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Prologue

The following private journal entries were written by the late Kate Hurley, a thirty-seven-year-old, physically fit (played lots of tennis and was careful about her diet), moderately compulsive, third-grade elementary school teacher and doting mother of two boys, aged eleven and eight. Until her death during a horrific home invasion, she lived with her family at 1440 Bay View Drive in Mount Pleasant, South Carolina, across the harbor from Charleston. The house stands in a relatively secluded wooded section at the very end of the road. She was married to Robert Hurley, an aggressive personal-injury lawyer.

Saturday, March 28, 8:35 A.M.

It is a dreary, gray day as I look out the window of my hospital room in the Mason-Dixon Medical Center. Hardly the spring weather we all expect. I haven’t been good about writing in my journal over the last six months even though doing so has always been a great solace for me. Unfortunately I have been exhausted at night and much too busy getting the boys and myself ready for school in the morning, but I will make an effort to change. I could use the consolation. I am in the hospital, feeling sorry for myself after a dreadful night. It had started promisingly enough as Bob and I had met Ginny and Harold Lawler for dinner on Sullivan’s Island. They all had fish, and in retrospect, I wish I had done the same. Unfortunately I had chosen the duck, which was prepared on the rare side and which I would later learn from the emergency room physician probably had been contaminated, most likely with salmonella. I began to feel strange even before finishing the entrée, and it got progressively worse. While Bob was taking home the babysitter, I had my first episode of vomiting — not pleasant! I made a mess of myself and the bathroom. Luckily I was able to clean it up before Bob returned. He was sympathetic but tired from a busy day at the office and soon turned in. Since I still felt horrid, I parked myself in the bathroom and threw up several more times, even after I thought there was no way there could be any more food in my system. By two A.M. I realized I was weak and getting weaker. It was then that I woke up Bob. He took one look at me and judged that I needed to be seen by a doctor. Our health plan directed us to the Mason-Dixon Medical Center over in Charleston. Luckily we were able to get Bob’s mom to come over to be with the kids. She’s been a lifesaver on a number of occasions, this being one of them. At the emergency room, the nurses and the doctors were great. Of course I was mortified as the vomiting continued and bloody diarrhea began. I was started on an IV and given some medication, which I’m sure they explained, but I don’t remember. They also advised that I be admitted. I felt so out of it that I didn’t object, even though I have always feared hospitals. I also must have been given a sedative, because I don’t even remember Bob leaving or my being transferred from the ER to a hospital room. Yet a few hours later I do remember partially awakening when someone, probably a nurse, came into the dark room and adjusted or added something to the IV. It was as if I were dreaming, because the person appeared like an apparition, with blond hair and dressed in white. I tried to talk but couldn’t, at least not intelligently. When I awoke this morning I felt like I had been run over by a truck. I tried to get out of bed to use the bathroom but couldn’t, at least initially, and had to call for assistance. It is one of the things that I dislike about being in a hospital: you’re not in control. You have to give up all autonomy when you check in.

The nurse who helped me said that a doctor would be by shortly. I will finish this entry when I get home to talk about how this episode has made me realize how much I take general health for granted. I had never had food poisoning before. It is much worse than I had imagined. In fact it is god-awful! That’s all I can say.

Sunday, March 29, 1:20 P.M.

Obviously I already have failed to follow my resolution about writing in this journal more frequently. I did not finish yesterday’s entry as I promised myself because things did not go as I had planned. Soon after I had written the above, I was visited by one of the hospital’s resident physicians, Dr. Clair Webster, who noticed something that I hadn’t, namely that I had a fever. It wasn’t a high fever, but it was a change, since I had a normal temperature the night before. Although I didn’t realize it, machines were recording my pulse, blood pressure, and temperature continuously, which was why I hadn’t seen anyone during the night except for the person who had adjusted my intravenous. Even my IV is being controlled by a small computerized device. So much for the human touch in the modern hospital! Dr. Webster said my temperature had started rising about six A.M. and that she wanted to wait to see what it did before discharging me. I called Bob to let him know about the delay.

As it turned out, it was more than a delay, as my temperature did not return to normal but rather proceeded to climb all day and all night up to 104º F, so here I am still. And there have been some further complications. Right after Bob and the boys left from their afternoon visit yesterday (the boys were not supposed to visit because of their ages but Bob snuck them up to the room) I started to get very achy, and now I understand what people mean when they say they have joint pain. Worse than that, I have begun to have some breathing problems, and as if that is not enough, when I took a shower yesterday, I noticed I had a slight rash under my arms, and under my breasts, that are flat, tiny red dots. Luckily they don’t itch. The nurse said I had some on the whites of my eyes also. All that brought the resident doctor back. She said that she was confused because the symptoms were suggesting I might have typhoid fever, and she insisted I be seen by an infectious-disease specialist. So he came by and examined me. Thankfully he said it wasn’t typhoid and gave a number of reasons, chief of which was that I didn’t have the right strain of salmonella. Still, he was concerned that my heart had speeded up while I’ve been in the hospital. To check this out, he called in a cardiologist, a Dr. Christopher Hobart, who examined me as well. My room was like a convention center, with all these doctors coming and going. Dr. Hobart immediately ordered a chest X-ray because he thought I was having some fat embolization! As soon as I had a chance I looked up fat embolization online (thank God for the Internet) and found out it is globules of fat in the bloodstream, a condition usually seen in patients with severe trauma, including broken bones. Of course I haven’t had any trauma except emotional, so the cardiologist concluded it was from severe dehydration. But since I already had the intravenous line, he said there was no need for any further treatment, especially since my breathing seemed entirely normal. I was pleased about that, but, I have to say, all this has made my hospital phobia skyrocket. I read something about hospital complications a few months ago in the Post and Courier, and what was going on with me seemed similar and was making me really anxious. The only thing that was wrong with me when I came in Friday night was food poisoning, and now I was supposedly having fat embolization. I called Bob and told him how I felt and that I wanted to get out of this place and come home. He advised me to be patient and that we would discuss it later, when he comes to visit, after his mother comes over to the house to watch the kids. I will finish this entry after Bob and I talk. On top of my other symptoms I’m having some trouble concentrating.

Monday, March 30, 9:30 A.M.

Once again I failed to write in the journal, as I had planned after Bob’s visit. My excuse was feeling spaced out. That’s the best way I can describe it. I had written yesterday at the very end of the entry that I was having trouble concentrating. It got worse. I don’t even remember all that Bob and I talked about when he was here, although I do remember that he, too, got upset about all my emerging symptoms, demanding to talk to the doctors who had come to examine me. Whether he did or not, I don’t know. And I don’t remember much else that he said, although I do remember that he was going to call Dr. Curtis Fletcher, our old family doctor, and get him involved.

I vaguely remember getting agitated after Bob left, worrying that I was getting worse and not better. That got Dr. Webster back, and she prescribed a sedative to calm me down, which certainly did. The next thing I remembered was again waking up in the middle of the night. This time it was with someone doing something to my belly that felt like a needle prick. Maybe it was the same person who had adjusted my IV the night before. I’m not sure. When I awoke this morning, I wondered if it had been a dream until I found a slightly tender area on my abdomen. Are some sedatives given there? I will try to remember to ask. My fever is down slightly, although still above normal. More importantly, I don’t feel so spaced out, and the achiness is much improved with ibuprofen. Maybe they will let me go home. I hope so. My dislike and fear of hospitals have not improved. They’ve gotten worse.

10:35 A.M.

I am back writing! I am very upset. I am not going home. Dr. Chris Hobart just returned with bad news. He said he had ordered an albumin test yesterday, which turned out to show that the albumin was okay but that I had another blood protein that was way up! He said I was developing a monoclonal gammopathy, whatever the hell that is. I have yet to look it up on the Internet. I hate it when doctors talk as if they don’t want you to understand. I know this sounds paranoid, but I think doctors do it on purpose. To his credit, he did say that the elevated protein was probably not a problem, but he wanted me to have another consult with a blood specialist, meaning I wasn’t going to be discharged.

3:15 P.M.

The blood specialist just left, promising to return in the morning. If her visit was supposed to calm me down, it didn’t work. My worst fears about hospitals are coming to pass in spades. This new doctor is a blood cancer doctor! An oncologist! I’m now terrified I’m going to come down with something like leukemia. The doctor’s name is Siri Erikson, which sounds Scandinavian, and she looks it. All I can say is that I want to go home! Unfortunately I still have a high fever, and Dr. Erikson said it would be better for me to stay another few days to see if they can find out what is causing my temperature to go up, or, at the very least, let it come back to normal.

But I’m really anxious. Everything that is happening is convincing me that hospitals are not safe places to be unless you really need them, like I suppose I did Friday night. It seems that the longer I stay here, the more problems I get. I will talk to Bob about all this when he comes to visit after work. On the plus side, my GI system is getting back to normal. My diet has been upped to normal foods, which I am tolerating fine. I just want to get out of here and get home with Bob and the boys.

4:45 P.M.

Bob expects to be here around six P.M. In the meantime I put in a call to Dr. Fletcher, our old family doctor, which Bob had forgotten to do after he said he would. I remembered seeing the GP for a physical about two months ago, when Bob and I were toying with the idea of getting some life insurance. The examination had included some basic blood work, and I wondered if it included blood proteins. At the time I had been told everything had been normal. When Dr. Fletcher called me back to commiserate about my bout of food poisoning, he told me that the blood work he had done did include a blood protein screen. He confirmed it had been normal. When I told him about possibly having a protein problem now, he was surprised, although he said such a problem can start at any time but usually only involving people much older than I. His advice was that the test should be repeated, and I told him that it had already been ordered. As far as getting him involved in my in-hospital care, he said he couldn’t do it. He said that he did not have privileges at the Mason-Dixon but would be happy to talk to any of the doctors taking care of me if they wanted. I thanked him and told him that I would suggest it. Needless to say, I’m disappointed with what’s going on, and I have decided, no matter what, I will check myself out of the hospital tomorrow as long as Bob is okay with the plan.

7:05 P.M.

Bob just left. Unfortunately I’ve gotten him really upset. After telling him what I had learned from Dr. Fletcher, that my blood proteins were normal a few months ago, he wanted to sign me out of the hospital immediately. Strangely enough, his emotional response made me hesitant about leaving, especially since I had been told that it would entail signing out against medical advice. Finally I was able to convince Bob that we should wait at least until the morning, when I would be seeing Dr. Erikson again. After all, blood problems were her specialty, and I wanted to be reassured I didn’t have something really bad, like cancer.

Now, lying here at the mercy of this place and listening to the sounds drifting in from the corridor, I wonder if I should have let Bob check me out no matter what I needed to sign. To make matters worse, I have just noticed what might be a new symptom: my belly feels slightly tender. Or at least I think it does when I press deeply. But maybe it always feels that way. I don’t actually know. Maybe I’m being overly melodramatic and even a little paranoid. I’m going to ask for my sleeping pill and try to forget where I am.

Tuesday, March 31, 9:50 A.M.

I just hung up with Bob. I’m afraid I have ignited a firestorm. I told him that Dr. Erikson had come by with the news that the protein abnormality, or gammopathy, in my blood was real, and the level was even slightly higher than in the previous test. When she saw how upset I became, she tried to backtrack and calm me down. But her reassurances fell on deaf ears. Not after reading what I had on the Internet about blood protein abnormalities. As soon as she left, I called Bob and, bursting into tears, I told him what had happened. He told me to start packing my things because he was coming in to sign me out. And that was not all: he said he is going to sue the bejesus out of Middleton Healthcare, the corporate owners of the Mason-Dixon Medical Center and thirty-one other hospitals. When I asked why, he told me he’d pulled an “all-nighter” doing research using his inside channels (he actually pays informants at area hospitals to find out about difficult cases so he can contact the patients directly). He said he had learned something disturbing concerning Middleton Healthcare hospitals that he needs to follow up further and will explain when I get home. Meanwhile, he wants me out of the Mason-Dixon Medical Center pronto (his word). He said that the Middleton Healthcare hospitals had excellent stats in relation to hospital-based infections, but when it comes to a discharge diagnosis of a new, unsuspected blood-protein abnormality, like I supposedly have, their numbers are off the charts. He believes that he may have stumbled onto a class-action lawsuit that could make his career. He said that his intuition was telling him that Middleton was doing something strange, meaning some sort of corporate wrongdoing, and he intended to find out what it was and do something about it. We talked for quite a while, with him doing most of the talking. I have to admit I progressively felt a bit betrayed. His main interest had morphed from my problems and mind-set to a lawsuit supposedly in the public interest.

After I assured him I would be ready when he got to the medical center, and we disconnected, I stared out the window, feeling particularly lonely and worrying that Bob’s state of mind was going to cause problems for us over the long haul. We had to use Mason-Dixon Medical Center, as it was the only area hospital in our insurance network. The problem is, when Bob gets started on something like this, involving a major lawsuit, he is like a dog with a bone. I can’t imagine why Middleton Healthcare Hospitals would see more blood-protein abnormalities than other hospitals. It doesn’t make sense. Does Bob think they are drumming up business? I can’t imagine that could be true! But his aggressiveness about the hospital gives me a bad feeling, especially since the doctors and nurses really did help me when I was in need on Friday night. What if the boys need hospitalization in the near future? Could Bob jeopardize that? What I do know, and know better than anybody else, is when Bob says he is going to sue somebody, it happens. I suppose I can hope that once I am home I can calm him down, and we all get back to normal.