Kathleen Mitchell-Diary of a Death.

Kathleen Mitchell née Odell)           7 March 1947 - 3 March 1993
Diary of a death

(The following account has been published, finally, by me, after long reflection. Since I have no idea what may happen in the future to my papers and manuscripts, and since the safest place is where nobody can change them, i.e. published, here they are! I feel also, that they may be of interest to Kate’s family. It has certainly been difficult to transcript pages dealing with an event one would prefer to forget, but can’t)

The reader is under no obligation whatsoever to read this diary, and does so having understood, or at least having read, my reasons for open publication on this site.

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Diary of a Death.

Forenote:

Mrs Kathleen Mitchell was born in March 1947,in Keighley, Yorkshire, and trained as a State Registered Nurse at Guys Hospital, London, in the 1960’s.
In 1968 she married Mr I.W. Mitchell, who is the author of this diary.
They lived, and worked, in various European countries, until her death in March of 1993, from cancer.
Mr Mitchell is still alive at the date of this publication (2005) and has been living in the South of France since the death of his wife.
During the year 1992 up until her death in March 1993 my wife suffered from intestinal cancer, and was operated no fewer than 8 times during the period February 1992 and January 1993, inside 10 months.
The failures of the surgeons, particularly at Lorrach, Germany, are only briefly mentioned, suffice to say that the very first operation was disastrous, spreading rather than destroying the cancer.
These notes or “diary entries” are a reminder to me and to others that modern medicine is still often in the hands of people, with all the faults appertaining – pride and belief of their infallibility . Not only Lorrach and the University Hospital Freiburg in Germany are responsable for the eventual death of my wife, but the whole system, corrupted often by over-zealous surgeons, jealous of their positions, and by drug companies – the modern day gangsters of the entire world.
These notes accompany my wife from her return from the University Hospital, Freiburg, Germany, up to her death in the Hospital at Lorrach, Germany.
It has long been my intention to publish these little notes, together with one or two articles from my wife, but for too long I have stared at the book, instead of writing in it!
If there are critical remarks, even scathing comments, that is because they are merited by those concerned, and I have never hid my opinions of things and people in this life.
All “medical” or “ semi-medical” references/opinions are those given by medical/surgical personnel, in my presence.

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30th January 1993: Lorrach,Germany.
Returned from Freiburg this morning. Ambulance trip not the most comfortable, but supportable. On arrival, the urine catheter was taken out immediately, due to a bladder infection caused by the same, and because of the pains associated. Pains increased due to a distended bowel not due to the cancer.
To try to distract a little, I took in TV,radio, musical discs,magazines, newspapers, writing paper etc., as well as some food and drink articles, allowed by the doctors, but not available in the hospital. The fact that they allow all these things, and have moved Kate to single room (normally occupied by 3 people) are not encouraging signs.
The Doctors finally advised against her coming home at this particular stage, because they preferred to try and “stabilise” her condition first.
The morphine dosage is up to 200mg. I don’t really know what this all means, but I accept the obvious fact that the higher the dose, the more pain Kate must be suffering, but equally the more dependence on the drug. I know that she, as a highly qualified nurse is equally aware of all these facts, but she doesn’t talk of it, and I don’t feel it will help if I bring up the subjects.
For the moment, breathing is OK, just the occasional use of oxygen.She sleeps badly, nonetheless, and is extremely tired and “used”.
Sunday 31st January1993
Temperature has risen overnight to 39c and then redescended to 38.2c- otherwise no change. Kate talked about having a “jolt”(?)
1st February 93
Kate slept a little. Took some drops in the night against her fever.They made her feel sick, and there was quite a bit of vomitingand nausea. A “down” day. Started taking daily newspaper in, to try to renew interest. The biggest problem is still eating.Nothing goes down permanently.
Today was declared “final solution” day by the German Doctors here, a request for instructions regarding sedation was made. Who should take this decision – I can’t, and I’m not sure that Kate can. I suggested that the only thing to do was to follow her (Kate’s) instructions, so long as we could understand them, and that the minimum of sedation would be that to stop any physical suffering.
A bad day.
2 Feb 93
Slept a little, but I see that Kate is suffering physically and mentally. We finally got a longish period of time with Doktor Berger, and the decision was taken that from today, Vallium will be given, and the high calory drip food is to be stopped, in an attempt to get Kate to nourish herself from the diat in liquids (and milk puddings like semolina etc).
Immediately after the first administration of Vallium, I noticed a decided improvement, but this is the nature of the drug, which kills the pain, and puts the patient in a sort of “high”. She is certainly more peaceful and rested, but still so very tired and used.
The medical and nursing care is better, due to the fact that they are doing something for their ex-colleague.
3 Feb 93
Kate in very good form. A good night’s sleep, only problem today are that the slight pressure pains on the stomach are getting worse. Vallium and Morphine doses at the same level.Kate broached the subject of “funeral” and so we talked about that and other similar things.We watched a TV film together and Kate slept in.
4 Feb 1993
Kate in good form again, her bag or “beutel” which is there to catch the excrement, is working in fine form (which means the healthy intestine left inside her is working, and isn’t blocked by any cancerous growth) and like two kids, we watch this bag filling up, and congratulate each other! The drug dosage is still at the same level, as I understand it, Morphine at 240 (whatever that means) plus Vallium. Kate is eating a little, and expressed a desire for some water “Perrier zest” which I went out to get.
5 Feb 93
No change – still in good form. The stomach shows strange “coloured wrinkles”-this may be the first signs of further problems.
6 Feb 93
Moral dropped. “Eye wandering” and almost depressive tears. She has every right to react so, having been so incredibly brave. A diat expert is due to come on Monday.
On leaving the hospital, I found that some friendly person had stolen my bicycle.
Sunday 7th February 1993
No change, except that she asked for the morphine to be raised from 240 to 260. Vallium stays the same. These figures mean nothing to me, but as the professional nurse that she is, Kate is aware of their significance, and I asked the Doctor privately, if he thought it was a good thing that she was informed of the doses given. As he said, it was Kate herself who suggested what dose should be given!
Same day – evening – Morphine dosage up to 300! Otherwise – no change, in fact quite cheerful.
8th Feb 93
Kate slept long, and very soundly. On awaking, she was a little confused, as though a good sleep had let her forget everything. She was sick only once, possibly due to adapting to her new diat. This worried her slightly, and when I left to do the shopping , she had a slight fever, and was very warm, but then so was I!
PM – same day – Fever gone temperature down to 36.6c. All these little triumphs we have to hold on to. She is very sleepy, due to possibly too high morphine dose, when the pains go down, the morphine makes you sleepy.Kate described her state of health as “quite well!”Frankly, such courage is remarkable.
9 Feb 93
No change – still quite sleepy. Temperature is normal, but she has “cold sweats” from time to time.The doctors say these are due to the medicaments, and that blood counts and other tests are excellent. I try to get this information over to Kate, and she seems pleased.
PM – same day – Very bad. Back onto oxygen, due to a vein canal tube falling out and the morphine running onto the bed, and not into the vein. Kate was asleep at the time, and must have turned awkwardly or something.At the moment she is in extreme pain, and a new tube has been installed, and the morphine is flowing. This will subdue the pain, but is a bad setback – to reality maybe – for Kate and myself, for now we know what happens when the drugs are stopped. She is drowsy but restless, with cold sweats, still on oxygen and still uneasy.The vein drip is ok now, but a new artery drip is being put in today.
Weds 10 Feb 93
Arterial drip has been done, and Kate is in a much better condition.Vallium doses stays the same, but we know how depend she is on the drugs now.She is still tired, but cheerful, and less oxygen is needed.
Thursday 11 February 1993: This is a big day. A new summit meeting is set up with the Doctors. Vallium and Morphine doses are to be raised to 20ml and 360ml respectively.Kate was very depressed after this visit, and cried a little, but said that her body and mind were not yet ready to die. I wish I could take her place, but I can’t, and all I can hope is that when my time comes, that I am as cheerful and brave as my wife, Kate.
She has decided to try the higher drug doses, and let them increase them as necessary, instead of the alternative – a spinal nerve closure, which would effectively take all sensation (pain or otherwise) from her, from the waist downwards. In the afternoon, she had obviously chewed it all over in her mind, and seemed to be back to normal cheerfulness.
12 Feb 93
Kate slept heavily, there is no change, but she is in good spirits. She feels sick quite often, and when she vomits, the odour and colour is the same as diahorrea (indicating not very good things) on top of which, her bag is not filling anymore, and her stomach is very swollen.Cortison and anti-nausea treatment is being given.She complains of pains in the upper thorax, and pressure, Temperature 37.4c
13 Feb 93
Slept very solidly and seemed to be in good cheer.Slightly different attitude, as though she is coming to terms with destiny.Her stomach is becoming very problematic, and the bag is still not filling, for a second day.The result is that she is still feeling and being sick.
PM: No change apparent.The stomach appears to be empty, because although still nauseaus feelings, no passage of vomit has been made.
Kate shed a few tears, because she was unable to eat anything, and she wanted so hard to please me. We had a little laugh about it afterwards, and we ordered ourselves cups of tea! (Coffee is not allowed, of course, and quite frankly the tea is so weak, it is hardly recognizable, but with the cheerful atmosphere it brought, it seemed to be champagne.
Her strength is going rapidly, but her willforce is unbelievable.
14 February 1993: St Valentine’s Day.
Kate hadn’t slept too well, but was quite cheerful. I hope my little gift and Valentines card helped a little. No chocolates of course, this year, but I promised them double in the next year, and we both had a giggle about it. Don’t know how or why, but the situation and the nearing departure of Kate, seems to have now been assumed by both of us, and it simply isn’t a subject. We both know what implications are involved when we breach any particular subject, particularly of the future, but we still do so. No future kills quicker.
Not really an event for Valentine’s Day, but an event of note – the “bag” suddenly started working and filling again, after 3 days. This cheered her (and me) up a lot. She still feels sick now and then, but according to the Doctors this is probably due to the morphine.
PM: Took in some lemon sorbet, and an Orchidee, the sorbet melts and passes nicely, soothing the throat with the coolness.Kate was cheerful, but at the same time talked in a sad voice.
15 Feb 93
No change. The bag is now going like mad, filling over and over again. Kate jokes that I may have found the solution, and a great medicine, for bowel cancer – Lemon Sorbet! She was able to eat a little more at breakfast time and at lunch. She was quite cheered by this fact.
16th Feb 93
Slight rectal and stomach pains have appeared. Morphine dose is up to 400
Eating seems to be better or “easier” for her, but otherwise little or indeed no change. This afternoon the morphine dose is to be increased against the pain. Vallium has stayed at 20mg’s. I’m told by the Doctors this is “normal” because the Valium is given basically to “buck-up” psychologically, and this didn’t seem to be necessary. Higher doses would result in a quicker and more permanent and deeper state of “drowsiness/sleep”.
17 Feb 93
No change – no treatment – day passed calmly.
18 Feb 93
She didn’t sleep too well, and looks drawn and tired and weary. I get the feeling she has made her decisions.
PM: Pains returned. Morphine up from 400 to 500, Valium increased, and coming through very quickly. She is extremely tired, and things are looking very bad.
At this time, this publication will be stopped. The remainder will be published at a later time.
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(I would like to recall to the reader that they are NOT obliged to read this diary, that they do so having understood that I publish it only after a long period of reflection, and only because I have no idea what may happen to my papers and documents in the future. I feel that these notes may be of interest to Kate’s family, or friends – and maybe even to people suffering in a similar manner, to let them know that there are many others out there in the same situation).

Monday, November 21, 2005

Diary of a death Part II and fin.The Diary of a death - Part II

The Diary of a death - Part II



19th Feb 93: No change in the condition today. Kate is not being sick, and although very weak, she was able to sit on the edge of the bed for a while. The Nurse inside her told her to try and move a little to avoid “bed-sores”.
20th Feb: She slept solidly, otherwise no change. A period of relative calm over 2 days.
PM: Bad afternoon, Pains and increase of morphine. The new Doctor Hornimann may not be entirely in the picture, since he had attempted to reduce the dosage.
21st Feb: This was the worst night and morning.Kate is back onto the food drip, and is still suffering pains.
PM: Doctor is not available/present, and the pains are getting worse. Kate is very down and depressed, and seems to be on the outmost limits of consciousness
22nd Feb 93: Phone call in early morning from Hospital, fears for Kate’s life. No sleep, fever, back onto oxygen. The Doctors raised the Valium. This should have been done before, but the non-presence of Doctors at given moments is pre-occupying. Since the entry on scene of Dr Hornimann, the situation has rapidly got to the end point. He reduced the Morphine and Valium dose, he was not available on many instances, I have almost the feeling that the Hospital have bowed (as both I and Kate have earlier) to the inevitable, and have taken the chance to end the story, by the introduction of a Doctor and Nurses unknown to Kate, and Kate unknown to them. I can’t forget that Kate was, after all, the head Nurse of this very ward, where she has been a patient for so long, and where she will die. This could not have been easy for the Doctors nor for the Nursing staff, but now the inevitable changes to Staff and Doctors has taken place, and this was accompanied by an extreme worsening of my wife’s condition. That she will die, is inevitable now, but I was forced to put, very pointedly, with a language very understandable, to the Doctors and a couple of Nurses, that although I now accepted that, I did not, and would not accept the fact that their efforts be reduced. In particular concerning the pain factor, no reduction in anything would be made in future, without the control of the Doktor Berger, who had been promoted, and now had no direct function with the case. I pointed out the circumstances, and it was agreed that Dr. Berger would be consulted in any further treatment. Both I (and more particularly) Kate had a certain amount of confidence in this Dr Berger, who had done a maximum, and had gone as far as to “suggest” bad practices in the Operating Theatre by the Chief Surgeon, who had insisted on carrying out this operation on (as he called her) “his little English sister”. Bad operational methods and practices had apparently led to a spread of the cancer, and not to the end of it.
(There are more details of this at the end of this diary).
22nd Feb 93 PM: The decision to give heavy sedation was taken by the medical staff.
Shortly after, Kate was no longer speakable to. Morphine 800 Valium 80.
23rd Feb 93: Very sleepy, highly sedated – no communications, just a gasping noise, until the oxygen mask installed. Kate is going downhill very fast. She can’t speak, has all the appearances of an “artificial coma”, but nobody can tell me whether she can hear me, if she is aware of my presence or not. So I just talk.
24th Feb 93: This morning Kate was conscious, and we heard from the medical staff the decision, and were asked if we (more Kate than me) were in agreement. Due to pains, and other problems, it is proposed to sedate highly, in an attempt to “improvement through sleep” that is to minimize the bodies efforts, and let it concentrate on its own healing procedures. They know, I know and Kate knows, that this is what amounts to the final step.
When the Doctors/Nurses/Experts had left, we had the opportunity to talk a little together, although there is little to talk about. Kate tried to give me her wedding ring, now far too big for her finger, but I suggested that we tried it on all the fingers, and if necessary even the thumbs! We found finally a finger thicker than the others which held the ring in place. I was relieved, and Kate was too. She asked me for some more of the “Perrier” zest water, which I gave to her, and said I would bring some more in, this afternoon, since there was very little left.
PM: I returned after lunch with the water, and realized that it would not be needed. Over the lunch period, the Medical Staff had increased the sedation, and my wife was now in what I can only call a “trance” or comatose stage.
Valium is now 120 and Morphine 1000. Consciousness, I am told, is not possible under such doses. I was extremely displeased that this action had been taken in my absence, and that we had not been told. We could have made at least a final farewell. Had my wife not been in her condition, I know I would have physically attacked certain Doctors, and they knew that too.
Kate’s condition is no longer of this world. Her body weight has gone from some 55 kilos to 38 kilos in the last 3 weeks, she is in a coma, artificial yes, but nonetheless a coma. All I can do now is be present as much as possible, and hope that nature will take it’s course, either healing or killing, but any normal mortal can only support so much.
25th Feb: No change – Kate is still unconscious. General condition very bad, but her facial features show a tranquility which suggests that no pain is present, and that the dice have been thrown and the result accepted.
26th Feb 93: No change, I feel that she has left us in all but shallow breathing. I understand that the Valium and Morphine levels have been raised again.
27th Feb 93: Apparently Kate was “restless and uncomfortable” (the Nurse’s words) after her morning wash, and became slightly conscious. When I saw her, she seemed to be at peace, but became a little agitated and then very upset, until we both figured out that what she was trying to do was to say “Good Morning” to me! The love of this woman is enormous, and I reciprocate it. One of my problems right now, is that Kate has her birthday on the 7th March, and I firmly believe she is trying to survive till then. What do I do, is there any point in arranging gifts, cakes, etc?
28th Feb 93: I was called at 5.45 and when I arrived, I found no change in particular, her feet were very cold (a circulation problem?) and her breathing extremely irregular. She is unconscious, and shows no reflexes.
1st March 93: This “coma” condition continues. There are no reactions, except at washing time. Strangely enough, her stomach is much less inflated, her “bag” is working, even although she is on the liquid drip nourishment. Her breathing and pulse are however extremely weak, and irregular.
2nd March 93: No change in general condition. To the total disbelief and astonishment of all (me included) the urine and faeces are now coming from the correct places. No apparent reason for this. Kate is still comatose.
PM: No change, breathing shallower and gasping.
I have informed the staff (and Kate – if she hears me ) of my whereabouts tomorrow morning – I shall be in the Hospital, but in the Cardiac Dept, having an appointment for myself. If anything untoward happens, they can call me there. Life goes on – although it is of little interest to me personally what is to be done with me, it appears that the Doctors are keen!


********** 3rd March 1993 **********
Kate died at 0030hrs this morning,
and I died with her.
After a long and careful consideration of my personal position from the 3rd March 1993 onwards, I think I can say that the events leading up to this date, and the death subsequently of Kate, were also my destiny, and I effectively lost interest in the act of living from then on.
I was able to reject all treatment for cardiac and other conditions, was able to lead a relatively full life, mainly for others, arranging meals, parties, holiday events etc, for as many people as possible, on the basis that for me it was finished, but for them, their lives were still in full swing, and they should not be influenced by ANYTHING. If life is there to be enjoyed, then enjoy it in your own individual fashion.
I have no final thoughts, except that I have tried to remain faithful to the agreements made between myself and my wife, Kate, particularly in matters regarding religion, priests, minister’s prophets etc. I have tried to arrange the non-participation of any religion on the occasion of my death. I have left instructions that my body be donated to Science, or in the case of non-recognition, be cremated, with no ceremony of any religious variety, just as for Kate, whose urn is to be found in the cemetery at Lorrach, in Germany, and I look forward to rejoining her, not in the cemetery, but in spirit.
Mrs Kate (Kathleen) Mitchell-Odell



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Details regarding certain professional physicians in Germany
Most of these details were given “ad-hoc” to me by other medically involved people, after the death of my wife.
Some of the details only came out after her death, some had been overlooked at the time:
The “Oberartzt-Chefartzt” in Lorrach who had carried out the initial operation, and who had been accused on various occasions of malpractice (it always concerned his own state of health) effectively committed suicide some months after the events.

The “Professor-Professor-Dr.-Dr.” (and he used all these titles!) retired expert from Basel in Switzerland, who was called in by Dr Berger for an opinion, was about as useful as a Swiss cheese, full of holes, would be as a boat. An old retired, man, still, true to Swiss traditions “in it for the money” and who loved the “authority” and “respect” he believed was shown to him.
He too died some months after the death of my wife.

The indignities suffered at the University Clinic at Freiburg, Germany, who installed my wife, together with around 10 other women (all at the same stage, roughly) into a room with no windows, 4 walls, bare, and two doors, one double size (which allowed the passage of mortuary trolleys) and one single size which allowed the passage of people who had “escaped”.
These things were all changed rapidly, within 2 days, after I had taken the pleasure of explaining to the University Clinic Administration in my best (which means worst) Bavarian what I thought of them, their clinic, their attitudes, and what I planned to do about it.
One other thing on the positive side, Dr Berger. A dedicated professional, who often put himself into hot water for his patients. He was promoted (as stated in the Diary) and no doubt made his way in his profession. My wife, and I had immense respect for him and his attitude, and although it was he who suggested (almost pleaded) with my wife to go to the University Clinic Freiburg, to avoid the operating tables in Lorrach, he couldn’t have known of the conditions at Freiburg.

So the story is finished, and if I get the chance and pleasure to meet you all again, I shall still be trying to lead the life I chose, with my wife, and not one imposed upon me by others.

END

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