In late December 2003, suffering from a fever of 103^0 F, their 37-year-old daughter Quintana headed off for the emergency room of Beth Israel North, a New York City hospital - just to be sure. The hospital diagnosed common-or-garden flu and sent her home.
On Christmas Day, her symptoms worsened, and she returned to Beth Israel. This time, the doctors discovered what they believed were bacteria in the lower lobe of her right lung. Although characterised as 'walking pneumonia' - a "five on a scale of 10 in terms of seriousness" - she was admitted to the intensive care unit (ICU) for monitoring. She was given Ativan, Demerol, then massive amounts of five of the world's most ferocious antibiotics, including vancomycin, intravenously. The infection carried on spreading, eventually to her other lung. By Boxing Day, she was in septic shock. She remained in the ICU for 20 days, under heavy sedation.
Eventually, her parents learned, hospital tests showed no pneumonia bacteria. The real danger, it seemed, had been a hospital-acquired infection.
While recuperating at her mother's house, she developed pulmonary thrombosis, largely from being immobilised for so long, and had to be rushed back to hospital, where she was placed on anticoagulants (blood thinners).
On March 24, she flew to California for a holiday with her new husband. Right off the tarmac, she collapsed. Emergency surgery uncovered an artery "gushing blood like a geyser", with no clotting factor. She'd been given too high a dose of anticoagulants. She caught another hospital-acquired infect-ion and more sepsis, and lay in a coma.
Again she survived, and returned to 15 weeks at the Rusk Institute of Rehabilitation Medicine at New York University Medical Center in New York, learning again how to walk. A year later, she died, age 39, ostensibly from pancreatitis.
As for her father, on December 30, while Quintana lay unconscious in Beth Israel, Dunne collapsed with a sudden massive fatal heart attack, possibly brought on by the stress of observing his only child beyond his help. Dunne had had advanced heart disease. He'd had blocked arteries, then atrial fibrillation, and had undergone angioplasty, had a pacemaker implanted and, most recently, was given periodic cardioversion, where the same defibrillating paddles used during cardiac arrest are employed in an attempt to jolt the heart into beating regularly.
After the angioplasty of some 18 years before, the doctors had never looked at his arteries again. His heart had presented with one more well-known symptom of advanced atherosclerosis after another, but his physicians believed that he'd been sorted out. It had been broken, and now it was fixed.
Quintana only learned of her father's death 20 days after the event, after she'd recovered from her first hospital-acquired infection, but before the hospital-acquired pulmonary emboli and before the hospital-acquired stroke.
I wanted to cry when I finished the book. One of my girlhood heroines, whose taut narrative style I'd long admired, had lost her entire family in the span of 18 months to modern medicine.
The book is a beautifully rendered memoir to a 40-year partnership. But to me, it carried a different kind of message, a moral about the wisdom of the body and the calamitous ignorance of treatment for heart disease (see page 6).
Their mistake started and ended with the fever. If only they'd just let it run its course (see page 18). If only they'd trusted the process.