Caroline's 'death is, in every sense, tragic'

It is easy in hindsight to piece it all together, but the speed at which the illness had taken hold left little room for reflection or ancillary investigation.

Still, if I were to fix on one point of information which would, in the course of those weeks, have been of real value, then it is the now seemingly established view that there is no known correlation between the extent of hypothyroidism and psychiatric symptoms that subsequently develop.

In other words, once hypothyroidism gives rise to psychiatric symptoms, measuring the extent of that thyroid malfunction will not provide a reliable indication of when or how severely those symptoms will kick in.

Given the nature of Caroline’s death and the paucity of knowledge, in general, about the condition, it was assumed by many that she had a history of depression.

This erroneous assumption even found its way into the autopsy report, but was corrected in the light of data provided by practitioners familiar with her very good health record.

There is much to be grateful for in the care and concern displayed by the medical personnel with whom she came in contact.

Lesson to be learned

If there is a lesson to be learned, then it is certainly not a new one. It requires examination of the system as a whole. Communication between the various treatment agencies is necessarily compromised when, as in Caroline’s case, there were six such agencies involved.

The time-honoured sealed letter, often brought by the patient from one treatment centre to the next, may not be the best way of building a comprehensive profile of a patient. For instance, the “personality type” ascribed to Caroline, at one point, was “shy and reserved”, the very opposite to what she was.

The absence of an accurate profile can frustrate best practice. And this is particularly so in cases where, like Caroline’s, there is a physiological basis to a psychiatric condition.

Equally, relying on a patient, referred for psychiatric care, for accurate family medical background data is questionable.

Regrettably, data in this regard, provided by Caroline in the initial stages of admission to both the Blackrock Clinic and St John of God’s Hospital, when she was very distressed and confused, was, in several instances, far from accurate.

We miss Caroline every minute of every day. She was the life and soul of the family, a deeply loved and loving parent and wife, the instigator of countless adventures, which we now recall with affection and gratitude.

Her boundless energy, her extraordinary ability to engage in conversation, her formidable intellect, her humour and, above all, her unremitting generosity of spirit all combine to compound the sense of loss we feel. Her death is, in every sense, tragic.

We have, however, the legacy of our happy lives together to build on and for that we will remain forever grateful to Caroline. We just hope that this brief account of her illness might be of benefit to others.