Allow me to translate the jargon. (opinions herein, your mileage may vary)

[Mayberry Machiavelli]

(some opinions herein, take it as you will this is not being stated as fact, but just a "translation" of what was seen on TV)

Verified, from the news conference:

1. The man has had a heart attack, or myocardial infarction. This means that part of the tissue of the heart has died. This is detected either through blood tests showing that enzymes from heart muscle have been released into the blood from dying tissue, and/or EKG readings.

2. The man went into atrial fibrillation, an irregular heartbeat.

3. The man had a cardiac catheterization, presumably to diagnose if a blockage in the coronary arteries caused either or both 1 & 2. According to the conference, the results of the catheterization were unremarkable.

4. From all of the above it sounds like the cause of the myocardial infarction, or MI, was most likely direct injury to the heart tissue from birdshot trauma.

5. At least one or more pieces of shot were lodged either in the muscle of the heart, or immediately at its surface, causing inflammation and irritability, leading to the atrial fibrillation (AF).



Things that were not specifically said, or were said in an ambiguous way but but can be reasonably inferred from the doctor/hospital news conference:

A. It sounds like this guy had a penetrating chest wound from the beginning. Meaning, the birdshot probably penetrated beyond the skin, fat, and muscle into the chest cavity with the original shot. Shot, bullets, do migrate over time. But it seem pretty unlikely in 2-3 days time that it would go from the skin or fat, through the muscle layers and into the chest cavity where the heart resides. Likely there was penetrating trauma to the chest cavity with the initial injury though this was not stated.

B. This means that the initial injury was likely life threatening, even if the guy looked fine. Where this guy was shot, the potential for massive blood loss from major blood vessels in the chest and near the heart was high. The major blood vessels of the body enter and leave the heart within the space where the shot injured the heart. Even if bleeding did not occur, just from the chest cavity being penetrated, even by small shot, a pneumothorax can occur, a collapse of a lung, which in the most extreme cases can lead to cardiac arrest and death even in the absence of ANY blood loss, due to a buildup of air pressure in the chest. ("Tension pneumothorax") If true, this man could easily have died at the ranch or in transit.

C. Since we have received so little information, we have to infer from what little info has been made available. I've seen no info about the nature of the original surgery. It could have ranged from as minor as picking out shot and washing the wounds with sterile fluid to try and minimize chances for infection, or as serious as opening the chest to explore and/or repair major blood vessels or lung.


Of interest from the news conference: The doctor mentioned that they were "in communication with the White House, and the White House medical team" about this guy's care. He was asked why, and said that well the WH docs treated this guy in the field and were still involved in his care.

Also: he was obviously coached to try to get him to say "BB" instead of "shot" or even "pellet". He screwed up initially, correcting "BB" to "pellet", and then later in the conference, corrected "pellet" to "BB". Simply saying "birdshot" would have been correct and spin free, but of course they don't want that.

The language used seem designed to promote the impression that this was some very unusual migration of shot from the skin to the guy's heart. They didn't say this outright but that is the impression cultivated. What seems pretty likely from the scenario is that the shot penetrated the guy's chest into his heart and/or around it with the initial blast. It SOUNDS LIKE he was very nearly killed. It SOUNDS like he's likely to do fine, but he's by no means completely out of the woods yet.

One person's opinion and interpretation, take it as you will.

[CottonBear]

1. I've read that the shot can enter the vessels in the neck and travel

through the veins and arteries and caue problems. COuld this have happened? If the shot actually entered the chest cavity all thet way to the hear then obviously he was more than peppered. :(

Post from Firedoglake blog:
Speaking as a 20-year veteran of The-Big-ICU-In-Knife-And-Gun-Club-Territory, there is no way in hell that the victim is relatively uninjured.

Shotgun injuries are some of the worst cases I have taken care of, due to the spread-shot nature of the wounds. If the victim got "peppered" in the neck, there are waaaayyyy too many important structures in that small space (oh, like maybe one of the internal or external carotid arteries) for this to be a "no big deal" situation. If any of the pellets nicks a blood vessel, it may travel as far as it can go--I took care of a kid shot in the chest and some pellets eneded up in his ankle, blocking the bloodflow, leading to an amputation. In this situation, add to that the victim's age and potential underlying medical problems--this is huge.

These days, God Almighty doesn't get to stay in the ICU unless it is absolutely imperative that He do so.

This stinks worse than a gangrenous leg....
LittleBit | 02.13.06 - 8:04 am | #
http://www.haloscan.com/comments/firedoglake/113984118736473358/#259119

[Mayberry Machiavelli]

2. Hard to say. My guess is this is less likely than the stuff just went

right through the guy to around where it is. But one can't know with as little information as has been released.

[TomInTib]

4. I agree. Slight "peppering" won't get the shot in a larger vein to..

get it to the heart that quickly.

There had to be some pretty serious penetration.

Just my opinion.

[librechik]

5. The Doc said shot got into the heart muscle and then travelled

I got the impression he said literally that Cheney had shot the guy and it penetrated into the heart at that time.

[Mayberry Machiavelli]

10. Yes I think so too, but they definitely tried not to emphasize that aspect

If you were not listening REALLY carefully it would be VERY EASY to come away with the impression that miraculously, the shot migrated from a really superficial wound to the guy's heart! Whoda thunk it, this stuff NEVER happens! :shrug:

[cynatnite]

3. Good insight...

more to tell me Whittington was standing much closer than what they've said. I also think he's not as 'healthy' as they claim he was before the shooting.

I would also like to know why they had an ER chief do the press conference. Why not one of the cardiologists who is actually caring for Whittington?

There is so much about this we DON'T know.

[Mayberry Machiavelli]

6. ER chief would be a reasonable spokesperson, since they generally

coordinate the trauma care for a trauma center, along with surgeons.

This is a trauma case (gunshot to the face/neck/chest), with a cardiology complication. Most likely the physician in charge of the case overall is a surgeon, with the cardiologists consulting, even though the cardiac issues are the most serious at this point.

If the other surgical issues are stabilized then they may have already turned over care to the cardiologists entirely.

[trof]

9. And there's this (proximity of victim)

I'm guessing the face and neck were relatively unprotected.
I'm also guessing that the victim was wearing a T shirt, shirt, and hunting jacket or vest.
And possibly a hunter orange vest on top of that.
I sure like to see the condition of the clothing he was wearing.

[Pachamama]

13. Yeah, I wonder what they did with Whittington's "clothing"?

:eyes:

Seeing is believing, eh? I bet the shirt, vest/hunting jacket he was wearing that day sure would reveal a lot....

I'm sorry, but I just ain't buying the "official" story...I think this guy was injured far more seriously than they have admitted and that he was hit at much closer range than they have led on....

As someone who has gone hunting for game in my lifetime (and atleast it wasn't at some pre-caged bird farm), I am not buying the official story of how this went down...

[trof]

7. Do you play a doctor on TV?

Or did you just sleep at a Holiday Inn last night?
But seriously, thanks for the interpretation and explanation.
There's a lot of good talent around this place.

[Jacobin]

8. Thanks for that MayMach

Helps to have someone knowledgeable translate the attempted spin by the media whores.

Hope the guy pulls through okay.

[CottonBear]

11. My thoughts are with the lawyer & his family. I hope he survives. nt

[Hekate]

12. The WH keeps trying to minimize, but for a change the MSM is in a tizzy

It's like the MSM just figured out there might actually be a problem with Cheney and Bush acting like Czars of All the Russias. Once again we find ourselves hoping this will prove to be the thread that unravels the whole evil structure.

K&R, Mayberry, for a good explanation of what's between the lines. Let's hope the old guy lives to tell the tale.

Hekate