In what Kathy Day says is her favorite photo with her father John McCleary, she’s a curly-haired two-year-old and he’s a "handsome but poor young man, who quit school at age 15 to help his parents pay the bills." A lifelong resident of a small town in central Maine, John spent most of his working life in paper mills, taking on extra shifts to pay for his three kids’ educations and weddings and to save for his golden years with wife Gerry. Into his early 80s, John had to use oxygen at night for lung problems, and was less steady on his feet. But he still enjoyed horseplay with his great-grandkids, and the hearty meals Gerry cooked almost every day of their 60-plus years of marriage.
On Sept. 26, 2008, John fell getting out of bed and landed awkwardly on his right leg. The ambulance took him to the 25-bed, hometown hospital where his family had been treated for years (and where Kathy, an RN, had her first job out of nursing school). Doctors told John the ankle injury was so minor he would need only an elastic compression stocking, and a week or two of physical therapy. Rather than travel to a distant, unfamiliar rehabilitation facility, John stayed in the hospital for the therapy. After 12 days, he was in good condition, getting around with a walker, and was discharged to go home.
Two days later, John awoke with a high fever and so weak he couldn't sit up. He was rushed by ambulance back to the hospital, where Kathy’s nursing background made her a particularly sharp-eyed observer of his care and condition. On John’s first day back in the hospital, doctors diagnosed pneumonia and ordered a lung scan. On day two, although John was taking two antibiotics, Kathy warned the hospital nurses, "He’s not right, something’s going on." Checking, they found John’s blood pressure so dangerously low that an emergency team was called, and fluids and medications administered to bring it up. Doctors said John had suffered a mild heart attack, though Kathy saw no changes on the EKG. To her, the symptoms suggested sepsis, the body’s immune system responding to a life-threatening infection.
John was moved to the intensive care unit and because he was too weak to use a bathroom or bedpan, doctors ordered a urinary catheter. "I remember it like it was yesterday," Kathy says. "The nurse said, 'You know, he’s going to get an infection' — and I said, 'What? Is that a given?' I was floored. I’ve been out of bedside nursing for 10 years and I didn’t realize the seriousness of the increase in infections that has happened over that period. And sure enough, in two days’ time, he’s got a urinary tract infection — and it cultured out as MRSA," the antibiotic-resistant staph infection found mostly in people who’ve been in hospital and health care facilities.
"We thought we were going to lose him that day," Kathy says. Kathy’s brothers were called to come; a priest was called in to administer last rites. But John held on. After the urine culture showed MRSA, Kathy says, "I asked a nurse, 'Isn’t anybody going to do a sputum culture?'" to see if the pneumonia was that bacteria strain as well. "The nurse left the room, came back and handed me the cup to get the sputum sample, without a word," Kathy recalls. "And I thought, 'All right, we’re going to find out what’s going on.'
"After six days in the hospital, Dad was diagnosed with MRSA pneumonia. Only then were I and all my family members told we had to wear gloves, gowns and masks when we were with him. So that was six days without appropriate precautions — my mother is lucky not to have contracted it. And that’s when they finally got him on the drug of choice for MRSA pneumonia."
John spent another two weeks in the hospital, then nine weeks in an isolation room in a nursing home. "Dad just catapulted right into becoming a full-care nursing home patient," Kathy says now. "He never walked again. His skin broke down. He never regained his appetite or his strength — and yet he remained coherent and continued to make decisions about his own care. He wasn’t ready to give up; he wouldn’t discuss hospice care because he saw that as end-of-life, and he thought this was an infection that he could get better from. He asked me, 'Where did I get this infection?' And I told him. He knew he caught it from the hospital and he was angry and frustrated."
At the end, Kathy says, "I don’t think he weighed 120 pounds, he was just skeletal in appearance." John McCleary died on Jan. 9, 2009, with his family at his side. He was such a shadow of himself that at the funeral, Gerry chose to keep the casket closed.
Kathy says she always feared her father would die some day from his respiratory condition, "and that would have been difficult but somewhat anticipated. But for him to go into the hospital with a minor injury and come out with a deadly infection is just absolutely not right."
In her father’s honor, Kathy has become an advocate. She has helped write legislation that would require Maine hospitals to institute more rigorous screening, detection and isolation practices for MRSA and other infections. For her hometown newspaper in Bangor, she wrote an article listing safety measures patients and families can take to minimize risk during hospitalizations. And she frequently gives testimony and speeches in which she warns audiences, "We as consumers and patients cannot completely rely on our hospitals to protect us and our safety."
"My dad was very special and I do miss him terribly," she says. "But I know he would be very proud that his family is telling his story to help others."