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Medical Mystery

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Dear Deanna Isaacs:

Thank you for your engrossing article in the May 15 issue of the Reader. Your persistence in researching the causes of amniotic fluid embolism in women giving birth has turned a personal tragedy into life-saving understanding for many others.

I was particularly interested in the article because I had been considering conducting some researches of my own, much more informal than yours, into the causes of respiratory failure in certain hospital patients. Two close friends of mine died in recent years as a result of suffering unexplained respiratory failure while they were in the hospital for seemingly unrelated treatments. These patients were quite different from the ones whose deaths you investigated. My acquaintances were older women, in their 70s. However, neither had had respiratory systems compromised enough to account for their deaths.

The second of my acquaintances to die suffered a particularly arduous, puzzling series of setbacks. She experienced respiratory failure three times, each time just hours after being sent to a physical-therapy ward in anticipation of being discharged. After her second episode requiring code-blue intubation, I desperately urged the medical staff to consider allergic reactions to latex, to certain foodstuffs, etc. The hospital personnel didn't think an allergy to latex could be implicated because they believed that exposure would have to be massive to cause respiratory failure. They believed that patients would virtually have to have had latex gloves shoved down their throats in order to suffer such systemic collapse. I'm not sure that the medical personnel were correct in this belief. But they did seem to make aggressive attempts to solve the mystery. They ran batteries of tests on her, including several MRI tests, trying to find the source of her respiratory failure in some neurologic anomaly. They weren't able to find anything to account for her death, and they said the only comfort we could draw from the months of suffering she endured on a respirator was that this type of unexplained respiratory failure was rare, indeed almost unprecedented.

I also had reason to doubt that last assessment because of the virtually identical course that my other acquaintance followed after admission to a different hospital several years ago. That made two people I've known who were hospitalized in recent years, and two deaths from respiratory failure. I can't help but suspect that unexplained deaths due to respiratory failure might be more common than is generally acknowledged.

I hardly knew where I might begin any investigation into the matter though. But your article suggested some possibilities. You mentioned making use of a "registry" of people who died of AFE in childbirth. I wonder if a comparable register is kept of people who died of unexplained respiratory failure. If so, where does one go to find such a register? Would a layman have access to it?

Of course I realize that respiratory failure and shock might be brought about by a wide range of susceptibilities. There is no reason to believe that both of my acquaintances had the same allergy. Still, I think it would be helpful to start a conversation among surviving family members of intubated patients. Anyone interested in starting such a dialogue can write to me at 3755 N. Kedzie, Chicago 60618.

In any event, I thank you again for the magnificent job of investigatory medical journalism that you did in order to arrive at "Code Blue Birth." We all owe you a debt of gratitude.

Rosalie M. Schultz

N. Kedzie

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