Two doctors disagreed over a near-comatose man's level of awareness as testimony opened in a hearing that could decide whether he can be removed from a life-support system.
Baltimore County Circuit Court Judge John F. Fader heard the first medical testimony yesterday relating to Ronald W. Mack, 28, who was severely brain damaged in a California car crash in 1983. For most of the time since then, Mack has been a patient at the Fort Howard Veterans Administration Medical Center.
The hearing, expected to conclude today or tomorrow, will determine whether his wife, Deanna V. Mack, regains custody of BTC him. Deanna, who moved to Florida with their two children a year after her husband's accident, wants to move Mack to Florida, where she would seek to have his tubes removed under that state's right-to-die law.
Mack's father and sister were granted an injunction to keep Deanna from moving her husband, leading to the hearing. Custody was turned over to a guardian.
The doctors who testified yesterday agreed in the diagnosis of Mack, which classifies him as near-comatose, or in a persistent vegetative state, but his level of awareness and ability to feel pain were in dispute.
Dr. Clark Watts, director of neurotrauma at the Shock-Trauma Unit in Baltimore, said the movements of a patient in a persistent vegetative state, including blinking or movement of the arms or legs, are often misinterpreted as voluntary.
"They can make spontaneous movements . . . that can be elicited by many sensations," he said in response to questioning by Rachel A. Wohl, attorney for Deanna Mack.
Watts said claims from doctors and nurses at Fort Howard that Mack can respond to simple commands with blinks or hand movements were just examples of involuntary movements found in patients in a persistent vegetative state.
Watts also testified that Mack is unable to perceive pain.
Dr. Sheldon L. Margulies, a specialist in neurology who examined Mack about a month ago, disagreed.
Under questioning by Gary Strausberg, who represents Mack's father, Ronald E. Mack, and his sister, Karen Mack Carson, Margulies compared his ability to recognize pain with that of a newborn baby.