UPDATE — I have more details from royal and medical sources about what happened to Princess Bajrakitiyabha

Andrew MacGregor Marshall @zenjournalist

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UPDATE — I have more details from royal and medical sources about what happened to Princess Bajrakitiyabha last Wednesday, and also spoke to a specialist foreign-based ICU and trauma consultant to help interpret the information. 1/

 

To make this clear once again, I have no personal animosity against the princess, and while everybody knows I am not a fan of King Vajiralongkorn, his grief is clearly genuine and he deserves compassion and understanding right now. 2/13

 

But the people of Thailand also deserve to be told the truth, instead of being dragged into days or weeks of royalist theatrics to pray for the recovery of a woman who has already been dead for four days according to any sensible definition of what it means to die. 3/13

 

So I am not writing about this to mock or taunt the royal family, I am just doing my job as a journalist to try to provide reliable information to Thais because they can't get this from any other source, least of all the palace or the regime. 4/13

 

When Ong Bha collapsed at the army dog event in Pak Chong province it was initially assumed she'd had a heart attack. Even the palace medical bulletin released almost 24 hours after her health emergency said she lost consciousness due to a heart condition. 5/13

 

But in fact, doctors at Chulalongkorn Hospital have concluded that the princess had suffered a brain aneurysm causing a massive subarachnoid haemorrhage. 6/13

 

What this means is that a narrowed or weakened artery in Ong Bha's brain had caused blood to accumulate at the weak point in the artery. This had probably been happening for several years but because it didn't cause any apparent symptoms nobody would have known about it. 7/13

 

The princess unknowingly had a ticking time bomb in her brain, and on December 14, it exploded. Her skull was flooded with blood, which in turn caused cardiac and respiratory arrest. 8/13

 

It took at least an hour to get her to Pak Chong Nana Hospital, during which a soldier performed CPR, but by the time she arrived there her brain had already been fatally starved of oxygen. 9/13

 

Once that had happened, not even the finest neurosurgeon in the world would have been able to save her. Brain death usually occurs less than 10 minutes after oxygen deprivation, even with the most heroic CPR efforts. 10/13

 

Ong Bha was connected to a ECMO machine that circulates blood outside the body. It's a way to keep people with profound heart & lung failure alive. But if somebody is already brain dead, all you are keeping alive is their body. As the specialist consultant explained to me: 11/13

 

"The ECMO basically makes the blood circulate in the body, the blood is oxygenated outside in a machine. The blood pressure from the ECMO can indeed maintain the body cells alive. But the brain does not come back from this damage..." 12/13

 

The princess died on Wednesday evening but her body is being kept artificially alive. This is tragic news. Thais should be told the truth about it.  13/13