This has clearly been an intense few days for many individuals who have re-lived the nightmare of Chris Martin’s illness last fall. Most obviously for Mary McGonigle-Martin and Tony Martin, and for Melissa Herzog, whose daughter, Lauren, was sick at the same time and at the same hospital as Chris. But also for a number of other individuals, like Ken Conrad, who shared their own stories of medical nightmares.
There’s been so much food for thought, as it were, that I don’t want to try to say too much more. I’ll just make a few personal observations by way of adding to this ongoing discussion.
One thing the story did was remind me of the challenges any of us face when an emergency thrusts us into the midst of the healthcare system’s urgent care services. It’s a system much different from that portrayed on Grey’s Anatomy, where doctors and nurses agonize and debate about each patient’s care. (At least I think that’s what happens–I have only caught bits and pieces of the program, since I usually can’t stand to watch it for very long.)
I got a slight taste of the realities last summer, when I badly cut my finger in an accident. After five hours of waiting in a hospital emergency room, I finally got to see a plastic surgeon. She confirmed that I had partially severed a tendon, and thus required highly delicate surgery. She administered painkiller, and began her cutting and sewing. Yet even in the midst of her efforts, she was interrupted three times to consult with other doctors and/or tend to other patients. A 15-minute procedure wound up taking 45 minutes but, more disconcerting to me, made me wonder whether her effectiveness, and my finger’s long-term recovery, had been compromised. (It seems to be gradually returning to normal, ten months after the accident.) My point here is that the urgent care system is highly stressed.
Second, it reveals the problems of communication among physicians. I know that on even routine visits, it’s not uncommon for doctors to have obviously not reviewed my records. Once you begin moving around in the system, as Chris Martin did, it’s uncertain your records will quickly follow or, if they do, that they will be carefully scrutinized by harried physicians and nurses who have to administer care.
Third, it reveals the wide disparity in expertise and sensitivity among medical practitioners. They may all be highly trained technically, but they aren’t equally knowledgeable or sensitive. Thus, some doctors knew enough not to give Chris antibiotics, but others thought antibiotics were warranted. Mary remarked to me at one point that she felt as if she was pre-judged (negatively) because her son had consumed raw milk. “I think everyone would have been more compassionate toward us if Chris had become ill from spinach or Taco Bell, but when you tell the doctors he drank raw milk, and we gave it to him, they look at you as if they’re thinking, ‘Are you some sort of @&#% idiot!’ The experience was horrible!”
Fourth, it helps explain our fascination with technology. It can be argued that the system made Chris sicker than he should have been, but it’s clear that once he reached that stage, the system had some amazingly sophisticated equipment to keep him alive so that his body could begin to heal. Unfortunately, too many people observe such sophistication and think it can be substituted for natural functioning and healing.
Finally, there’s the tantalizing matter of what caused Chris’ illness in the first place. I appreciate Elizabeth McInerney’s persistent probing and questioning about the role of raw milk in all this. (For the record, I wrote about Lauren Herzog’s illness in a posting last December; the woman who served raw milk to Lauren Herzog, Chelsea Higholt, told me then that California authorities tested her milk and found no contamination.)
A scientific paper I just came across sheds further light on this subject but, of course, nothing definitive. A paper examining an outbreak of E.coli in Washington state concludes that unsanitary conditions led to the milk contamination. It indicates that the more milk individuals drank, the greater their likelihood of becoming sick. But it also comes to some questionable conclusions. For example, at the end it says there are 73,000 cases of illness from E.coli each year and "raw milk is an important vehicle of transmission…" As a proportion of 73,000 cases? I don’t think so. Unfortunately, as several readers have suggested, it’s nearly impossible to come up with definitive causes, and this is something that applies not just to situations involving raw milk.
At least one matter that is still outstanding here, and that is the reaction from Kaiser officials to the experience of Chris. I have asked Mary and Tony to let me know reactions they eventually learn from Kaiser officials to their concerns. It certainly would be nice to know that Kaiser is trying to learn from this situation.
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