Tetanus: When Gardening Becomes Life Threatening

Karen Marie Kline

Santa Fe, New Mexico 87507
October 7, 2004
Dr. Fitzpatrick and Pattie (nurse),
Whole Life Clinic
404 Brunn School Road, Building C
Santa Fe, New Mexico 87505

Dear Dr. Fitzpatrick and Pattie,

I am grateful that you ordered the tetanus test. Because it apparently takes
ten days, I wish it had been ordered last week. But be that as it may, this is
good.

On Monday, October 4, 2004, I waited at the Emergency Room for about
4 hours. I would have waited longer, but all of a sudden, the cramping
stopped. I moved around a bit, to see if it had really stopped, and it had. So
I decided to leave. Among other things, I wanted to get some aspirin to take
to thin my blood a bit, since in the morning when I’d had blood drawn for
the tetanus antibody test, my blood had not only been very brownish in
color, prompting the woman drawing my blood to ask if I was on pain
killers... over two days I’d taken 8 Advil, and my blood seemed to be very
sluggish as it flowed into the vial. Because I used to have my B12 tested
regularly, I have some experience of my blood seeming to flow more
quickly.

Anyway, the hospital refused to give me an aspirin, and on Monday I was
nauseated as I had been on Sunday. Since I hadn’t eaten, I felt the nausea
could have been from the lack of sufficient blood or however that works, to
my heart. When I had all the chest pain back when I was living in the
hydrogen sulfide, the health care people would ask me if I were nauseated.
So, I thought that maybe nausea is associated with heart problems. And,
the Bayer commercials on telly tell me that aspirin helps.

Anyway, at the hospital Emergency Room they saw everyone that was
there before me, and then they saw everyone that came in after me. But
they didn’t see me. When I asked about how long it was still going to be,
they said that while I couldn’t see the Ambulances and the people brought
in by the Ambulances, that there were a lot of those people and they had to
be seen before me. That makes sense. But the fact was that all the people I
could see who came in after me were being seen before me.

Monday my muscles were cramping a lot. It got more and more painful.
But then the pain just stopped and my muscles weren’t cramping anymore.
So I decided that if I left I could get the aspirin and then get some rest.

Before I left I talked to some other people who were in the room. One lady
and her husband had brought in his 93 year old mother that morning at 9. 9
a.m. and the hospital had said that she could go home, then that she must
stay, then that she could go home, then that they wanted to keep her over
night. The couple was concerned because they had been told there weren’t
any beds available; his mother who has diabetes had not been given
anything to eat all day by the hospital, so that they were also concerned
about that and had gone out and gotten a sandwich for her.

My feeling was that the hospital did not believe that I was really sick
because I didn’t have a fever. I also was aware that when I’d come in at
the time of my suicide attempt in 1997, that they had labeled me
“paranoid” and ignored all my blood work that showed I had very low B12.
They hadn’t even bothered to ask me if anyone in my family had
pernicious anemia, which my mother did. So they had totally ignored my
physical problems, and worse, because they had labeled me paranoid, they
had caused subsequent doctors to treat me as if I had mental, not physical
problems. The result was permanent nerve damage. When I tried to sue
because of the impact the cognitive dysfunction part of the nerve damage
had on my ability to earn a living, their lawyers succeeded in keeping me
from getting any kind of remedy. But, I did see that the hospital changed
their records to eliminate the records that were most incriminating.

Since the Emergency Room most likely had access to my previous medical
records, I figured that they were going on the “paranoid” diagnosis and that
they thought I only thought I had a physical problem.

Okay, so I left and I went to Wal*Mart and got some Saltines to eat and
the aspirin. Next day I still felt great and I was so happy. I did a lot of
things for the first two hours, but then the pain began to come back. Only I
thought it was just soreness from how long my muscles had been cramping,
so I pushed on.

Also, because of the poverty I live in, there are so many problems, like the
bad food I had, which raised a question of whether that could be the cause,
and then there was the fact that I couldn’t afford a new air mattress, which
greatly reduces the amount of pressure on my right thigh which seems to
alternate between feeling like it has a BAD sunburn, and being numb. It
seems like that thigh was causing me to have some cramping because of the
pain from the irregular surface I was sleeping on, in the absence of an air
mattress after mine got a leak. So, in a way on Tuesday I was thinking the
hospital may have been right, that nothing was wrong with me.

Only that thinking changed when the pain became like that of an
appendicitis attack. It was just soooo intense. It made me sweat, it hurt so
much.

So I went to bed.

Also, I’d been taking Ledum, a homeopathic remedy, and I had thought
that might have worked, as another explanation for why I’d felt better.

Wednesday the pain was still bad, but not of the intensity of an appendicitis
attack. I couldn’t do anything, though, because as soon as I was up for
more than a minute or two, the pain’s intensity increased. I prayed that if I
stayed in bed, then Thursday (which is today) I could have a reprieve from
the pain and be able to try to get the medicine to make the tetanus go away.
I think this must be tetanus because of how all my muscles are affected.
Not “all” but pretty many, like especially those in my mid-section.

Right now my back muscles are beginning to hurt really a lot, again, so I
think I will cut this off here.

I wanted to explain what had happened so far.

I will go in to Dr. Fitzpatrick’s about 9:30 a.m. because I think that it is
unwise to not have medication.

Sincerely,

Karen Kline

Copy: St. Vincent Hospital and Alice Sisneros

Karen Marie Kline

Santa Fe, New Mexico 87507
October 9, 2004
Dr. Fitzpatrick, Whole Life Clinic
404 Brunn School Road, Building C
and Alice Sisneros
Galisteo Road, Suite
Santa Fe, New Mexico 87505

Dear Dr. Fitzpatrick and Alice Sisneros,
The results are not yet back from the tetanus test ordered by Whole Life Clinic, so I don’t yet know whether or not
I have tetanus.
What I do know, is that I was in EXTREME pain when my muscles began contracting at Whole Life Clinic on
Thursday morning. That was when a Whole Life Clinic health care provider called an ambulance to take me to the
Emergency Room.
Today, two days later, the pain is so intense when I stand, that I can not handle more than a minute or two, and
bending is beyond my capacity to withstand the pain.
Significantly, the pain restricts my activity so severely that all I am able to eat is Saltines which require no
preparation.
Making myself a cup of coffee or green tea is such a painful undertaking due to the amount of standing required, that
if I make one cup of each a day, it is a tremendous triumph over the pain.
I am writing to note that the hospital gave me a pain killer in the I.V., and then several hours later gave me two 250
mg Erythromycin and a prescription for same.
One of the hospital nurses showed me a medical book that said antibiotics stop the toxins from forming. Apparently
the toxins attach to nerves or something.
Because tetanus, if this is tetanus, is a virus, the antibiotic doesn’t kill the tetanus, it stops the toxins. I don’t pretend
to understand this, I just know that this sounds pretty simple and I’m pretty angry that you failed to give me a
prescription for antibiotics on the first occasion that I came to each of you.
I came to you, Alice, on October 1, 2004, when you refused to see me. In the past when I asked you if I could pay
in the future, you said no, that I should go to the Emergency Room, that they take people who can’t pay.

I came to you, Dr. Fitzpatrick, when I called your home over the weekend. That was October 2, 2004 after a
pharmacist had told me I needed to get a toxoid test and that I needed antibiotics which she couldn’t give me
without a prescription.
I came to you, Dr. Fitzpatrick, again on Monday, October 4, 2004. At that time a tetanus test was ordered at
TriCore, to be done “STAT” which I was told meant right away. Later that day, when I learned that it would take
ten days to get the results, I got scared because of the level of pain, and went to the Emergency Room.
At the Emergency Room, after waiting an hour or so, I called you to see if I could get a prescription for the
antibiotics, since bad muscle cramps were making my wait in the Emergency Room difficult. I was told, no, you
would not give me a prescription without seeing me and that I should stay at the Emergency Room.
Two or three hours later, the cramps stopped. Even when I moved around, the cramps did not return. So I left,
thinking that whatever it was, was gone.
I felt great, in comparison to the days preceding.
The next morning, Tuesday morning, I felt great until I had been up about three hours, but by then I was far from
home, trying to do things I need to do to save my home and income property from foreclosure. By the time I got
home, the pain was severe and similar to the pain I had prior to having my appendix out. The pain receded when I
was in bed, but returned immediately upon getting up.
Thursday morning, I felt certain I needed the antibiotics that the pharmacist had mentioned. By then I’d figured out
how to type, “tetanus symptoms” into Google. I got a list of pages of symptoms and treatment. The symptoms
sounded like what I was experiencing. The treatment was said to be antibiotics.
I went to your office on Thursday morning, taking with me a letter to which I had attached a check for $90.

I saw a doctor whose name I forget because the muscle contractions were so severely painful that I screamed as
each one attacked. I feel that the doctor was thoughtless to have me lay flat when I’d told her about the pain I was
having. She could have checked the tightness of my muscles while I was sitting.
Because the contractions were so severe and painful, she called an ambulance to take me to the Emergency Room.
The ambulance came and took me to the Emergency Room.

I also believe that the severity of the contractions and extreme worsening that was allowed to take place, have made
my health much worse.
If I did not have a notebook computer, so that I can write this while I’m in bed, I could not write this because I have
too much pain when I’m up.

Sincerely,

Karen Kline

Copy: St. Vincent Hospital, Governor Bill Richardson, Representative Tom Udall, Senators Domenici and
Bingaman, KOAT, KOB, KRQE.

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.