Fundie Lite Wife Having Baby with Husband with Severe TBI

[Ariel]

I don't agree with it either, and have read nothing on her blog that states anyone has "established" that. He doesn't even understand what marriage is. As for the facebook posts, I think his wife is writing them for him.

That is foul if true. When the facebook page was mentioned in the thread I checked it out. The clarity of the posts changed my perspective on Cale, and I began to think he was functioning at a much higher level than her blog led me to believe. Imagine how mislead some of his friends and family (who live far away) must be.

[church_of_dog]

Who established that?

I apologize; I shouldn't have said that. I had seen some posts that addressed the use of that phrase as semantic and not fully appropriate, and I thought that was presented in a compelling way -- also the fact that Kathleen, who has a biased and somewhat dramatic interpretation, was the only one who said that, and there is a real likelihood that she wasn't using it in a highly technical sense but rather as a general guideline or descriptor so people could imagine how Cale is doing -- but you're right, everyone else didn't chime in their agreement and nowhere was it a "settled" issue (except in my own mind, lol)

[Curious]

This right here is so true. I evaluate and rehab cognition, memory, language and I absolutely hate when people put an age with an ability level. It is outdated, old school way of diagnostics and just does not do justice to a patient as an individual. Unless there is wide spread consistent damage throughout the cortex (can't even think of what would do this) some areas will be spared and others will be disproportionately in deficit. Calling an adult a mental 3 year old is insulting.

Since you work in this area, I would be interested in learning more about it, if you would not mind sharing. Do you know why the 39 month label that Kathleen seems to be using would have been attached to Cale in the first place? Also, I realize you don't have any experience in the case at hand, but could you describe what an individual with a similar type of injury might be like based on the information we have? I know every injury is different, of course, I'm just trying to get a picture of Cale that isn't influenced by Kathleen.

[Curious]

The comments equating Cale with a 3 yo came from no one here but rather directly from his wife, and it is those comments that are triggering such backlash from so many posters here, imo.

I have no idea why she chose to describe him thus (whether for the sake of simplicity or because she really believes it), but it's certainly not surprising that people find it objectionable that she's having sex with someone she claims to consider the same as a toddler. There's seemingly little or no respect there, either for him or for his dignity.

I think this is the crux of it for me. Whatever level Cale functions at, it's seems clear that Kathleen VIEWS him as a child/toddler. How she can then reconcile having sex with him, if it's not solely to fulfill her own desires is a bit hard for those of us that don't have cognitive dissonance to come to grips with.

[LaLele]

Since you work in this area, I would be interested in learning more about it, if you would not mind sharing. Do you know why the 39 month label that Kathleen seems to be using would have been attached to Cale in the first place? Also, I realize you don't have any experience in the case at hand, but could you describe what an individual with a similar type of injury might be like based on the information we have? I know every injury is different, of course, I'm just trying to get a picture of Cale that isn't influenced by Kathleen.

Sure. I can't say specifically about Cale, but I have had some clinical experience in an acute care facility that was a "stopping point" between a general hospital and a skilled nursing facility. I mostly worked with TBI and strokes as they transitioned (or didn't) out of minimally conscious states. There are some pretty predictable stages a person progresses through as they are recovering from a TBI (8 stages in all). Some people get stuck along the way and never progress past certain stages. You can read about the stages here: https://www.rancho.org/research/bi_cognition.pdf

It sounded like Cale was/is in stage 5-6 of recovery for a while. Lots and lots of confusion, not realizing where he was, what he was doing. I have absolutely no idea who would have given him an age equivalent. There are some cognitive tests on the market that offer age equivalent as an option for scoring, but if it was an adult test, I can't think of one that wouldn't just give a score of <13 years of age. If it was not an adult test then they would have been using it without normative data so any age equivalent would have been inaccurate. And I never, ever use the age equivalent when scoring because it is pretty meaningless. There are so many facets of cognitive ability. Just because one area is offline or in deficit, that doesn't mean all areas are out. Typical TBI's have the biggest deficit in attention and executive function (skills that make us act like adults) but many times other areas can be relatively spared. Giving someone an age equivalent in one area doesn't give a very good picture because they may have awesome compensation skills or strategies to make up for the deficit.

39 months is so specific that she must have heard it from somewhere, but unless they have an old school neuropsych or SLP I can't think where.

[RosyDaisy]

It was quickly abandoned, I think because it raises the problem about how a TBI's woman's body would be carrying the baby, as if that means Cale should have fewer rights to say no.

I know I wouldn't feel differently, because I already feel Cale has been done a great injustice by his no's being ignored. His consent was not given for making a baby on purpose, and that is wrong. It would be wrong to create a baby on purpose with a woman who said no too, and that would probably bring a media firestorm and debates over consent issues for getting a severely brain-injured woman pregnant on purpose just because she sometimes says yes and the husband really wants a baby. People would say she was demoted to her reproductive organs, but so was Cale.

I completely agree!

[DGayle]

That is foul if true. When the facebook page was mentioned in the thread I checked it out. The clarity of the posts changed my perspective on Cale, and I began to think he was functioning at a much higher level than her blog led me to believe. Imagine how mislead some of his friends and family (who live far away) must be.

The pattern of speech on his Facebook page is very different than how she quotes him on the blog. Either he is not the one writing his posts on Facebook, or she is seeing him as much more disabled than he actually is. If it's the first, maybe his family and friends know, but if it's the second, then she's so far from seeing the situation accurately that I'd be worried about how long it'll be before he gets tired of her saying his cognitive ability is 3 years if it's higher.

[lipstickgoalie]

Sure. I can't say specifically about Cale, but I have had some clinical experience in an acute care facility that was a "stopping point" between a general hospital and a skilled nursing facility. I mostly worked with TBI and strokes as they transitioned (or didn't) out of minimally conscious states. There are some pretty predictable stages a person progresses through as they are recovering from a TBI (8 stages in all). Some people get stuck along the way and never progress past certain stages. You can read about the stages here: https://www.rancho.org/research/bi_cognition.pdf

It sounded like Cale was/is in stage 5-6 of recovery for a while. Lots and lots of confusion, not realizing where he was, what he was doing. I have absolutely no idea who would have given him an age equivalent. There are some cognitive tests on the market that offer age equivalent as an option for scoring, but if it was an adult test, I can't think of one that wouldn't just give a score of <13 years of age. If it was not an adult test then they would have been using it without normative data so any age equivalent would have been inaccurate. And I never, ever use the age equivalent when scoring because it is pretty meaningless. There are so many facets of cognitive ability. Just because one area is offline or in deficit, that doesn't mean all areas are out. Typical TBI's have the biggest deficit in attention and executive function (skills that make us act like adults) but many times other areas can be relatively spared. Giving someone an age equivalent in one area doesn't give a very good picture because they may have awesome compensation skills or strategies to make up for the deficit.

39 months is so specific that she must have heard it from somewhere, but unless they have an old school neuropsych or SLP I can't think where.

This is the post where she states it for the first time. adarlingkindoflife.com/2011/03/we-gonna-do-this-one-step-at-time.html

She has mentioned the Rancho scale and other forms of evaluation too. He is chronically confused and still has impulse and anger control issues. Unless she failed to mention it he can not be left alone.

[Curious]

Sure. I can't say specifically about Cale, but I have had some clinical experience in an acute care facility that was a "stopping point" between a general hospital and a skilled nursing facility. I mostly worked with TBI and strokes as they transitioned (or didn't) out of minimally conscious states. There are some pretty predictable stages a person progresses through as they are recovering from a TBI (8 stages in all). Some people get stuck along the way and never progress past certain stages. You can read about the stages here: https://www.rancho.org/research/bi_cognition.pdf

It sounded like Cale was/is in stage 5-6 of recovery for a while. Lots and lots of confusion, not realizing where he was, what he was doing. I have absolutely no idea who would have given him an age equivalent. There are some cognitive tests on the market that offer age equivalent as an option for scoring, but if it was an adult test, I can't think of one that wouldn't just give a score of

39 months is so specific that she must have heard it from somewhere, but unless they have an old school neuropsych or SLP I can't think where.

Thank you. That page with the stages was quite informative. I've never seen that before. Reading through those stages on paper, none of them makes me think particularly "child like," such that I would equate the behavior to that of a toddler the way Kathleen seems to do (I hope that made sense).

I watched a pretty good movie about a football player that got in a car accident and had a TBI. The movie showed his recovery from it and while I realize that was a movie, it was based on a true story, so I am guessing it was at least an attempt at an accurate portrayal of a TBI. I don't recall thinking his behavior was "child like" either, now that I've thought about it quite a bit.

Ah ha! Found the movie. I've actually seen it several times during my LMN phase ;) http://www.imdb.com/title/tt0465535/

As an aside, Cale looks a bit like Jim Carrey in some of those pictures

[lilith]

The difference between the Cale Kathleen portrays on her blog and the Cale portrayed on his Facebook is startling. I really don't know where to start with working out which is more accurate, but if he's writing his own Facebook statuses he's more capable in at least some areas than Kathleen implies.

[LaLele]

Thank you. That page with the stages was quite informative. I've never seen that before. Reading through those stages on paper, none of them makes me think particularly "child like," such that I would equate the behavior to that of a toddler the way Kathleen seems to do (I hope that made sense).

I watched a pretty good movie about a football player that got in a car accident and had a TBI. The movie showed his recovery from it and while I realize that was a movie, it was based on a true story, so I am guessing it was at least an attempt at an accurate portrayal of a TBI. I don't recall thinking his behavior was "child like" either, now that I've thought about it quite a bit.

Ah ha! Found the movie. I've actually seen it several times during my LMN phase ;) http://www.imdb.com/title/tt0465535/

As an aside, Cale looks a bit like Jim Carrey in some of those pictures

Every injury and person is different, but if I had to pick a stage that most reminds me of an age, it would be Stage 4. At that stage a lot of patients remind me of drunk teenagers. Lots of aggression and defiance. It is sad because it is the first stage where they are actually considered "out of the coma" and dramatically interacting with their environment. Families don't expect their loved one to come out literally swinging and swearing.

A good movie to watch to get an idea of what these recoveries really look like is a HBO documentary called COMA. I had to watch it in grad school and it is really quite good. It follows 4 people from stage 2/3 on. (Not all have happy endings.)

I feel like I should say that I really don't agree with Kathleen's decision to have a baby given that Cale is still recovering and does not sound like he is progressing to the point where he would be able to be a functional parent.

However, I don't feel like Cale and Kathleen should never have intercourse. Cale is still an adult both chronologically and likely in many other cognitive ways. Without assessing him directly I would give the benefit of the doubt on other professionals signing off on his ability to give consent. I would feel the same way if genders were reversed. Just because someone has a brain injury, the desire to participate in and enjoy sex does not disappear.

[LaLele]

Found Coma on youtube!

[lipstickgoalie]

The difference between the Cale Kathleen portrays on her blog and the Cale portrayed on his Facebook is startling. I really don't know where to start with working out which is more accurate, but if he's writing his own Facebook statuses he's more capable in at least some areas than Kathleen implies.

I don't think for a minute he posts his own Facebook status updates.

[DGayle]

Sure. I can't say specifically about Cale, but I have had some clinical experience in an acute care facility that was a "stopping point" between a general hospital and a skilled nursing facility. I mostly worked with TBI and strokes as they transitioned (or didn't) out of minimally conscious states. There are some pretty predictable stages a person progresses through as they are recovering from a TBI (8 stages in all). Some people get stuck along the way and never progress past certain stages. You can read about the stages here: https://www.rancho.org/research/bi_cognition.pdf

It sounded like Cale was/is in stage 5-6 of recovery for a while. Lots and lots of confusion, not realizing where he was, what he was doing. I have absolutely no idea who would have given him an age equivalent. There are some cognitive tests on the market that offer age equivalent as an option for scoring, but if it was an adult test, I can't think of one that wouldn't just give a score of <13 years of age. If it was not an adult test then they would have been using it without normative data so any age equivalent would have been inaccurate. And I never, ever use the age equivalent when scoring because it is pretty meaningless. There are so many facets of cognitive ability. Just because one area is offline or in deficit, that doesn't mean all areas are out. Typical TBI's have the biggest deficit in attention and executive function (skills that make us act like adults) but many times other areas can be relatively spared. Giving someone an age equivalent in one area doesn't give a very good picture because they may have awesome compensation skills or strategies to make up for the deficit.

39 months is so specific that she must have heard it from somewhere, but unless they have an old school neuropsych or SLP I can't think where.

Unfortunately this doesn't change that his cognitive ability is very low, she views him as a child, and he has said no to having a baby, but she overruled that.

The official diagnosis is likely to be different, with 3 years being used as a comparison point for her. People who specialize in this stuff spend years learning the different degrees. A spouse doesn't have that time, and saying "comparable to 3 years" spares time that isn't available.

Regardless, Cale. Said. No. And what's creepy about her having sex with him is she's having sex with someone she sees as a child, and to be honest, I'm concerned that if he ever says no to sex, she's going to plow ahead, just like she did with getting pregnant.

[theologygeek]

I think this is the crux of it for me. Whatever level Cale functions at, it's seems clear that Kathleen VIEWS him as a child/toddler. How she can then reconcile having sex with him, if it's not solely to fulfill her own desires is a bit hard for those of us that don't have cognitive dissonance to come to grips with.

Same problem that I have. Having sex with someone she considers a toddler is disgusting.

[Deesire]

After reading this whole thread, I thought I would at least say something... not that there's much to say that hasn't already been said.

I am pretty fixated on the issue of consent, and what the implications are if Cale (or someone like him) does not have capacity to form consent to various aspects of his life, including sexual activity.

My understanding is that if someone does not have proper ability to form consent, a substitute decision maker makes those decisions on their behalf. This would apply in situations like deciding in medical treatment.

So assuming Cale is incapacitated in terms of giving consent to medical care, does that mean that the default is he gets no medical care? No, it means someone else must make those decisions on his behalf.

Does the same reasoning apply to sexual activities? I am leaning towards thinking that, yes, that is what should and does happen. I think this is where the discussion got heated in this thread. It seemed that some posters were saying if he did not have capacity to consent, then the result was that anyone having sexual contact with him was sexually assaulting him. This would be true if he both did not have the capacity to consent himself AND there was no substitute decision-maker who consented on his behalf. This is analogous to medical treatment: if a medical professional performs a medical exam on someone without their consent (implied or explicit), then that is assault. However, when people no longer have the capacity to give consent, someone else must do it for them. If no family member or other close individual is available for the role, presumably a state-appointed guardian will be appointed to fill the role. The substitute decision-maker is supposed to make medical decisions in the interest of the person on whose behalf they are deciding.

My point is that when when someone doesn't have capacity to consent to medical treatment, the result is not that no medical treatment can be provided, but that someone else will provide consent on behalf of the person who has become incapacitated. Can the same not be extrapolated and used for sexual activity, so that the default is not that a person who has lost capacity to consent can no longer have sexual activity (lest their partner be assaulting them) but that the substitute decision maker steps in and decides what sexual activity is appropriate?

If so, then, in this couple, it is Kathleen who is giving consent to sexual activity for both herself and for Cale. She is also, of course, the one providing consent to the result of the sexual activity: parenthood.

In her role as Cale's substitute decision-maker, though, she is supposed to be acting in his interests, and deciding in his stead. And it is not clear that she is fulfilling that role. She is probably basing her decision to have a child on Cale's expressed desires and intentions at the point where they got married -- having children was, in all likelihood, something they had discussed and something that they both wanted. However, that is perhaps not the entirety of what she ought to be considering as his substitute decision-maker. And, of course, she is in an inherent conflict of interest, where it would be nearly impossible to make decisions on Cale's behalf without regard to her own preferences and desires. So it can be questioned whether she is properly fulfilling her role, and whether she has stepped outside the bounds of what can reasonably be upheld as an appropriate decision for a hugely significant decision she made on Cale's behalf (parenthood), but I do think it was up to her to decide for both of them about sexual activity and parenthood.

On the point of Cale expressing that he did not want to have a baby, that, of course, should have been a factor for Kathleen in deciding whether to consent, on his behalf, to parenthood. However, if he is incapacitated from making his own decisions on significant life choices, then it is up to her to decide. Just like if he said "no, I don't want a shot" (or any other medical treatment), that shouldn't be the end of her decision-making process with regard to his medical treatment. If it's recognized he doesn't have capacity to decide on medical treatment, the fact that he appears to not consent to treatment is not necessarily the result that must appropriately flow. She must make decisions on his behalf, in his interests, based not just on the fact that he says he doesn't want treatment, but also on what is at stake, and whether the treatment is necessary or desirable for his overall well-being.

It may very well be that she formed the view that parenthood was desirable for Cale's overall well-being, based primarily on the goals they had together before he was injured. It is questionable whether that view is sustainable, but it was within her purview to arrive at that decision.

In any case, now it is a done deal and little Nora has been born so I wish them all well.

[Arete]

I think equating medical care and sexual activity is asinine.

[DGayle]

Conceiving a baby isn't the same as deciding on medical treatment or even what to have for dinner. Medical care and food aren't option in life. You have to have both. You don't have to have a baby. Cale having a TBI shouldn't mean someone else can decide he's going to be a sperm donor after he said no. He's not a piece of property to be owned.

Would you support a husband making the same decision for his with with a TBI?

Also you shouldn't have a baby because it might make someone else feel better. Babies shouldn't be born with jobs.

[dianapavelovna]

I don't think for a minute he posts his own Facebook status updates.

Me neither.

Also on the subject of his Facebook...and I apologize if someone has brought it up (I haven't had time to read the last few pages of the thread closely), but why is his Facebook username AeryPariah? That has me befuddled.

ETA A quick google shows me that's his username on a number of sites, all of which seem to have been created pre-injury. Carry on.

[miffy]

Every injury and person is different, but if I had to pick a stage that most reminds me of an age, it would be Stage 4. At that stage a lot of patients remind me of drunk teenagers. Lots of aggression and defiance. It is sad because it is the first stage where they are actually considered "out of the coma" and dramatically interacting with their environment. Families don't expect their loved one to come out literally swinging and swearing.

A good movie to watch to get an idea of what these recoveries really look like is a HBO documentary called COMA. I had to watch it in grad school and it is really quite good. It follows 4 people from stage 2/3 on. (Not all have happy endings.)

I feel like I should say that I really don't agree with Kathleen's decision to have a baby given that Cale is still recovering and does not sound like he is progressing to the point where he would be able to be a functional parent.

However, I don't feel like Cale and Kathleen should never have intercourse. Cale is still an adult both chronologically and likely in many other cognitive ways. Without assessing him directly I would give the benefit of the doubt on other professionals signing off on his ability to give consent. I would feel the same way if genders were reversed. Just because someone has a brain injury, the desire to participate in and enjoy sex does not disappear.

My best friend sustained a TBI last year. Quite soon after her chemical coma was lifted completely she randomly turned up at the nurses station one night. :lol: Nobody thought she could even walk, let alone do that.

It's about 8months in and she would be much more 'able' than Cale is already, but her recovery is still a full time job at the moment and a very tiring one at that!

[theologygeek]

Conceiving a baby isn't the same as deciding on medical treatment or even what to have for dinner. Medical care and food aren't option in life. You have to have both. You don't have to have a baby. Cale having a TBI shouldn't mean someone else can decide he's going to be a sperm donor after he said no. He's not a piece of property to be owned.

Would you support a husband making the same decision for his with with a TBI?

Also you shouldn't have a baby because it might make someone else feel better. Babies shouldn't be born with jobs.

I agree. Even if the wife was sterile, I would still think it was disgusting to have sex with a woman who couldn't fully consent to it. A husband can be arrested for rape if he forces himself on his wife. This should be no different.

[bionicmlle]

I have been thinking about Cale, Kathleen & baby Nora lately. I wonder how they are doing. She hasn't been posting much at all and baby is nearly 6 months old. I wonder how all are adjusting.

[keen23]

I have been thinking about Cale, Kathleen & baby Nora lately. I wonder how they are doing. She hasn't been posting much at all and baby is nearly 6 months old. I wonder how all are adjusting.

I expect she's really busy and finding life isn't quite as photogenic as she'd hope.