Friday, July 13, 2012

Painful Memory of My Father's Death

I came across the following Huffington Post news item today, and it chilled me. I usually don't re-post news itemes, figuring people read them on their own elsewhere, anyway, but this one it home because it so strongly paralleled the case of my father's death. I definitely don't know what the right answer is in the case described in the news story. I don't even know what the right answer should have been in my father's case. I know only that some wounds don't completely heal and some questions never go away, as in my father's case. But first, the story from the Huffington Post:

After more than eight years, Linda Carswell finally has proof: According to photographs submitted as evidence at a recent court hearing, her husband's heart sits in a locker in the morgue of St. Joseph Medical Center in Houston, stored in two plastic tubs.

But the hospital still won't return it so that Carswell can bury it with his body.

ProPublica wrote in December about Carswell's battle for the heart, and for answers about her husband's unexpected death. Jerry Carswell, 61, went to a different Houston-area hospital for kidney stones in January 2004 and was found dead in his bed after receiving pain medication on the day he was supposed to be released.

The family's experience showed how problems with clinical autopsies — which are conducted on just 5 percent of patients who die in hospitals and rarely include toxicology tests — can thwart survivors’ ability to determine what happened to their loved ones.

The pathologist at St. Joseph Medical Center who conducted Jerry Carswell's autopsy never determined a cause of death. Linda Carswell sued Christus St. Catherine Hospital, the facility that treated her husband, in Harris County District Court, losing a claim for negligence, but winning a $2 million award for fraud based on the handling of the autopsy. Christus St. Catherine is appealing the verdict.

An opinion issued in June by the Texas Supreme Court says a deceased person's next of kin is entitled to possess his body and bury it. That's standard practice nationwide, said Dr. Victor Weedn, a lawyer and pathologist who is professor and chair of the George Washington University department of forensic sciences.

Weedn said he doesn't see why the hospital couldn't give Jerry Carswell’s heart back and warned that it could be incurring liability by keeping it.

Erin Lunceford, an attorney for St. Joseph, told ProPublica that the hospital realizes it could be sued for the organ, but is concerned that turning it over would violate a judge's order during the negligence case to preserve evidence.

The ongoing saga turned Carswell into an advocate for improved autopsy laws and other patient rights. She said her prolonged legal struggle illustrates obstacles encountered by those harmed in medical facilities — the type often cited by members of ProPublica's Patient Harm Facebook group. Patients and their loved ones can't get answers to basic questions, encounter roadblocks in obtaining medical records and are not treated with dignity, she said.

"They don't understand the human meaning of this at all," Carswell said.

As for my father's story, it happened so many years ago that one would think that it would be lost in the deluge of stories and memories that have followed, but some memories just remain. Period. My father's death is one of those.

My father was admitted to the hospital with walking pneumonia in the nearest city to our country Maine farm in January 1973, at the age of 58, with five of his eight children still living at home. I was the oldest, living in Montana, and not able to be there when this happened. I also did not think that there was a reason to be there because nothing seemed abnormal -- everyone in rural Maine during one winter or another got pneumonia in those days. I myself had pneumonia three times growing up. The doctors knew what to do to cure it. So, no one was concerned and probably did not need to be. My father spent a week in the hospital. Early Saturday morning, on the day he was to be discharged, completely healed, my sister Katrina, home for a visit, went to pick him up. In my sister's presence, the nurse, my long-term childhood friend, now grown and educated as a nurse, gave my friend his final shot of antibiotic. Only it was not an antibiotic!

Immediately, my father went into cardiac arrest and died in my sister's arms. The chief of staff of the hospital, our personal physician and family friend -- his oldest daughter and I were classmates and are friends to this day -- told my mother to get an autopsy and then do whatever she considered right. My sister Danielle was working as a nurse in Washington state at the time and looked at the autopsy results. As in the case above, the liquids, including blood, had been removed. There was no way to prove the error in medication, but wrong medication was the only reasonable explanation since the autopsy showed an otherwise healthy heart.

My mother decided to take no action, unlike Linda in the Huffington story. The hospital was the only one for dozens of miles around, and she still needed health care for the five kids. Moreover, my father's death threw her onto welfare because she had always been a housewife, had no job or job skills, and still needed to work the farm and be with the kids. So, not only did she need the hospital, but she was also now reliant upon the hospital to take the kids at welfare rates. (A lawsuit might have ended up with requiring free care, but she worried about the result being negative because there was no proof.) There was also the complication that the chief of staff had been immensely kind to our family over the years, coming to our farm after work hours to take care of sick kids in exchange for a bushel of corn or peas, which he picked himself. His children and my sisters and I were good friends. And then there was the case of one of my closest friends (and her parents were friends of my parents) having been the one to make the mistake that killed my father. My mother and the rest of us decided to move on and take what Life had dealt us.

I am still friends with the friend who killed my father. I know she feels horrible about the matter. In fact, moving on was just as hard for her as for us.

What should my mother have done? I don't know. I think she probably made the best decision possible under the circumstances. I would be interested in learning others' views. It is, after all, not a forgettable memory.

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