Karen Marie Kline Santa Fe, New Mexico 87507                                                                                                 October 10, 2004 Dr. Bardwell, Admitting Doctor, Emergency Department, St. Vincent Hospital 465 St. Michael’s Drive Santa Fe, New Mexico 87505 Dear Dr. Bardwell, I am feeling worse than I did before Thursday morning when I began having the muscle contractions that were so violent and painful that I couldn’t move and was screaming and Whole Life Clinic called an ambulance to take me to the Emergency Room. The reason I say I’m feeling worse, is that my stomach muscles feel as if I just had my appendix out; I can’t stand up long enough to make myself a cup of coffee because the pain so rapidly becomes unbearable; I became exhausted from sitting in the car (while the lady delivered some of the summonses – not all because I began to have so much pain); I become as fatigued from thinking as I do from actually being up; the muscles in my back hurt as bad as the labor pains that began in my back when I had my son; my eyes burn; I have to sleep sitting up just as I did before being in the Emergency Room; and I seem to be getting weaker -- my car door has long stuck, but now it’s like I’m trapped in my car because I don’t seem to have the strength to open it like I did before Thursday, and when I lift my little notebook computer, it feels as if I’m lifting a stack of books. If I didn’t have this notebook computer that I can use in bed, I couldn’t write this because sitting at my desk caused immense pain in my back muscles. I can’t go into my garden and pick vegetables because I can’t bend down without major pain. I can’t cook things to eat because I can’t bend to turn on the faucet to wash utensils and pots because there’s a tiny stretch involved and it’ s so painful and because it feels as if the muscle contractions will begin again. The bending to turn on the faucet is really minimal yet it is major painful. And all of this is after taking the prescribed amount of Ibuprofen. Before Thursday, October 7, 2004, I wasn’t taking any Ibuprofen because I was taking Aspirin because I’d been nauseated and I was afraid the nausea was because of my heart. I didn’t think it would be good to take Aspirin and Ibuprofen together. Yesterday I thought I might feel better if I sat in the sun for a bit. So I moved a chair about 10 feet so it would be in the sun. That minimal exertion caused me to start trembling so that I decided I’d better go in and lay down again. I had to stay in bed four out of seven days before the severe muscle contractions that forced me to have to be taken to hospital by ambulance. Now I’m in bed all of the time except when I go to the bathroom. When I told you in the Emergency Room how much better I was, it must have been the muscle relaxant or pain killer that was put into my I.V. that made me feel better. Once that wore off, there wasn’t any improvement. In fact, I feel worse. Because this is so, I must make it clear that I strongly object to the fact that the doctor who saw me, Dr. William Raboff, required me to have a psychological evaluation before he would prescribe any medical remedy. Because of my TBI, it was very confusing to have the I.V. in my hand, and to be in the Emergency Room and to be feeling better... and to have to work out whether there was anything that had been done that might make me feel better in terms of my original complaint. I mean, it was just so hard to be able to work out that nothing had really been done to address whatever was causing the violent muscle contractions. I had to actually ask a nurse or tech about this. The person I asked confirmed that nothing had yet been done to relieve whatever the underlying problem was. When I asked Dr. Raboff about the results of the tetanus test, he said the results weren’t back but that even if they were, the test wouldn’t show whether I had tetanus because if I’d ever had a tetanus shot, then the results would be positive and that would be meaningless because all it would be showing was that I’d had a tetanus shot. I asked if that was even if my last shot was 30 years ago, and Dr. Raboff said yes. Dr. Raboff at no time touched my toe, even though I said that it had hurt when I’d bumped it against the washing machine on Tuesday, (October 5, 2004). Dr. Raboff did not ask me about my life style, like whether or not I was exposed to the earth where tetanus might be contracted. (Because I grow so much of my own food, and move my compost pits periodically, I am constantly getting dirt on my feet because I constantly wear sandals. I am also concerned that when the psychologist, Paolo Guidici, came to see me, he had been told that I had come to the Emergency Room by myself. The fact was that I’d been brought there by an ambulance. I am concerned that Paolo Guidici appeared to have been told by Dr. Raboff, that I said I had tetanus. (Paolo Guidici wrote that I said I had tetanus.) I was and am afraid I have tetanus. That’s why I got the tetanus test at TriCore after I called a pharmacist on the evening of October 2, 2004, and she’d said that the only way to know was to test for toxoids. I don’t know what those are, but maybe they are the tetanus antibodies. I asked several times in the Emergency Room whether they had gotten the test results. If I “knew” I had tetanus, I wouldn’t need a test because I’d already be certain. I consistently said I thought I might have tetanus because of the darning needle I jammed into my toe by accident. I didn’t say, “I have tetanus,” because while I am afraid that I have it, I don’t know that I have it. Not only that, I explained that I have some TBI brain damage and that saying things clearly is hard. In the beginning it was really hard to talk because of the pain. My concern is that I have a very serious disease that should have been given immediate attention. It’s such a serious disease that I think it might have been wise to err on the side of caution and to give me the antibiotics immediately rather than withholding antibiotics until after I’d been screened by a psychologist. When I asked what else might be causing the muscle pain, I was told a trauma could do that. But I haven’t had a recent trauma and, no other explanation was offered. So, if Dr. Raboff didn’t think I have tetanus, what did he think was causing the severe muscle contractions, and what did he do to provide medical care for the cause as he saw it? I am in extreme stress as a result of my condo being built over an old privy pit and the other unit owners not paying their share of fixing the common element defect. Because of their refusal I am in foreclosure on my home and on my income property. I write this because Paola Guidici said he’s noted that I have “moderate” stress. When PNM was threatening to shut of my electricity this spring it was so scary that the stress caused me to get tinnitus. I think the stress caused my tinnitus because I was shaking from apprehension and then the ringing started. The ringing has been so loud that there have been two times when I could understand how someone could kill themselves because of it. In fact, a family friend of a girl in a therapy group that I went to, had killed himself with a bullet into his head. I don’t think this stress is moderate. I don’t have the money for healthy food. My garden is great, but the growing season is fast approaching its end, and besides that I can’t bend down to pick things now, much less work in my garden. I don’t think it is a moderate stress when people you know refuse to pay what they owe when they can see the extreme damage their refusal causes. It’s stressful to be in poverty. But it’s way more stressful to know that the people who are causing ones poverty, know they are causing the poverty. (The papers I filed in the foreclosures are relatively clear in showing the facts and I will post them on my web site as soon as Yahoo! replaces the SiteBuilder program I was using before it went bad.) If I continue to be this sick, though, I don’t know how I will do the legal things necessary to save my property, especially since I’ve had to battle to get the district court to accommodate my disability. Which reminds me, Dr. Raboff did not seem to understand TBI. He kept asking me if I’d had a head operation. He didn’t seem to have any concept of how the pain could make it extremely hard for me to answer him the way I could if I were not disabled and not in pain. He made no attempt to accommodate my disability. I am concerned that he did not want to consider whether or not I might be in an early stage of tetanus. He seemed to think that the fact I did not have some sort of facial nerve disorder from tetanus, was conclusive proof that I did not have tetanus. He actually said that tetanus was very rare and I couldn’t have it. When I realized how worrying and risky it was that he had taken that position, I spent a lot of time organizing how to tell him about the B12 I take because of my B12 malabsorption illness. I felt it was imperative to make the point that if someone with less healthy levels of B12 were exposed to tetanus, then they might have more severe symptoms earlier on than I had them. Tomorrow I will complain to St. Vincent’s Mental Health and Psychiatric Services about the ten areas in which Paola Guidici made factual errors. While his errors may reflect what Dr. Raboff told him, I believe he had a duty to report facts, not hearsay. My concern which I want to raise with you, is the influence Dr. Raboff may have had in instigating the errors. If Dr. Raboff formed faulty impressions and failed to ask appropriate diagnostic questions of me, and then influenced the psychologist by relating to him false concepts of facts, then that is a serious failing and negligence and it caused false statements to be made about me in my records. But worse, Dr. Raboff may have failed to do an adequate job of giving medical care to someone who had symptoms related to tetanus and whose factual history involved a puncture wound. I remain very worried because I don’t feel any better, and in fact feel worse. I’ll carry on taking the prescription and Ibuprofen, and if I still don’t feel better on Tuesday, I’ll call you then. 10/11/04        I am scared because when I woke up this morning my back muscles felt the way they did last Thursday, the 7th, which was the day they contracted so painfully for such a long time. I have a stiff neck from the tension of the worry. But that’s rather normal because of all the tension in my life: foreclosures, but before that the condominium privy pit that was expensive to remedy and the other owners refused to pay their shares, plus just finding out I have brain damage. I knew something was wrong, but to actually find out that it’s for sure, that’s very stressful. I was also thinking, I wonder if I would have gotten so much worse if the Emergency Room experience had not been so stressful, like being refused medical attention for my underlying medical problem until after I’d had a psych evaluation. I do not understand why they would not let me have water or anything to drink when I was so thirsty. I asked several times. When the techs had a hard time drawing my blood and they kept saying that the flow stopped, I asked if that could be because I had so little liquid in my body. I told them and the nurse that I’d not had anything to drink that morning so that I wouldn’t have to go to the bathroom while I was out. I didn’t get anything to drink until the shift change and Karlene came on duty. She brought me something to drink. I believe that was over five hours after I was brought in and began asking. Each tech that I asked said they’d have to ask the doctor. So, did Dr. Raboff deny me water? And if so, for what reason? Sincerely,                              Karen Kline Copy: St. Vincent Hospital, Governor Bill Richardson, Representative Tom Udall, Senators Domenici and Bingaman, KOAT, KOB, KRQE.

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