generalizations.

Sprocket said...

Dear T&T Readers:

First, I know I am behind in updating the Jahi McMath Quick Links page with the latest news reports over the last week or so.

I've been busy helping Mr. Sprocket with his business and working on my own sewing business. I thank you for your patience and hope you understand.

Second, I received a timeline a few weeks ago, that one of T&T's readers put together. They are a great contributor in the comments, yet did not want credit for the work. T&T is grateful for the time and energy they put into this project. I still have to go through it and verify information and links. Once that's done, it will probably be posted as a separate Quick Links entry, that can be edited as more information is added and confirmed.

Third, I don't know what to think about the letter that is supposedly signed by Jahi's mother. I'm still pondering that. What are your thoughts on that?

Finally, Please remember that our contributors and guest writers donate their time to T&T. No one is paid a salary.

It should also be noted that although most of T&T's writers choose to write anonymously for their own privacy, they are not anonymous to me. I know the real name of each guest writer. I also have verified that the legal and medical professionals who contribute entries are licensed professionals. And although I write under a moniker, I have never been "Anonymous." My real name (Yes, it REALLY IS Betsy A. Ross!) is posted on T&T's ABOUT Page. There you can see T&T's complete masthead as well as a bit of information about me.

T&T would again like to thank our readers for all the help we receive with links to stories and relevant information.

For those of you who don't wish to leave a comment but would like to ask a question privately, you can always email me at:

sprocket.trials AT


Anonymous said...

Here is some of the letter posted on Facebook and Twitter,
In a Facebook message posted Wednesday, Jahi's mother, Nailah Winkfield, wrote that "despite what people say about my daughter being dead and how I must be ignorant not to get that, I can tell you that she is much better physically since she has left Children's Hospital and I see changes that give me hope."

She went on to thank people "who view my daughter as the sweet, innocent, 13-year-old girl that she is and not a dead body or a corpse, I deeply appreciate that."

I really find it very hard to understand this woman and why she is doing this to her daughter. The condition Jahi is in must be very poor at this point. And what about the siblings?

Anonymous said...

Here is Jahi's mother's comment in its entirety. To me it reads as if it was written by a PR agent.

A letter from Nailah;

It has been over a month since I have spoken about my life with Jahi to anyone outside a very small circle of family and friends. So many people have asked how we are doing and if Jahi is alive. This has and continues
to be an unbelievably difficult time for me as a mother and for us as a family. I have withdrawn for reasons of safety and privacy and to focus on my daughter and my role as her mother. However, I have not been alone. I
have been surrounded by the love, support and prayers of so many kind people. Despite what people say about my daughter being dead and how I must be ignorant not to get that, I can tell you that she is much better physically since she has left Children's Hospital and I see changes that give me hope.

As I prayed today, I felt called to express to people that I am truly grateful for the amount of love and support my daughter Jahi McMath and I have received from people all over the world. We feel your prayer and support. Because of your unselfish generosity I was able to do what I was
afraid I would never be able to do, move my daughter from Children's Hospital Oakland before they removed her from her ventilator and stopped her heart. This was itself a miracle. Please know that all of the support we received has been used towards helping Jahi. If I had it my way, I would say thank you to each and every person in their native language so they could understand how much I appreciate them for all their support and, most importantly, prayers. It is my belief that faith in God,
your prayers, and the incredible kindness of good hearted medical professionals, are the main reasons my daughter is alive today. I know people are concerned and I want to make sure you know that Jahi is not suffering, she is surrounded by love. I will never let her suffer.

On the long hard days when I'm feeling down I think about all the people who are praying for me and Jahi and I feel so much better. I want you to know that I'm praying for you as well.

Thank you to all of the people who view my daughter as the sweet, innocent, 13 year old girl that she is and not a dead body or a corpse, I deeply appreciate that. Thank you to everyone who hasn't forgot how my daughter
got into this situation in the first place. No one should have to go through this.

I would like to thank all of the people who have reached out to me and shared their stories of their family members. Some have been heartbreaking, some have given me hope. All have helped me feel that I am
not the only person who has had this struggle. Some of you have shared how you fought for your loved ones and they got better, some of you have shared your regret with not fighting more and some shared with me the incredibly difficult decisions you made to let go. I have prayed for you as you have for me. Sadly I can say I know how you feel.

I also want to thank those who felt the need to go public with their opinions about me and my daughter, positive and even negative. It is because of you that my daughter's experience is so relevant and that people
all over the world know who Jahi Mcmath is. What you may not know is that her name, Jahi, means one who is known by many. Hopefully my daughter can
change some of the ways brain death is viewed in today's society. Honestly, I think she already has.

Finally, thank you for all the love, support and prayers you give Jahi every day. I am certain that she knows you are praying for her. I feel the support from your prayer all the time. I don't think I or Jahi would be here today without you. May God bless all who have shown love and
compassion as well as those who have expressed their contempt. All are deserving of God's grace and love. For those who believe, please, keep praying for Jahi. God can overcome all things and I believe that his will has yet to be fully revealed. I love Jahi and where there is love, there is hope.

Nailah Winkfield , Jahi's mom

one_blogger said...

Yes, that very well-written letter was not written by Nailah. PR firm or a collective of the Dolan Law Office for sure. Mom doesn't have an education and speaks poorly. I also think the timing, once again, is transparent. Donations were drying up as people slowly came to realize what 'brain death' is and began to see the family as money seeking psychopaths.
Also of interest is the reference to 'native languages' and 'people from all over the world'...this seems to imply that they're reaching globally for donations now. It's all quite obvious to most by now how ugly this familly is and how Jahi has been victimized and used as income. So sad and angering. I hope, as someone else mentioned, that this woman's remaining children are taken from this abusive family by CPS and placed into a caring, warm and healthy family so that they too don't become 'sick' like Jahi was and psychologically wounded for life.

Anonymous said...

Interesting quote in Nailah's letter: "Please know that all of the support we received has been used towards helping Jahi."
How exactly did playoff tickets for Uncle help Jahi??

Anonymous said...

I found this article, it says the family is going to receive an award from the Terri Schiavo foundation.

Anonymous said...

The fact that press releases & videos from the family have all but dried up lead me to believe the Jahi's body has deteriorated to the point where even they are having trouble finding something good to say. As others on this blog have stated, there has been no independent verification of her body's condition since the move from the hospital. We are going on 3 months since her death - at what point do these people stop expecting a miracle?

Anonymous said...

If the family is preparing for a lawsuit, I would think that they would be sending out "progress" reports daily or weekly at the very least. Perhaps they have finally confronted the fact that Jahi is dead and has been dead since December and are trying to figure out how they can spin it so that they still have a malpractice case against CHO.

Anonymous said...

I just found an article in the San Jose Mercury News that details an investigation into the conduct of CHO regarding the McMath case. Here is the link:
href="">State Releases Report

Anonymous said...

The uncle is now claiming that Jahi is actually tossing and turning in her bed, looks healthy and is showing signs of awareness. Incredible (literally).

Kimberly said...

After reading the article about the investigation report, it's not surprising that Dolan was unhappy with it. If I had to guess, I'd say he was hoping the investigation would bolster any case he hoped to bring against the hospital. A quick check of the go fund me page shows that the balance has been holding pretty steady in the $59,000 that may definitely explain the claims in the second article.