Patterico's Pontifications

5/10/2010

The Will to Live

Filed under: General — DRJ @ 11:46 am



[Guest post by DRJ]

Al Hayes knows his wife Katy has a will to live:

“[Al’s] daily online musings began not long after he witnessed the home birth of their third child Feb. 10. But the joy of that moment was quickly overshadowed when he found himself giving doctors permission to amputate his wife’s legs and arms. To stop a raging infection spreading from her uterus, doctors said her limbs had to be sacrificed or she would die.

He wrote later that signing the permission papers while Katy was in a coma was the hardest thing he ever did.

“I hope everyone will understand why I did this. I hope Katy will forgive me,” he wrote.

To the dozen who wrote him that he should have just “let Katy go” or that “Katy wouldn’t want to live like this,” he responded: “You really don’t know my wife.”

Read the whole thing.

— DRJ

13 Responses to “The Will to Live”

  1. Gods been good to me, why I dont know. What a mother this woman is to fight so hard to be there for her family. I wish them all the best

    EricPWJohnson (554c4e)

  2. Life and death. Two forces each struggling to become infinity. I like life, personally, with all its pain. We will all have an infinity in which to be dead.

    nk (db4a41)

  3. I’m dismayed at how the Chronicle’s readers on their site are angrily complaining that the story was too sad for them.

    It is sad, but it’s a great story that I’m glad I read. I really feel for this selfless husband having to be his wife’s voice to friends who doubted he knew her. Conventional wisdom is to refuse to live ‘like that’, but I agree with these two. If I can keep going, I want to keep going. So long as my brain is even remotely functional. As nk says, I’ll have plenty of time to be dead, too.

    Dustin (b54cdc)

  4. 2 responses …

    Emotional – yes, inspiring in that the mother is a survivor with spirit … sad – for all involved whose lives are impacted negatively … also angry, in that earlier detection in a hospital is likely to have avoided the necessity …

    Rational – 1 more vote for hospital delivery of baby …

    Alasdair (ae634a)

  5. The article says she was screened for strep and it was negative, and the physician said it could have happened no matter where she gave birth. Plus, given how quickly mothers are released from the hospital — especially after the first child — she probably wouldn’t have been in the hospital anyway.

    DRJ (d43dcd)

  6. Very close family friend went through this very same thing — not resulting from child birth, but simply an infection of unknown origin that was not responsive to treatment. She had no history of health problems — completely a shock.

    Started with losing her hands and feet to the infection — she was in a coma the whole time — and eventually her legs. She died after about 2 months when her organ systems began to shut down. Never regained consciousness. Left behind two little girls both under 12.

    shipwreckedcrew (bafbcb)

  7. It’s easy to take modern antibiotics for granted – until you see the sort of thing that happens when they don’t work. I assume this was one of the new strains of antibiotic resistant bacteria. There’s a gory article on necrotizing fasciitis – what this woman had – at wikipedia.

    Subotai (440f66)

  8. It’s so easy to judge from afar, isn’t it?

    Dana (1e5ad4)

  9. I would agree with DRJ, that even if she had given birth in the hospital she would have been home before the onset of symptoms.

    Antibiotic resistance is not necessarily a feature of the condition. What is a typical feature is that the initial site of infection is relatively deep within the body and gives relatively little symptoms or signs of how bad the condition is, until the bacteria have had a “head start” in damaging tissues and producing toxin. One semi-accessible technical article is here:
    http://www.cfp.ca/cgi/content/full/55/10/981

    You can also do a “Scholar” search in Google on necrotizing fasciitis (click on “more” on Google main page to see the option).

    It’s the kind of condition that will not be caught until usually too late, unless the physican/medical staff are bothered by subtle things that “don’t add up” and actively pursue the possibility.

    Definitely gives evidence why third parties who don’t know a person should not project their thoughts and feelings onto someone else.

    MD in Philly (ea3785)

  10. MD in Philly wrote at 5/10/2010 @ 7:30 pm:

    It’s the kind of condition that will not be caught until usually too late, unless the physican/medical staff are bothered by subtle things that “don’t add up” and actively pursue the possibility.

    True, and recent story —

    Friend of mine awoke one day and felt pain near armpit when raising his arm over his head to put on a shirt. He and his girlfriend looked at the area, found it appeared bruised. Went to his doc. Doc said essentially, it’s a bruise, take some aspirin and call me in a week.

    They went back home. Pain increased greatly within an hour or so, and the “bruise” was spreading. They went to emergency room. Luckily, there the examining physician figured it out very quickly: necrotizing fasciitis. They carted him to surgery immediately.

    He was in hospital for months in an induced coma. the bacteria was apparently antibiotic resistant. They performed debridements very frequently. He lost a lot of muscle and skin on one side and arm, as well as some elsewhere. After he was clear of the infection, he then went through months of grafts and other surgeries at a burn center.

    He is now fully recovered, in the sense that he is alive, walking around, and undergoing intensive physical therapy. He has regained most, but not yet all the facility of his arm and hand that he once had.

    He considers himself lucky to be alive. Another few hours before going to that particular hospital would have meant he likely wouldn’t have survived.

    IANADoc, but my understanding is that these bacteria strains (I think it was strain of e. coli.) are both rare and very poorly understood.

    Reader who doesn't comment much (8a67a5)

  11. My own personal axe to grind – at least now maybe will understand that pregnancy and childbirth pose significant risks, even to healthy women.

    SarahW (af7312)

  12. Comment by Reader who doesn’t comment much

    Thanks for sharing that experience. Typically when a doctor says “see you in a week” that is with the understanding that there are no significant changes in the meantime. That may or may not have been understood. It is often the case that this or other things (like meningococcal meningitis) at some point have nothing that makes you suspect them, then at a later interval it’s pretty obvious that something very bad is happening. The deciding factor is how close to time A rather than time B the realization comes.

    As the article I linked above reveals, the bacteria doesn’t have to be antibiotic resistant or unusually virulent to cause this syndrome. It is more of a “bit of bad luck” that somehow a scratch or other incident led to a bacterium finding a nice place to grow where it could hide for awhile. Mike K. can speak more to this if he wants, but I’m sure he would say that when a surgeon does a debridement it is a difficult decision “where to stop”. No one wants to remove more healthy muscle, etc than necessary, but if you don’t remove enough at a margin you’ll stay playing catch-up.

    My own personal axe to grind – at least now maybe will understand that pregnancy and childbirth pose significant risks, even to healthy women. – Comment by SarahW

    Well, that’s a two-sided axe to grind. Prior to this event, and maybe perhaps even after, Katy would have said that childbirth is a natural event that happened billions of times before there were modern obstetrical wards. So I think it’s a matter of perspective whether you see this as indicative of the inherent risks of childbirth or an example of anything can happen out of the blue on any given day. If one takes the former perspective, then logically it would suggest that any woman who doesn’t want an in-hospital birth accompanied by a physician is taking an unnecessary risk, and that we should push hospitals, doctors, and insurance companies to keep moms several days post delivery “like they used to do”.

    Yesterday two people were killed in a head-on collision at 1 in the afternoon on roads I routinely travel less than 15 miles away, when one car swerved into the opposing lane for some reason. Is it a reminder for me to pay attention not only to my driving but to be more attentive to others? Yes. Will it make me take greater precautions like buying a bigger car, or driving less, or anything else? No.

    It is both a sad story and a heroic inspiring one. I don’t think it is a meaningful reason to point out why child-birth poses a “significant” risk to a woman’s health. I think you could probably make a better argument with multiple problems that are much more likely, but not as drastic, as this one.

    MD in Philly (ea3785)


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