Opening session: Sepsis undiagnosed, cancer unreported

We opened by reading together the tragic, tragic, tragic story of the death in Naas hospital on Christmas Day just gone of twenty-four-year-old Karen McEvoy from sepsis, only days after safely having had her third child, as reported by Kitty Holland in the Irish Times.

https://www.irishtimes.com/news/health/woman-24-who-died-a-week-after-giving-birth-had-sepsis-says-coroner-1.3776483

The overall sense that came across from the reading was one of incredulity: how could this have happened to this young, healthy mother; how was the sepsis missed; how could she have handled so much pain without the urgency of the situation becoming apparent to everyone?

We looked at the language of the reporting and at what Karen’s partner, Barry Kelly, has said since, as quoted by Holland:

“Nobody asked Karen anything about why she was on crutches… “I went into her and I was talking to her. I was like: ‘I love you. You can’t leave me. We have to build our house. We have to get married in 2025.’ I just kept calling her. I can still hear the sounds of the compression pump on her chest, and all I wanted was to hear the beep, but it was just a flatline… “I have to do this for Karen. Her shoes are my shoes. No matter what I do or say I can never bring Karen back.
“I have to get answers for my kids. They are not going to believe in fairies forever. I have to be able to tell them: ‘This is what happened to your mum’.”

We discussed some of the factors that may have fed into the disastrous dynamic that led to the tragedy: her background, her situation, the time of year, the healthcare resources.

I wondered might there be anything in simply the fact that Karen was a woman (aside from the postpartum aspect of the pathology). There was a discussion about the idea of women being taken less seriously than men when it comes to their reports of pain. I suggested we keep in mind the possibility of some women in some cultures (Ireland, for instance) being less likely to report pain in the first place for fear of being the focus of attention, of causing someone a problem, of ruffling feathers, of breaching the unwritten code of behaviour that says you’re not worthy of anything more than survival.

With that in mind we moved onto our second text: John McGahern’s The Barracks, particularly the story therein of Elizabeth, who develops breast cancer and is very slow to report her symptoms with tragic results.

She could not let herself collapse …

She tried to brush it off as nothing. With all her will she rose from the chair. She lifted off the boiling kettle, put on a saucepan.
  “It’s nothing at all,” she smiled casually with every muscle in her face. “It’s only to be sure.”


It’ll probably be just another iron tonic,” Elizabeth tried to close the conversation.

“Have you been aware of them for long?” he asked.
  He did not even ask to see them yet. She pretended to count back.
  “Last November,” she diminished. “I felt as well as usual. Christmas was coming. There seemed so many things I had to do. It went on the long finger and slipped from day to day.”

  “In the breast. There are cysts there. They may be malignant.…”
  “When did you notice them?”
  “A few weeks ago,” she lied.
  “You never told?” he reproached.
  “I thought that they were nothing,” she tried to excuse. “I didn’t want to cause you more trouble. I was feeling tired and didn’t know till he said.…”

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