Murder in the Family

by Jeff Blackstock

  Dr. Mercer described Carol’s second hospital admission: “Physical examination this time revealed an acutely ill young woman with dry, parched mucosae, dry skin, somnolent and complaining of thirst.” After recording her vital signs, Mercer focused on her personal life.

  AT THIS TIME A PAST HISTORY AND FAMILY HISTORY WAS OBTAINED WHICH REVEALED THAT THE PATIENT WAS BORN IN CANADA, AN ONLY CHILD, DEVELOPED NORMALLY, MARRIED AND LEFT HOME AT 15, FIRST PREGNANCY AT 17. THIRD PREGNANCY LED TO LONG AND PAINFUL LABOUR AFTER WHICH SHE HAD A “NERVOUS BREAKDOWN.” THIS CONSISTED OF TIREDNESS, LACK OF INTEREST IN HER SURROUNDINGS AND HER FAMILY AND CAME AT A TIME WHEN SHE WAS SUBJECTED TO SEVERAL OTHER EMOTIONAL STRESSES IN THE FAMILY.

  It is possible that Carol fibbed about her age at the time of her first pregnancy, which was fifteen, not seventeen, because she felt embarrassed about it, as anyone might understand. On the other hand, maybe it wasn’t Carol who told this story. Dr. Mercer didn’t say who gave him the information. It was commonplace in those days, especially in Latin countries, for doctors to consult privately with the husband about his wife’s medical case, and indeed Dr. Mercer did just that, as he wrote later in his report. I don’t know how Dr. Mercer interpreted Carol’s “nervous breakdown” (his quotation marks) after her third pregnancy, but as his clinical record shows, he was now firmly focused on a psychosomatic explanation for her illness.

  Dr. Mercer touched on Carol’s relevant symptomatic history and potential causes of her sickness, only to dismiss them in the same breath.

  NEVER DURING PREGNANCIES OR OTHER MILD ILLNESSES HAD SHE REACTED BY VOMITING. SHE WAS IN THE HABIT OF DRINKING ONE ALCOHOLIC DRINK DAILY OR LESS, NO DRUG INTAKE OR EXPOSURE TO TOXINS. OTHERWISE THE PAST HISTORY WAS UNREMARKABLE. SYSTEM REVIEW WAS UNREMARKABLE AND UP TO THE TIME OF HER ASTHMATIC BRONCHITIS SHE WAS WELL.

  Evidently, Dr. Mercer had raised the possibility with Carol that she’d been exposed to toxic substances—that is, poisons. But his report referred to it in cursory fashion, apparently accepting at face value her or someone else’s statement that she’d had no exposure. Having thus eliminated that diagnostic possibility, he didn’t bother testing for the presence of toxins in her system. But what if the patient were unaware of what she’d been ingesting?

  Dr. Mercer reported that Carol’s earlier physical symptoms kept reappearing.

  HOSPITAL COURSE: ON THE FIRST DAY THE PATIENT…COMPLAINED OF…PARASTHESIAE [ABNORMAL PRICKLING OR TINGLING] OF TOES OF BOTH FEET. ON THE THIRD DAY, PARASTHESIAS AND NUMBNESS OF BOTH LEGS…. ON THE FOURTH DAY, SHE COMPLAINED OF WEAKNESS OF LEGS BUT MUSCLE EXAM OF ALL GROUPS GAVE 5 + STRENGTH. SENSORY EXAMINATION WAS VERY DIFFICULT TO EVALUATE. THERE SEEMED TO BE A NEUROTIC ELEMENT WHICH CONFUSED THE EXAMINATION.

  This examination was indeed confused, as the final outcome would show. Though Dr. Mercer persisted in interpreting Carol’s symptoms as neurotic, it would soon become clear that neurosis had little or nothing to do with it.

  ON THE SEVENTH DAY, SHE COMPLAINED OF BEING UNABLE TO WALK, BUT DID SO WITH SHUFFLING GAIT DRAGGING BOTH FEET FLAT ON THE FLOOR. THE NEXT DAY SHE COMPLAINED OF LOW ABDOMINAL PAIN, CRAMP-LIKE AND COMPARED TO LABOUR PAINS…. ON THE NINTH DAY, THE ABDOMINAL PAIN INCREASED AND PREVENTED SLEEP AND NO MEDICATION SEEMED TO PROVIDE RELIEF INCLUDING OPIATES, THOUGH IT WAS NOTICED THAT THE PATIENT FELT WORSE WHEN LEFT ALONE…. ON SUBSEQUENT DAYS THE PAIN WAS REFERRED TO THE UPPER ABDOMEN AND THE PATIENT WAS CONCERNED BECAUSE THE PAINS WERE PROGRESSING “UP” AND THAT THE SENSORY LEG CHANGES WERE PROGRESSING PROXIMALLY [NEARER TO THE PAIN’S POINT OF ORIGIN].

  The cramps, resembling labour pains, became so severe that Carol required opiates, yet Dr. Mercer continued to focus on her personal history.

  ONE NIGHT AFTER A LONG CONVERSATION WITH THE PATIENT WE WERE ABLE TO DISCOVER A STRONG DEPENDENCY ON MOTHER AND LOCAL NURSEMAID WITH A GUILT COMPLEX TOWARDS HER PARENTS. THAT NIGHT THE PAIN IMPROVED REMARKABLY AND REQUIRED NO MEDICATION.

  It shouldn’t have been surprising that Carol had feelings of dependency toward her mother and María—especially at a time when she was seriously ill and her doctor couldn’t tell her why. Dr. Mercer, nevertheless, seemed to be fixated on this observation, whether it came from Carol or George, and so pursued his line of inquiry.

  WHEN THE STRONG HYSTERICAL COMPONENT SUGGESTED THAT A NEURO-PSCHYATRIST [SIC] SHOULD BE CONSULTED, THE HUSBAND REQUESTED A CONSULTATION WITH ANOTHER INTERNIST AND THE PATIENT WAS SEEN BY DR. RAUL KELLY, WHO…SUGGESTED AMONGST OTHER THINGS THE POSSIBILITY OF COLLAGEN DISEASE.

  Although George at first resisted the doctor’s recommendation of consulting a psychiatrist, eventually Dr. Mercer had his way.

  FINALLY NEURO-PSCHYATRIC [SIC] CONSULTATION WAS REQUESTED AND DR. INSUA FELT THERE WAS A HYSTERICAL HYPER-REACTION TO THE SYMPTOMS.

  Although he had difficulty spelling psychiatrist and psychiatric, Dr. Mercer’s preoccupation with neurosis as an underlying condition was remarkable, especially since he wasn’t a psychiatrist himself. In 1959, the stereotype of the “hysterical woman” exhibiting neurotic psychosomatic behaviour was very much alive. In Carol’s treatment, it created a pernicious distraction from a serious investigation of her physical symptoms and their causes—an omission that would turn out to be fatal.

  More recently, I’ve received a professional medical opinion that the progression of my mother’s neurological symptoms, together with her persistent vomiting, should have indicated the true cause of her illness—a diagnosis that was sidetracked by the preoccupation with hysteria. That opinion is disturbing enough. An alternative possibility, that Dr. Mercer actually knew what he was doing and deliberately created a distraction from the truth, would be even more disturbing, but there is no evidence of that. A third possibility, and my personal view, is that Dr. Mercer, however misguided, tried to do his best, however inadequately, with a case totally unfamiliar to him.

  Carol wrote a much more down-to-earth account of her hospital treatment in a letter to Granny dated Monday, June 21, 1959. First, she apologized to her mother-in-law for her handwriting: “I can see how bad my writing is and I do hope you will forgive me. I have been sick but I am getting better.” Her handwriting, which by the last page of the letter started to resemble a childlike scrawl, would soon get even worse.

  Last Saturday I started that terrible vomiting again. That went on steadily until Thursday night when I was again taken to Little Co of Mary…. I have been getting mass doses of iron, penicillin (which causes my face to swell) and blood transfusions along with injections for stopping the vomiting. All in all I am a bit of a mess. But I am on the way up now at least. I don’t know how long I will have to stay in the hospital. The doctor won’t commit himself.

  Almost none of this detail was mentioned in Dr. Mercer’s clinical record. At least Carol herself didn’t pull any punches when describing what was happening to her. Evidently, she wasn’t worried about upsetting Granny with the truth, as she had been a year earlier after her accident with the horse cart.

  She ended the letter by writing, as usual, about others rather than herself.

  George took Jeffrey to the…concert last Wednesday. It was Beethoven’s 2nd and 6th symphonies…. It didn’t start until ten and I thought he would fall asleep. But no he enjoyed it thoroughly. He was telling me all about it and he blushed and said, “You know Mummy, Mr. and Mrs. Krapf invited us out to eat after.” I asked him what he had had. “I ordered tomato soup and ice cream.” Isn’t that Jeff for you, tomato soup. It is a wonder he hasn’t got it coming out of his ears.

  With Mom in hospital, Dad had an extra ticket to the concerts at the Teatro Colón, so he took me along. It was arranged that Doug and I would go to bed, as usual; then Doug would fall asleep, I would get up and dress in a jacket and tie, and Dad and I would go off to the concert. Like most cultural and social events in Argentina, it began and ended late. The after-concert dinner started around one o�
�clock in the morning. I don’t know how I managed to stay awake through school the next day, but I did.

  Carol finished her letter to Granny by saying George had to put it in the mail: “Well, George is going to mail this now, so good bye. All my love, Carol.”

  She also wrote to her parents from her hospital bed that same day, June 21. She thanked them for a parcel they’d sent to the house, which George had brought to the hospital after work: “It was so much fun opening it up.”

  Carol’s handwriting looked more than ever like a child’s: “My writing is so bad cause I can barely move my fingers and I am holding onto the pen like grim death.”

  Once again, she made the brave declaration “I have been sick but I am getting better now.”

  I was sick every day (all day) for six days and I was so worn out and dehydrated that here I am [in the clinic], back again…. At first they thought I had virus pneumonia, but when they got all through the tests they found it was a rare case of fungi (yes I know, now you can call me Moldy Milly) of the lungs. It produces the spasms of the pylorax [she was referring to the pylorus, a valve in the stomach] and also is [a]ffecting the nerves in my feet and legs and my hands.

  Strangely enough, next to nothing of this diagnosis of lung trouble was mentioned in Dr. Mercer’s clinical record. It seems, however, that the medical staff were trying everything on Carol, no matter how painful. She didn’t spare her parents the graphic details.

  I have been getting up to five injections a day in the hips, intraveno[u]s blood transfusions, pills and I really feel as if I had the book thrown at me. My backside looks like a sieve. It’s so bad that the nurses spend ten minutes just looking for an unjabbed space. Not only that but the weather’s lousy too….

  …Well now you know. I won’t say “It’s not serious” (said with a high pitched voice) because I wouldn’t be wearing the skin off my fanny in the hospital if it were a common cold. I have lost 10 lbs and do I look like the perennial bean pole.

  She insisted that she was, nevertheless, on the mend.

  I have one of the best doctors (Anglo Argentine, studied at J. Hopkins for 3 yrs) and I am in the best private hospital in the country. I am responding well to treatment and although it is going to be an uphill march for some time, I am well on my way to recovery.

  She closed with a reassuring dash of humour.

  Please please, do not get upset or worry, because I’m not. In fact when you think of it I feel fairly smart to have sumpin rare-like. You always said “Now don’t be common.” Does this meet with parental approval.

  All my dearest love, Carol

  Despite her natural inclination not to worry her parents, Carol was quite open about her condition. Later, George would claim she’d wanted to spare her parents the knowledge of what was happening to her—but if her letters are any guide, that was untrue.

  * * *

  —

  CAROL’S LETTERS HOME sometimes went by embassy pouch, by far the fastest method, and sometimes by regular post, which in those days meant surface mail, unless marked “airmail.” From the hospital, she’d told George’s mother that George was mailing her letter for her. Grandma and Grandpa received her June 21 letter two weeks later, on July 5, 1959. Why did it take two weeks to reach Toronto instead of one, as it normally did, when the subject matter was so urgent? From the envelope with stamps but no airmail label I can see George must have put the letter in the slower regular mail, probably because he didn’t want Grandma and Grandpa to become immediately disturbed and involved in Carol’s sickness, which he knew would be the result of her letter. His solution, short of not sending the letter at all, was to delay its delivery.

  Naturally, Grandma was upset by Carol’s news. The day they got her letter, Grandma sent both an overnight cable and a letter, clearly by airmail, because Carol received it on July 8, three days after it was mailed from Toronto. While Grandma tried to be as upbeat as possible, she didn’t disguise her alarm: “We were shocked to hear you were back in hospital, after being there before…. We are both so distressed with the second bout of illness.”

  What parents wouldn’t be shocked? And what parents wouldn’t want to take action immediately? Grandma prepared a passport application and had a passport photo taken, stamped on the back “July 21, 1959.” She began looking into reserving a plane ticket to Argentina. They couldn’t really afford the trip, but they were too disturbed by Carol’s condition to worry about the expense.

  Grandma and Grandpa took another step, one that would turn out to be highly consequential: they contacted George’s employer, the Department of Trade and Commerce, in Ottawa. They wanted to alert his superiors to what was happening to their daughter, and ask them to ensure that everything possible be done to help her.

  In Carol’s reply, on July 8, the same day she received Grandma’s letter, she asked about the inquiry her parents had made to the department.

  I would be interested to know if it was you that informed Ottawa of my being sick. We got a long telegram demanding to know what exactly I had. This upset Mr. Bissett no end because he was about the only person we knew that hadn’t bothered to inquire about me…. The fact that I was sick wasn’t what bothered the B. But he had to go to the trouble of asking George and letting Ottawa know. That was work and believe me that guy never does any more than the absolute minimum in that line.

  From my experience in the foreign service, I’m certain it wasn’t just the work involved that bothered George’s boss. My grandparents had expressed their worries to the department in no uncertain terms. Apparently, the department had passed those concerns along to the embassy in “a long telegram.” Bissett was upset that headquarters had caught him unaware of an important personnel matter in his own shop. He was expected to know about an illness as serious as Carol Blackstock’s and to inform Ambassador Bower and his bosses in Ottawa so that, among other things, they wouldn’t be blindsided by a complaint from the public. What’s more, the telegram from HQ would have come to Bissett through the ambassador, who would not have been pleased with his subordinate.

  No doubt the telegram from Ottawa jolted Ambassador Bower into realizing just how serious Carol’s condition was, creating a real concern about her. Carol was popular with George’s colleagues, and they would have wanted to know how ill she was. Embassies are, or certainly used to be, close-knit communities. In a workplace setting in Canada, Carol’s illness might have been considered a private matter, but in the context of the embassy “family,” it was everyone’s concern.

  George would not have been happy either. In all likelihood, he was annoyed that his parents-in-law had gone behind his back to his superiors, causing a disturbance at the embassy and embarrassing him and his boss.

  So why hadn’t George let Bissett know about his wife’s illness? It was naturally the kind of thing you told your boss about, if only to explain why your mind might be on things other than work.

  Carol was still in the hospital when she replied to her parents on July 8. This was the last of her letters that we could find. Unlike her other recent correspondence, it was typewritten, suggesting that the nerve trouble in her hands was making writing by hand difficult. Her spelling had deteriorated as well, as evident in the excerpts below. But she was definitely feeling more upbeat and hopeful.

  I am making excellent progress and the doctor says that I can come out of the hospital in a very few days. You will also be pleased to hear that my behind is looking much less like a pin cushion as I only get one injection a day. They have done just about everything they could think of and have samples of everything I could offer up. The only thing they haven’t done is [s]queeze my head to see if my brains will come out my ears.

  Her description of all the action in Room 219 shows she was back in her element, attracting people and making friends.

  I never realized just how many friends I had until I fou
nd myself stuck in here. Never has a day passed that I haven’t had at least two or three friends come and vosit me. They have loaded me up woth flowers and candies and generally made life as pleasant as possible. The Sisters and the nurses here are all without exception very kind and sweet. There is always laughter in 219 to the point that other patients have inquired as to where the party is. The young ones phone there [sic] boyfriends from my room and the night girls borrow my magazines and books. I even have a nurse who can sneak in a game of canasta between bells.

  She was now able to get around in the clinic, albeit in a wheelchair, unlike a fellow patient confined to bed, who aroused her sympathy.

  There is an American chap down the hall…here with Hepatitis and is yellow all over…. He is a good head and we console each other by trading books and jokes. He has two or three weeks more flat on his back. Boy that would really be tough. At least I am mobile, even if it is on wheels.

  María was doing a lot to support Carol and help her recover.

  María has been her usual wonderful, loving self. She is spoiling me so terribly that it will take me years to get back to normal. She comes every morning, does my hair, fixes my nails, jokes and tells me all the news…. The nurses all tease me about how spoiled I am, but María just laughs and calls me her baby. The doctor says she is twice as good for me as any medicine he could recommend. You know in one way we lead a very funny artificial life and although I have lots of very good friends, María is really my only confidante.