Pull up a chair in my domestic church and let's chat!

I have worn many labels (Not in any particular order): Catholic, Wife, Mom,Gramma, Doctor, Major, Soccer Mom, Military Wife, Professor, Fellow.

All of these filter my views of the world. I hope that like St. Monica, I can through prayer, words and example, lead my children and others to Faith.
"The important thing is that we do not let a single day go by in vain without putting it to good use for eternity"--Blessed Franz Jägerstätter

Thursday, April 30, 2009

What Would Mom Do?

My 21-year-old son just got a part-time job doing before school childcare. He is responsible for waking up two elementary school aged boys, feeding them breakfast, and getting them on the school bus. He came home the first couple of days shaking his head. “I have to say everything in triplicate!” I am not very sympathetic. In fact, I think my response is tinged with a bit of shadenfreude. He is caring for two boys who are in first and third grade. I remember those days. But when I had two boys that age I also had a pre-school daughter and another infant son. Only having to say something three times sounds pretty efficient to me.

This morning he came home feeling somewhat jubilant. He is making inroads in the child management process. He recounted this morning’s breakfast scene:

I made toaster waffles for breakfast as their mother had instructed. The youngest whined, “I don’t want to eat waffles again”. I told him to eat them. He said, “No!” I told him to eat them again. He said, “No!” again.

Seeing that this was not going to get us anywhere, I thought, ”What would Mom do?” So I told him, “Eat half the waffle”. He did. Then I told him to eat one more bite. He did. Then I told him, “Look. You only have two more bites left. Just eat those.” He did! He ate the whole waffle.

He then looked at me and said, “You manipulated us like that didn’t you?”

Who me?! I just smiled. No need to give out all the secrets at once.

Wednesday, April 29, 2009

Books for Confirmation Gifts

Check out my article at to see my picks for books for Confirmation Gifts. Do you have any favorites?

One More Chick Retrieved

I am a happy mama. I have three of my four chicks home in the nest. I drove up to Baltimore today to retrieve my daughter. She was supposed to fly in yesterday, but the severe rain and flooding in Houston kept her from getting to the airport. She brought the rainy weather with her as she traveled northward but we did not get near the deluge that Houston suffered.

We are all snug at home now. It felt great to set one more place at the dinner table. It may be cloudy outside but I am feeling all sunshiny in my home.

Tuesday, April 28, 2009

A Feast for Tough Economic Times

Friday is the Feast of St. Joseph the Worker. This is a good feast for tough economic times. Take a look at my article at to find out more.

Monday, April 27, 2009

The Washington Post Gets One Right

I subscribe to both the Washington Post and the Washington Times figuring if I read both I can sort the truth out as somewhere in the middle. Today, however, the Washington Post offers an editorial on health care reform that is spot on:

For liberals, labor unions and others pushing to make health care available to all Americans, however, the fixation on a public plan is bizarre and counterproductive. Their position elevates the public plan way out of proportion to its importance in fixing health care. It is entirely possible to imagine effective health-care reform -- changes that would expand coverage and help control costs -- without a public option.

The Washington Post has rarely met a big government option it has not embraced. Yet even the Washington Post is questioning the wisdom of government run health care. You can read more of my thought on health care by following the health care link on the side bar under serial posts. I do see a role for government, but it is as a safety net, not as a primary provider. You can read about that here and here.


The white wisteria is blooming. I wish I could share the amazing perfume with you. Athena, my labradinger (labrador and springer spaniel), is enjoying the cool grass and heavenly scent as well.

Thursday, April 23, 2009

Thomas Sowell on Medical Care

Thomas Sowell has some very wise words on the health care reform rhetoric that is emanating from the Obama administration Do follow the link and read his whole essay but here is a snippet:

People who believe in "universal health care" show remarkably little interest — usually none — in finding out what that phrase turns out to mean in practice, in those countries where it already exists, such as Britain, Sweden or Canada.

For one thing, "universal health care" in these countries means months of waiting for surgery that American get in a matter of weeks or even days.

In these and other countries, it means having only a fraction as many MRIs and other high-tech medical devices available per person as in the United States.

In Sweden, it means not only having bureaucrats deciding what medicines the government will and will not pay for, but even preventing you from buying the more expensive medicine for yourself with your own money. That would violate the "equality" that is the magic mantra.

Those who think in terms of talking points, instead of trying to understand realities, make much of the fact that some countries with government-controlled medical care have longer life expectancies than that in the United States.

That is where the difference between health care and medical care comes in. Medical care is what doctors can do for you. Health care includes what you do for yourself — such as diet, exercise and lifestyle.

This has been my concern as well. There are lot of people claiming we need universal health care but no one is explaining exactly what that means. We are hearing a lot about the numbers of uninsured but we are not hearing exactly what are the ill effects directly related to this lack of insurance that will be remedied by universal health care. Give me data. Is our infant mortality rate linked to a lack of insurance? Do we have children failing to get immunizations due to lack of insurance? Americans survive cancer and chronic illnesses like diabetes better than citizens of other developed countries.

I agree that there are real issues with our health care system. But we need to specify exactly what is broken and exactly how our actions will fix the problem. Health care reform will mean change. Not all change is good.


I do not want to trivialize the scandal of Notre Dame giving President Obama an honorary law degree, but this comment from Julianne Wiley at Amy Welborn's blog made me pause:

I very much doubt that Notre Dame would have invited as Commencement speaker or Law honoree a powerful political figure who consistently spoke out against, and effectively acted against, the value of collegiate football.

I hate to say it, but I think she is right.

Abortion is not the only issue with Kathleen Sebelius

Abortion is not the only issue that raises concerns about Kathleen Sebelius becoming Secretary of Health and Human Services. Senator John Kyl has some reservations:

Sen. John Kyl (R-Ariz.), the same senator who questioned Sebelius on her abortion ties, issued a press release Monday saying that he would not support Sebelius' nomination because she supports initiatives that could lead to a rationing of healthcare, to the disadvantage of the elderly and disabled.

"She [Sebelius] left me with no assurance that HHS, federal health care programs, or any new entity - such as the Federal Coordinating Council - will not use comparative effectiveness research as a tool to deny care," said Kyl. "And this should be a matter of concern to all of us."

Kyl highlighted one particular project that Sebelius supports, which promotes cost effectiveness research as providing "accurate and objective information to guide future policies that support the allocation of health resources for the treatment of acute and chronic conditions."

"'Allocation of health resources' is a euphemism for denying care based on cost," said Kyl. "Yet, Governor Sebelius did not agree to pull this project."

These are the same concerns I have expressed about the Obama administration approach to health care. (See the sidebar link for more postings on health care.) It is immoral to deem some lives unworthy of care. It is not at all surprising that those who feel they can judge the worthiness of lives in the womb feel they can just as easily pass judgment on lives that are elderly, sick, or disabled.

Secretary of State Clinton Rejects the Truth

Watch as Nebraska congressman, Jeff Fortenberry, respectfully offers Secretary of State Hillary Clinton the truth about abortion. Secretary Clinton rejects this truth and asserts that the failure of the United States to promote and fund abortions as part of our foreign policy has been detrimental to women around the world. We need more representatives like Mr. Fortenberry who will steadfastly support the intrinsic dignity of human life from conception to natural death. You can find contact information for Representative Fortenberry here. Let him know you support his efforts.

Rec League Catholic?

I have spent a good portion of the last seventeen years on the sidelines of soccer fields. All of my children have played soccer from the beginning leagues through high school. They have not all played at the same level. The level of their play was determined less by their natural ability than by their willingness to work at the game.

My two older boys played recreational league soccer. You show up for practice once per week and play one game per week. When you are at practice or a game, you work hard and play hard. But when you are not involved in team activities, you don’t really think about it too much. This leaves plenty of time for Boy Scouts, music lessons, jobs, youth group, and just hanging out. It is a great way to enjoy the beautiful game of soccer in a low stress environment.

The youngest son plays travel soccer on a mid-level team. He practices twice weekly with the team and also practices fairly regularly with a private trainer. His team does a couple of local tournaments every year. He still does Boy Scouts and takes piano lessons. It is not unusual for boys on the team to miss practice or games because they are involved in a school activity. At this level of travel soccer, occasional absences are tolerated.

My daughter played high level travel soccer through high school and now is on a Division 1 college soccer team. Her travel team practiced at twice weekly and had at least one game every week. In addition to league games they traveled throughout the country to play tournaments. They were one of the top travel teams in the country. Outside of team practices my daughter worked with a private soccer trainer every week. Every day she did some kind of fitness conditioning or weight training. Only Church or academics trumped her soccer activities. She still took flute lessons and participated in the parish youth group social events but those activities took a back seat to soccer. She left early from many a school dance because she had to be well rested for a game the next day. The drive to play at this level must come from within. There is a lot of hard work and sacrifice involved. My daughter thought it was worth it. My boys did not.

This striation of effort is perfectly acceptable when you are talking about soccer. It is just a game. It is not acceptable when you are talking about our Catholic faith. Our parish has begun to incorporate Latin and chant into the Novus Ordo Mass. I heard a gentleman complaining that this made the Mass too hard. He just wants to come in, get the Mass over with, and forget about all the frills. Is it really that hard to spend a few minutes outside of Mass learning the Latin prayers? Is preparation for Mass too much to expect?

I suggest that showing up for Mass on most Sundays with little thought about it either before or after Mass doesn’t even rank as a recreational league Catholic. This is the equivalent of an occasional pick up game. When it comes to our faith, we should all be aiming for the highest level. Mass is not enough. We need a private prayer life. We need the study of Scripture. We need to study our faith. We need to condition our consciences to think with the Church. Every thought, word, and deed should be an offering to God. When we fall, we throw ourselves on Christ’s Divine Mercy, and with His Grace, confess our sins, do penance, and avoid all that leads us to sin. When we are at Mass, it should be intentional not incidental. Prepare for the Mass. Read the readings ahead of time. Learn the Latin. Reflect on the message of the liturgical season. Don’t just attend Mass. Assist at Mass. Your active participation has nothing to do with how loudly you sing or how vigorously you shake your neighbor’s hand at the Sign of Peace. Rather, your active participation is determined by your awareness of the True Sacrifice on the altar. Are you actively joining your prayers with those of the priest?

Not all of us desire or are able to be Division 1 soccer players. However, we should desire to be Division 1 Catholics. By the Grace of God, we are each able to do so.

Tuesday, April 21, 2009

Good For The Soul

The sun is shining brightly today. What a contrast from yesterday when the rain just kept on coming. Athena, my one-year-old labradinger, was behaving like a cooped up toddler. When the deluge slacked off to just a steady rain I took her for a walk. We do this walk daily. Sometimes it is the 2.5 mile walk to the lake to the west of us. Sometimes it is a 4.5 mile walk around the lake to the east of us. Without regard for the weather, Athena needs her daily walk. And, truthfully, so do I. In my pre-dog-ownership days, I would have blown off such a walk due to the rain. Athena, however, allows me no such excuse. It has been great for my waistline. I am in the best physical shape I have been in the last decade. I sometimes wonder why I will walk for my dog but I am not motivated to walk for myself.

This resistance to do what is good for me is not limited to daily walks. Think about the Sacrament of Confession. I know it is good for me. I know it is important. I feel great right after Confession. I always resolve to go more frequently. But somehow, time gets away from me. I shoot for monthly but usually make it every two to three months. I can see the benefits of frequent confessions. The longer I wait, the greater I feel the weight of sin.

This past Sunday’s Gospel highlights the importance of the Sacrament of Confession.

On the evening of that first day of the week,
when the doors were locked, where the disciples were,
for fear of the Jews,
Jesus came and stood in their midst
and said to them, "Peace be with you."
When he had said this, he showed them his hands and his side.
The disciples rejoiced when they saw the Lord.
Jesus said to them again, "Peace be with you.
As the Father has sent me, so I send you."
And when he had said this, he breathed on them and said to them,
"Receive the Holy Spirit.
Whose sins you forgive are forgiven them,
and whose sins you retain are retained."

When Jesus first appeared to the disciples in the upper room, what was his first tasker for the new Church? What was the primary assignment?

Forgive sins

Christ knew that sin would still exist in the world, in spite of His Passion, Death, and Resurrection. He had reconciled the world to God. But until He comes in Glory, it is still a fallen world. Therefore, Christ gave the Church the authority to forgive sins. The priest stands in persona Christi to offer forgiveness of sins as Christ directed. There were so many things that Christ could have directed his disciples to address. He chose to put the forgiveness of sins first. Perhaps that is a signal to me to do the same.

Blogging Resumes

I know it has been a while since I have posted. My vocation is wife and mother so when those duties call, my avocation—blogging—has to wait. Just before Easter, my husband’s dear grandmother passed away. She was 102. She was buried in Arlington National Cemetery last week so I hosted several out-of-town family members who traveled to be here for the graveside service. She was a very gracious woman whom I am very pleased to have known. Please offer a prayer for the repose of her soul.

Réquiem ætérnam dona eis, Dómine,
et lux perpétua lúceat eis.
Requiéscant in pace. Amen.

Sunday, April 12, 2009

Easter Fun

Take a look at the Washington Post's gallery of Peeps dioramas/. They are too cute! While the winner is very clever, I would have selected the M.C. Escher themed entry as the best.


Alleluia! Christ is risen! He is risen indeed! Alleluia!

Saturday, April 11, 2009

The Gates of Hell Will Not Prevail

From Pope Benedict XVI's Easter Vigil homily:

And must not the Church, so to speak, always walk on the sea, through the fire and the cold? Humanly speaking, she ought to sink. But while she is still walking in the midst of this Red Sea, she sings – she intones the song of praise of the just: the song of Moses and of the Lamb, in which the Old and New Covenants blend into harmony. While, strictly speaking, she ought to be sinking, the Church sings the song of thanksgiving of the saved. She is standing on history’s waters of death and yet she has already risen. Singing, she grasps at the Lord’s hand, which
holds her above the waters. And she knows that she is thereby raised outside the force of gravity of death and evil – a force from which otherwise there would be no way of escape – raised and drawn into the new gravitational force of God, of truth and of love. At present she is still between the two gravitational fields. But once Christ is risen, the gravitational pull of love is stronger than that of hatred; the force of gravity of life is stronger than that of death. Perhaps this is actually the situation of the Church in every age? It always seems as if she ought to be sinking, and yet she is always already saved. Saint Paul illustrated this situation with the words: “We are as dying, and behold we live” (2 Cor 6:9). The Lord’s saving hand holds us up, and thus we can already sing the song of the saved, the new song of the risen ones: alleluia! Amen

Wednesday, April 08, 2009

When Medical Decisions are Made From Afar

Yesterday I pointed to the danger of making medical decisions without considering the individual patient. Today the Wall Street Journal offers a similar discussion. Here is a snippet:

Doubts about the relevance of quality metrics to clinical reality are even emerging from the federal pilot programs launched in 2003. An analysis of Medicare pay-for-performance for hip and knee replacement by orthopedic surgeons at 260 hospitals in 38 states published in the most recent March/April issue of Health Affairs showed that conforming to or deviating from expert quality metrics had no relationship to the actual complications or clinical outcomes of the patients. Similarly, a study led by UCLA researchers of over 5,000 patients at 91 hospitals published in 2007 in the Journal of the American Medical Association found that the application of most federal quality process measures did not change mortality from heart failure.

State pay-for-performance programs also provide disturbing data on the unintended consequences of coercive regulation. Another report in the most recent Health Affairs evaluating some 35,000 physicians caring for 6.2 million patients in California revealed that doctors dropped noncompliant patients, or refused to treat people with complicated illnesses involving many organs, since their outcomes would make their statistics look bad. And research by the Brigham and Women's Hospital published last month in the Journal of the American College of Cardiology indicates that report cards may be pushing Massachusetts cardiologists to deny lifesaving procedures on very sick heart patients out of fear of receiving a low grade if the outcome is poor.

Dr. David Sackett, a pioneer of "evidence-based medicine," where results from clinical trials rather than anecdotes are used to guide physician practice, famously said, "Half of what you'll learn in medical school will be shown to be either dead wrong or out of date within five years of your graduation; the trouble is that nobody can tell you which half -- so the most important thing to learn is how to learn on your own." Science depends upon such a sentiment, and honors the doubter and iconoclast who overturns false paradigms.

I've been in the situation as a physician where I know what the patient needs. She is right in front of me in my office. She has pneumonia. She is not responding to outpatient antibiotics. She needs oxygen. She needs parenteral antibiotics. She needs to be admitted to the hospital. But the insurance company clerk who didn't go to medical school and hasn't laid eyes on my patient but has a wiring diagram for care is refusing to authorize the admission because the policy is to use outpatient antibiotics for forty-eight hours before admission. I finally just sent the patient to the emergency room. They would authorize her admission from there.

Who do you want making the bedside decisions about your care--the doctor who sees you or the health care bureaucrat who knows you only as a statistic?

Tuesday, April 07, 2009

More on Solidarity and Subsidiarity

Like yesterday’s post, today's post is a merging of ideas. Start out with lawyer Elizabeth Schiltz’s essay at First Things:

A significant consideration in assessing possible responses to these questions should be the application of subsidiarity. Subsidiarity is a fundamental tenet of the Catholic Church’s social doctrine. As Pius XI wrote in Quadragesimo Anno:

Just as it is gravely wrong to take from individuals what they can accomplish by their own initiative and industry and give it to the community, so also it is an injustice and at the same time a grave evil and disturbance of right order to assign to a greater and higher association what lesser and subordinate organizations can do.

The Compendium of the Social Doctrine of the Church cautions that it “is impossible to promote the dignity of the person without showing concern for the family, groups, associations, local territorial realities.”

Then read Tony Blankley’s commentary in today’s Washington Times:

After first squeezing the private insurance policies by undercutting their offerings with subsidized federal health insurance, the government could then further undercut private insurance by denying the insurers tax deductibility unless they complied with federal health service regulations. As only the wealthiest could afford to buy private health insurance if the cost was not deductible, private health insurance companies would be compelled to follow federal benefits and cost regulations.

At that point, almost all Americans would get their health care pursuant to federally regulated systems. Then the president would be able to begin to deliver on his twin pledges to reduce the cost of entitlements and make health care overall contribute to lower deficits.

The federal regulators could merely do what the British regulators do:

• Constantly reduce the compensation of doctors and all other skilled health care providers. (As domestically trained American doctors would become scarcer, more not-as-well-trained foreign doctors would be needed).

• Limit the availability of medical technology. (in Canada, patients have to wait months for MRIs, so those who can do so come to America for immediate diagnostic services.)

• Ration available treatment to fit the federal budget requirements. The universal digitalized health data could be used to justify non-treatment on a cost-benefit basis. For example, hip replacement for older people could be denied because they would be unlikely to live long enough to justify the expense.

Catholic social teaching requires us to consider both solidarity and subsidiarity. We cannot be oblivious to the needs of our neighbors. That is solidarity. However, the problems must be addressed at the lowest effective level. That is subsidiarity. When the federal government is making health decisions from on high, the individual patients are not in focus. It seems reasonable from that distance to ration care based on arbitrary factors like age, mental capacity or disabilities. However, when you are on the ground in the trenches of health care, each individual patient is clearly in focus. Broad regulations that deny care based on age, mental capacity, disabilities or other arbitrary factors deny the dignity to which each individual human is entitled.

Monday, April 06, 2009

The Golden Rule

It is not uncommon as I peruse my daily blog routine that two seemingly unconnected posts strike a common chord. This happened as I read this post from Amy Welborn and this post from The Anchoress. Both of these posts address the extremely profound effects of seemingly small actions. For Amy, the extra effort of a grocery store bakery worker was a salve for her wound of grief:

I explained the situation to the lady on the other end, trying to hold back tears, trying not to let the subtext of the moment burst through:

This is my son's eighth birthday, and his first one without his daddy, who died two months ago today - oh, in fact, it was at this very moment, about 2 in the afternoon, yes, two months ago today, I was sitting in the emergency room at the hospital, contemplating his broken heart and mine, and ours...please help me figure this out. If not all of it, just this one little thing. This cake.

The woman explained that the Pokemon cake sets were old now, and no one had them anymore. But, she said, if I could bring in a picture of a Pokemon, she could put it through their machine - a copy-like machine that put images on the edible icing sheet - and she could do something. She was going to get off work at 2, but she would stay and do it

And the Anchoress admonishes us to give the poor bookstore clerks a break:

Now it is tempting to believe that bookstore people - who are probably majority-liberal - are hiding your copy of Liberty and Tyranny, but as you can see, even Amazon is saying it will take 1 to 3 weeks to get the book. It is selling like hotcakes, “United Hotcakes Preferred,” as Kurt Vonnegut would say.

As conservatives, it behooves us to remember that the people working in bookstores for $7.25 an hour do not get paid enough to take abuse from anyone, and moreover - why would we treat people differently than we ourselves would wish to be treated. The book is a runaway best seller, and not every store gets the 50-100 copies you might imagine. But believe me, it’s not the prospective grad-student-who is -working-all the -hours she -can for - low-wages’ fault.

Come on, now. We’re respectable people conducting respectable business. Act classy.

This reminds me of a scenario from many years ago. We were at a restaurant with our children and one of my oldest son’s friends. As each of my children ordered or received their drink they would address the waitress with a please and thank-you. Our guest conspicuously did not. In fact, he declared that there was no reason to offer such courtesy to the waitress because she was being paid to serve us. It was her job. In as non-confrontational manner as I could muster, I explained that even if this woman was being paid to serve our table, she was deserving of our respect and courtesy.

We never know the back story of most people we encounter during the day. We don’t know who is grieving, who is worried about his health, who is lonely, who is hurting. When we offer respect, compassion, patience, or kindness we may unknowingly be the bright spot in another person’s day.

Do unto others as you would have them do unto you.

Words from 1948

While the cartoon style is dated, the words are timeless

H/T Creative Minority Report

Thursday, April 02, 2009

When You Get the Miracle

Those who have been reading this blog regularly may remember that this past Thanksgiving I took a tumble while walking the dog and shattered my wrist. I’ve made a remarkable recovery and really have no functional sequelae from the fracture or subsequent surgery. Even the little twinge I felt a few weeks ago when I made the sign of the Cross has disappeared. Today I had a follow-up x-ray. The results are truly amazing. If you didn’t see the metal plate and screws you would never know the bone was recently broken. The anatomical contours of the joint surface, the radial styloid (which was completely missing after the fracture) and the facets that cup the little carpal bones look perfect. I complimented my surgeon on her good work. She looked at me and said, “Surgeons do not get these kind of results. This is the work of God.”

Her words made perfect sense. I know that prayers were storming Heaven when I had my surgery. In my own clinical practice history, I can recount numerous times when I knew that my work as a doctor was really just channeling the healing powers of God. I was His instrument and couldn’t take much credit for whatever positive result ensued. Still, it feels a little odd to be on the receiving end of this Divine healing.

What do you do when you know that God touched up the work of your very fine surgeon to make you as good as new? Of course I give prayers of thanksgiving. But I also know that these sorts of things don’t happen randomly. There is a purpose: God’s purpose.

Perhaps the first purpose is to let you know that prayers really do get answered. God is truly present and active in our world. He isn’t some sort of passive observer. That will have to do for now. I will let you know if I figure anything else out.

Wednesday, April 01, 2009

Human Lives are Never Worthless

Creative Minority Report reminds us that four years ago, we as a nation watched the euthanasia of Terri Schiavo. Terri Schiavo was not dying. She was profoundly disabled but medically stable. The withholding of nutrition and hydration was done with the intent of causing her death. That is, by definition, euthanasia.

Since September, I have been diligently studying bioethics from a Catholic perspective. I am working towards my certification in Catholic bioethics from the National Catholic Bioethics Center. I am not exactly sure what I will be doing with this certification once it is completed, but I am certain the Holy Spirit has a plan.

One of the nuggets of truth that I have gleaned from my study is this:
Treatments can be deemed useless or excessively burdensome. Human lives are never useless or excessively burdensome.

In the case of Terri Schiavo, the medical treatment was the insertion of the feeding tube. This medical act was quite simple and without burden. Feeding Terri Schiavo through this tube is not a medical act, but rather ordinary care. She was utilizing the nutrition and hydration that was provided via the feeding tube. Her organ systems were stable.

What was judged to be useless and burdensome was her life as a profoundly disabled human person. Therefore, this life giving nutrition and hydration was withdrawn in order to cause her death.

I know the term “slippery slope” is used so frequently it sounds trite. But as we head towards a radical agenda of health care reform, remember my nugget of truth above. Expect to see rationing of health care based on arbitrary criteria such as age, mental capacity, and disabilities. We will see guidelines that state people over the age of 65 will not receive treatment X. The reasoning will not be because patients over the age of 65 will not benefit from treatment X. Instead, it will be because patients over the age of 65 are not worth treatment X. Expect to see similarly those with mental or physical disabilities similarly excluded from some beneficial medical therapies because their lives are not “valuable” enough to warrant such care.

You don’t think we can reach that point? We already have. Remember Terry Schiavo.