I guess there was a reason I "won the war" of independence. In the past seven months, I have learned just how spoilt I had become as I now have to pick up all the roles that John had taken on. I've had to be independent - no choice.
Most of you have had individual discussions with me as to what happened in Croatia and how John died. This post is for those who might not have wanted to ask questions for fear of making me uncomfortable. So, this is a trigger warning. It's not a travel blog. Feel free to bypass it.
At the end of January 2023, we returned from a two-month trip to Australia and Bali. We had a wonderful trip. I especially loved the time we spent on Gili Meno, an island off Bali that we had visited previously and were thrilled to return to.
We were home for two months, and then we headed to our London housesitting obligation. Once again, to look after Max, Simon and Pablo.
John had been experiencing some fatigue, which we put off to jet lag and his difficult working hours in Bali. He developed a cough that was deep in his lungs.
So, to prepare for our trip, John went to the doctor to ensure that there was not something serious going on. The doctor ordered an x-ray. Upon receiving the x-ray results, the doctor told him that nothing was on the x-ray and it was likely a virus that would run its course.
So off to London, we went. John's cough continued to bother him a lot. I have always had to ask John to slow down, as he was always ahead of me with his long legs. In London, I was asking him to speed up. Something was going on.
He decided to visit the Chelsea/ Westminster Hospital emergency room on April 12th. I was not allowed to be in emerg with him, unfortunately. He had blood tests, an x-ray, ECG and an ultrasound done. Once again, the doctors told him that there was nothing on the tests that accounted for what he was feeling.
Despite no improvement and no idea what was happening, we continued our plans to go on to Croatia. By this point, John was not feeling well enough to go on walk tours, and once we travelled from Dubrovnik to Split, it was time to revisit a hospital.
In hindsight, it is easy to see that we might have had more success if we had managed to find the building housing all the world-class equipment that our insurer was telling us was there. However, the ambulance driver we asked for directions sent us to an old building that housed pulmonary issues. Due to reno's being done on the hospital the emergency ward was not obvious.
After testing, the doctors advised us that John's hemoglobin was 93. The average is 130-165. He was very anemic, and they wanted to admit him.
This building had no curtains around the beds, no monitoring equipment and even the pyjamas John felt were from World War 11 and fell off him.
We were in contact with our Canadian insurer, who had linked us with a subcontractor, United Healthcare Global, and UHC advised us that they were making arrangements to get John home. UHC was to send a doctor to accompany us on a flight home in business class with oxygen.
After three days, John was released from the hospital and advised to return to Canada ASAP. We assumed that UHC would be ready to do this, but they had not yet sent the doctor over. I attempted to get them to move more quickly by saying I could see John deteriorating. As a result of that statement, they sent us back to the hospital. It was very frustrating. UHC advised that even if the doctor was there now, he could decide that John could not travel. I wish they had done that. At that point, I think that he could have survived the flight.
Back to the hospital we went. John's hemoglobin had dropped again, and two doctors were curious about what was happening and interested in finding a prognosis. However, it was a long weekend, and doctors advised us there would be no testing until Tuesday. Dr.'s did not test John any weekend he was in the hospital.
We tried to convince UHC to get him home or even just to London, but they declined and wanted him to stay in the hospital, again stressing how this hospital was one of their global partners.
On May 1st, May Day in Croatia, John walked down the hall to the bathroom. He fainted and came to back in his bed. John realized later that he had broken two small bones in his ankle, which made him immobile. They put a crazy, massive cast on his whole leg.
In the next ten days, not a lot of testing took place. They did a gastronomy and gave him a couple of blood transfusions. There was still no diagnosed cause for the anemia. His doctor told us on May 5th that John could go home. UHC needed to have a Fit to Travel form completed by the doctor. Despite practically begging the doctor at 3:30 pm to complete the form, she advised that it was too late on Friday and she didn't have time. She never completed and submitted the form.
UHC did speak to the doctor on May 8th, but we had lost another weekend. UHC put out bids for an air ambulance to get John home. They had arranged a bed in Vancouver General.
Ultimately, UHC scheduled the air ambulance for May 12th.
John was starting to have moments of confusion. We put that down to not getting good sleep and having painkillers. But it did feel like something had changed in what was happening. He got chills and a fever. These symptoms were quite different from the anemia.
On May 10th, while I was there, John became disoriented. I notified the nurses that I felt he was having a stroke. I was distraught at the lack of urgency that I witnessed. A neurologist meandered over and looked at John. When I asked if it was a stroke, the neurologist casually stated, "Probably." When I challenged why he was not doing anything, if it was a stroke, he asked why I was even there as it wasn't visiting hours.
He ordered a C-scan, which showed that John had a minor stroke in his cerebellum. And there was nothing more to do. I sat in a room with him for the next two hours. No one checked on him. There was no monitoring equipment. I reported to the nurses' station that his breathing had changed, and the staff finally took him to the ICU at the end of the hall. Why wasn't he taken there when he came back from the C-scan?
The doctors then took John to the ICU in the other building. Passing me in the hall, the doctor said, "he's very, very ill, he's very, very ill". I guess that is where all the world-class equipment and specialists were.
After sitting in the hall alone for several hours, the residents came and spoke with me. They told me that after doing two C-scans and an MRI, they determined that John had not had a stroke. He was positive for sepsis. At that moment, I did not know much about sepsis, but I felt there was not much hope for John.
Ultimately, John died the following morning of multi-organ failure due to sepsis. I firmly believe that sepsis was given an opening into his already compromised body by the unnecessary catheter inserted and/or the bedsores that developed.
I went public through the media regarding my concerns about John's care at the hospital. I did that because I was hearing from Croats that "you go to the hospital to die." There was a total lack of trust in the government expressed to me by the people I was meeting. I felt that as a tourist in their country, I had a platform I could use to bring these matters forward.
Keenan had flown over to be with me on Wednesday, when we thought John had a stroke. By the time he arrived, John had died. We met with the hospital twice before we came home. The pathologist did an autopsy on May 15th, and four months later, we received the results. Everything was in Croatian, which we Google Translated. We still have no answer as to what was causing the anemia.
What have I learned?
The doctors didn't give us any paperwork when we left the hospital in London. I have those reports now, and his hemoglobin at that time was 102. Significantly lower than normal. Would we have changed our plans if the doctors told him about that? I think so. The least we would have done was get another blood test before going to Croatia.
Despite having 24/7 access to UHC and speaking to them frequently, we felt helpless in actually getting help. I asked for a clear outline of the process and a step-by-step statement of what they would do. I still have questions about how much contact and information they received directly through the hospital. In UHC's summary, received months after the events, most of the references to medical details were what I told them. We went from being able to come home in business class to having to come in an air ambulance. I don't fault the staff that I spoke with, but the delay in getting him home saved UHC a lot of money, as I realized when seeing the bids for the air ambulance.
John felt the nursing staff and doctors were doing their best and appreciated what they did for him. Both of us were highly frustrated by testing not being done. Disease does not stop on weekends.
I'm not as generous as my husband in those thoughts of the staff. The neurologist was extremely rude to me. I would even say that his behaviour was traumatizing.
The morning John died, the hospital asked that I attend for paperwork. When I arrived, the staff demanded immediate payment for his stay. I had provided billing information to their billing office earlier in John's stay. On May 11th in the morning, within 3 hours of John's death, I was dragged down the hall to point out the person I had given the information to.
Since I returned home, I have gained a lot of information that we did not have, but I still do not know what caused the anemia. I suspect that had we got John home, we might have learned that he had something seriously wrong, like cancer, and he might have suffered for a long time. Neither of us would have wanted him to go through that.
On the 6th month anniversary, October 11th, I contacted Canada Life and UHC-Global, NHS and Chelsea/Westminster Hospital, KBC-Split Hospital and the media in all three countries. I documented what happened to the love of my life, expressing my concerns and making suggestions to prevent the same outcome in the future.
The result of those letters?
A reporter I was in contact with in Croatia wrote another article that included my letter. I also provided the media there with the autopsy results and a copy of the two "independent reviews" conducted by the Ministry of Health looking into John's death. The reviews concluded that the doctors had done everything necessary. Despite a promise by the head of the hospital that we would have input into those reviews, that did not happen.
The reporter reached out to the hospital for a comment regarding my letter. Neither of us received a response from the hospital.
Our insurer, Canada Life, advised that they took my concerns seriously and that should I wish to pursue it I could file a claim with the Ombudsman for insurance matters.
The Chelsea/Westminster Hospital responded and advised that my Statement of Claim has been forwarded to the legal department.
Neither the media in Canada nor in Britain responded to my letters.
That's the best and last thing I can do for John—the answers I don't have, I will have to learn to live without.
Now, it is time for me to move forward............and on to more travel.