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(Continued from Page 10) for a while. This was the per- iod during which she was be- ing treated by the Clarke Insti- tute. Then he saw her on July 24, 1971. He also saw her son in relation to a drug problem. “In July she said ‘I’m here really so that you can send me back to the Clarke Institute.’ This was the first time I had heard of it, and she told me part of the story. She had call- ed the Clarke bu couldn't get her old doctor an was told she had to go through the channel of her family doctor. She wan- ted to have her medication conâ€" tinued again because she felt very upset and needed it. “I gave her a check-up, did blood sugar and urine tests at her request. They were normal." said Dr. Socol. He sent a letter to the Clarke Institute because they wouldn’t talk over the tele- phone. Then Dr. Abrams tele- phoned about 10 days later and got the information. She was started on the same medication as directed by the Clarke Instit- ute doctor,” said Socol. FAINTING SPELL He said Mrs. Mallory teleâ€" phoned again saying she had a fainting spell, funny feelings in her hands and feet and had pas- sed out. She was breathing deeply and was very upset. “She wanted some help, not what I could offer her. but for her emotional state. I felt she was in a severe anixiety state. I saw her on the afternoon of Mon- day August 16. She wasn't breathing heavily. She com- plained of her nose and throat and had a mild cold. Illness Masks Symptoms “I examined her and her maj- or diagnosis was her anxiety state. I told her this and gave her a combination of anti-his- tamine and anti-biotic for her wild. There was no doubt in my mind she was suffering from an; acutely agitated anxiety state." said 8000]. “She phoned Wednesday and said she was feeling no betterâ€" had vomited several times and was feeling terrible. I tolduher I was leaving for the office and provided an anti-nausea suppository medication . . .and told her Dr. Woo was on call. “I saw her again the next morning (at the hospital) at ab- out 8130 am...being called when I was in the pediatric ward. I examined and treated her...called an internist in... Dr. Chow. I talked to her sis- ster 20 to 25 minutes. . . got in- formation on (Mrs. Mallory’sl past year I didn‘t know about before. Around 11 o’clock I felt she was responding. .. and left the hospital around 12 . . ." FRONOUNCED DEAD "I pronounced her dead ar- ound 4:45 after an unsuccess~ ful battle against her acidosis . . . I learned she was diabetic ar- ound 10:30. It took an hour to get results of tests,” said Socol. He said it was possible for her to develop a diabetic condition and die in the 18 days after she made a blood test. He agreed symptoms of hyper-ventilation and confused anxiety were those of diabetes. He said it was 13 hours and 45 minutes that she was in the hospital before her condition was diagnosed. usual symptoms you look for in diabetes. There were no signs at that time to lead me to sus- pect diabetes," he said. Asked if he was sure he asked Mrs. Mallory about EXCBSSiVEl thirstiness July 24. Dr. Socol said, "I’m sure I did. She said no.” Next witness was Mrs. Sleep, who said she was one of Mrs. Mallory’s longest and closest friends, knowing her 24 years. She described being on a shop- ping trip with Mrs. Mallory a , vonr m- an hpt‘nro the fatal ill- “What would be the effect of more prompt diagnosis?" Dr. Socol was asked. His answer was, “I don't know ...it certainly would be a fac- tor.” He said any stress or strain could precipitate diabet- es. Dr. Woo, a 1970 University of Manitoba graduate, said (Mrs. Mallory telephoned him about 8:05 pm saying she couldn’t get through the night. He sent an ambulance to take her to em- ergency! Then he looked up Dr. Soc-‘ 01’s patient card on Mrs. Mal- lory and went to see Mrs. Mal- lory at the hospital. While see- ing Mrs. Mallory he stepped out and talked to Dr. Abrams. Their decision was to admit her for observation. Dr. Chow, specialist in in-‘ ternal medicine on staff ati YCl-I, told of being called in by‘ Dr. Socol after Mrs. Mallory: went into a coma. He said his1 initial opinion after 10 minutes of examination was that she was suffering from hyper-vent- ilation due to hysterical reac- tion or metabolic acidosis. A blood gas report received in the normal time of 25 minutes in- dicated metabolic acidosis. This showed she was either. intoxicated by a drug such as‘ aspirin or had diabetes. He‘ did a test for aspirin and a second blood test while waiting for the results of the blood su-| gar test that came in the normal‘. one hour of time This showed‘ Mrs. Mallory had the maxim- um possible high test reading! of 800 for blood sugar. A nor-1 mal count would be around 100. Insulin was given subcut- aneously and intravenously and she was responding much bet- ter by 11:45 am. i Dr. Chow said Mrs. Mallory’s heart stopped from two possible causes, or more likely both of them together: diabetic acidosis and high potassium content in the blood. He said once such a patient lapses into a coma the; mortality rate is very high. A secretary who worked with. Mrs. Mallory at a Metro school, Mrs. Smart was the next wit- ness. She told of Mrs. Mallory being tired all the time and often seeming like a very sick woman. Mrs. Mallory was con- tinually thirsty, often kept a glass of water at her desk and always drank an abnormal am- ount of water. BARELY WALKING On Monday, August 16, three days before she died. Mrs. Mal- wlu: AICL ul ulc uuoynuun said no. She had been cough- ing and vomitting.” He said before she was stric- ken he went out every night to the store for drinks and all she every wanted was “Coke”. He was at YCH the morning before she died and talked to Dr. Socol. Vanderstar said that at the time she fainted while with him. the onhz thing his doctor said was she had high blood pressure. any 57an t*#* Next witness was Mrs. Mal- lory’s sister Mrs. Harrington, a diabetic on insulin for five years. She said her cousin and an uncle on her mother’s side of the family had diabetes, while one of her father’s cous- lory arrived at work after the ins was diabetic. weekend. her visits with Mrs. Mallory “I never saw such a change over the months before death, in a person. She should have of noting quiet depression but been at home. She could barely no physical change. walk and was just dragging her- Mrs. Herrington happened to self around. She was obsessed call her sister Mrs. Mallory with keeping at work . . . ap- about 7:30 pm the night she parently she needed the money. was stricken and only minutes She laid down and was sent before she was taken to YCH home by the principal,” said by ambulance. Mrs. Mallory Mrs. Smart. was gasping for breath and Mrs. Mallory called on the couldn’t speak more than a telephone on Tuesday, reported couple of words at a time, she being to the doctor and getting said. So Mrs. Herrington prom- medicatiou. She said she was ised to be up to see her sister feeling better and was staying later on in the evening. off work the rest of the week SINKING FAST to really get a good test She became worried about * * * * _ her sister and called back Dr. Abrams was the DEXt Wlt' again. Mrs. Mallory sounded neSS- He told hoW Mm Mallory dreadful and said she was much came into his office about two worse_ "she said she was sink- weeks before her admission to jng very fast and didn't think YCH. She wanted her former she was going to last the night," psychiatric medicine but re- Mm Herrington told the in- fused to discuss her problems. quest jury She told ofipreg‘nant because diabetes could alter the results. He also said physical examination indicated. she was two months pregnant at the time and this might have caused her diabetes to flare up suddenly as it did, she said. Mrs. Herrington said she was aware weak spells and thirst could indicate diabetes, because these symptoms preceded the diagnosis of her own diabetes in 1965. a It a a The mother of Mrs. Mallory was the next witness. She told' how her daughter Joan was under stress and often com- plained of pain. She had two operations, one for gall bladder and the other a partial hyster- ectomy. She saw Joan quite frequently from May until her death. On Saturday, August 7 Joan visited her parents home, arriv- ing at about 71 ppm and going witness stand. He said Mrs! Mallory weighed about 130' pounds in July. Some years before she weighed about 140‘ pounds and was put on a diet, but not too successfully. Socol said with Mrs. Mallory he didn't have what he consid- ered a satisfactory doctor-pat: ient relationship, but he thought? she was mentally ill so he car-- ried on with her. “I felt there were times when she was hos- tile toward me . . . conversa- tions were mostly one-sided, of- ten comprised of my questions and her yes or no. he said. ADMITS STATEMENT He said when she came back to him in July she was very up- set because she couldn’t see her psychiatrist at the Clarke Insti- tute. He admitted saying She cried wolf once too often, ex- plaining he had just been through a very difficult situa- tion and was upset. Hun- manta] int-me: rnnnrfl you would have to be relatively close to the person to pick up the smell. And you would have to know what it meant to at- tach any significance to it," he said. Killinger said the injury Mrs. Mallory had to the left side of the brain might have been caused by a fall during a faint- ing spell. but in his opinion it hadn't any effect on her fatal diabetes condition. 75% MORTALITY He said the mortality rate in such 1 case as Mrs. Mallory’s at 10 o lock in the morning was abou. 75%. The insulin treat- ment given was quite standard and the replacement of her body fluid was normal proced- ure. The only thing he could have wished to add to the treatment would have been e1- ectrocardiograms. His opinion was that the “at titude toward the patientude- Mrs. Mallory called on the telephone on Tuesday, reported being to the doctor and getting medication. She said she was feeling better and was staying off work the rest of the week to really get a good rest. Dr. Abrams was the next wit-‘ ness. He told how Mrs. Mallory came into his office about two weeks before her admission to YCH. She wanted her former psychiatric medicine but re- fused to discuss her problems. After several telephone calls to the Clarke Institute he got her the medicine and made an ap- pointment with her referral doctor at Clarke. Dr. Abrams,nwhen question- ed, said urinalysis is done on a routine basis when patients are admitted to hospital, but isn't routine for those only at em- ergency. Asked what the policy is at the Torontq General Hospital if a person came in partly coma- tose and in an agitated condi- tion, Dr. Abrams said. “I can’t answer that question.” He said in Mrs. Mallory’s case a diagnosis of anxiety state and hyper-ventilation was made, and in his opinion that‘ was sufficient. He said it used: to be the usual routine at YCH‘ for blood tests and urinalysis to be done on admission, “But with financial worries, we have discussed decreasing the freâ€" quency of such tests,” he said Dr. Abrams said urinalysis isn’t a test for diabetes. “It gives you a clue, that‘s all,” he said. ’ Asked if Mrs. Mallory would have had a good chance to re- cover if a urinalysis had been made the night of her admittal, he said, “I wouldn’t presume to assume that”. Asked if a blood sugar color test could be made as hospital routine, he said, “I wouldn't suggest that at all." At this time Mrs. Mallory’s family doctor was recalled. Dr. Socol said on her July 24 visit to his office he asked her if she had any urinary problems, excessive thirst, weight loss, ab- dominal pains. “These are the usual symptoms you look for in diabetes. There were no signs at that time to lead me to sus- pect diabetes," he said. Next witness was Mrs. Sleep,‘ who said she was one of Mrs. Mallory’s longest and closest friends, knowing her 24 years. She described being on a shop-‘ ping trip with Mrs. Mallory a year or so before the fatal ill- ness when Mrs. Mallory had a fainting spell and hit her head on the shopping plaza terrazo floor. Next witness was Mrs. Mal- lory’s companion during the last few months, Adolf Vander- star. He told of meeting her in 1970 while a patient during Oc- tober at the Clarke Institute. He told of her having one of her fainting spells after he was discharged from the institute and she was allowed out for the day. He told of taking her to ‘ his own family doctor, who sent her to Toronto General Hospit- al for emergency treatment. ALWAYS NIBBLING Mrs. Sleep said she took Mrs. Mallory to Dr. 80001 after the shopping centre incident. She said Mrs. Mallory was always wanting something to drink, was always hungry and nibbling at something. She last saw Mrs. Mallory in July before going on holiday. “She looked dreadful . . . wasâ€" n’t well . . . was drowsy all the time," said Mrs. Sleep. She also remembered Mrs. Mallory in the spring of 1971 once tel~ ephoned her for help and on this occasion fainted and fell at home. Vanderstar said he and Mrs. Mallory met frequently after her discharge from the Clarke Institute, and that he resided with her for four or five months. He said during the ‘last while she didn’t eat anY- imore, just drank liquids. Her weight went up and down. He L'saw her Tuesday, August 17 the ‘day before her admittance to '-YCH. She was lying in bed : feeling pretty bad. . LEFT FOR WORK L “I had to go to work and left‘ ‘about 1:30 pm. I offered to .ltake her to the hospital but she :;said no. She had been cough- ng and vomitting." He said before she was stric- ken he went out every night to the store for drinks and all she every wanted was “Coke”. He was at YCH the morning before she died and talked to Dr. SUFFICIENT DIAGNOSIS Vanderstar said that at the time she fainted while with him, the onhz thing his doctor said was she had high blood pressure. She got to YCH a little over an hour after her sister arrived at emergency. Around 10 o’clock she was told the doctor prescribed some further mediu cation and was going to dis- charge her sister. “She looked dreadful. I ask- ed her if she had her blood sugar checked and she said yes, three weeks ago. I asked to talked to the doctor. Dr. Woo said nothing was wrong and that her hyper-vent- ilation was caused by anxiety. All this time Joan (Mrs. Mal- lory) was complaining she was dehydrated. Her speech was thick and furry, as if she had amouthful of feathers. She said she was weak. couldn’t stand up and was drinking water all the time,” Mrs. Herrington said. VOMITTED SEVERELY Woo felt something had up- set Mrs. Mallory and they had a long talk in the hall. Mrs. ‘Mallory’s son David was includ- ed and he said he didn’t know of anything that had upset his mother. David said she vom- itted very severely the night {before and was crawling around in the bathroom because she \was so weak. Mrs. Herrington said Woo told her Mrs. Mallory needed a psychiatrist, but there was no need calling the Clarke Insti- tute at that time of night be- cause there was nobody on dutY. Mrs. Mallory said, "Please don’t take me home. I’m so weak I couldn’t even put my clothes on. Please keep me here," said her sister. Mrs. Herrington said rather than have her sister sent home she would take her to Toronto Western Hospital and her own doctor. Then Woo went away and had a conversation, and came back saying Mrs. Mallory would be admitted for observa- tion. in the bathroom because she was so weak. Mrs. Herring‘ton said Woo told her Mrs. Mallory needed a psychiatrist, but there was no need calling the Clarke Insti- tute at that time of night be- cause there was nobody on duty. Mrs. Mallory said, "Please don’t take me home. I’m so weak I couldn’t even put my clothes on. Please keep me here," said her sister. Mrs. Herrington said rather than have her sister sent home she would take her to Toronto Western Hospital and her own doctor. Then Woo went away and had a conversation, and came back saying Mrs. Mallory would be admitted for observa- tion. ._ The sister said she told the emergency nurse of the fam- ily’s diabetic history, that Dr. Socol said she was in a pre-dia- betic condition and would have diabetes one day, and that she had been having regular tests for diabetes. “I asked to go up to the ward with her, but wasn’t al- lowed to go. So I went home." The father then testified, say- ing he could never understand that over the years his daughter could never get any other an- swer from her doctor than that the trouble was her nerves. Nor could he understand why she stuck with the same doctor. “There must have been some kind of perverse loyalty to Dr. Socol here. There’s a strange situation here that I don’t un- derstand. I feel I’m largely to blame because I didn‘t have enough sympathy about her problems which were largely marital problems. I’m sorry for that." CONFRONTED DOCTORS He told of going to the hos- pital where his daughter had been stricken and asking Dr. Woo, “Are you the man who was going to send Joan home last night? Wasn’t that casual treatment for a woman so ill? He said there was no history of diabetes and asked if I was ac- cusing him and I said yes. He said to take it up with the proper authorities, turned on his heel and walked away.” said Mrs. Weston. “I asked to go up to thel ward with her, but wasn’t al- lowed to go. So I went home," she said. ,She then called in the morning, found out about her sister’s critical condition and that a physical illness was now suSpected. POSSIBLY PREGNANT She told Dr. Socol she thought her sister might be pregnant, feeling this would explain her recent vomitting and worry, since she was separated and had children in their teens. l Dr. Socol said a pregnancy test was done and was positive, but this didn’t prove she was RICHMOND HILL happily! When you walk away from work for the last timeâ€"smile-secure in the knowledge that your Victoria and Grey retirement saving plan starts working for you the day you quit work. We have three tax saving retirement plans from which to chooscâ€"an “equity” plan designed to give you greatest capital appreciation, an V'v “interest” pian that gets you high cumulative income, and a high interest guaranteed investment certificate fund fully guaranteed as to principal and interest. Start retiring today WETORM GREX TRUST COMPANY SINCE 1889 The senior Trust Company devoted entirely to serving the people of Ontario. , WAKELIN, MANAGER 121 YONGE ST. N. I -â€" see Victoria and Grey. ing at about 1 pm and going with them to Ontario Place. She visited again on Thursday. Aug- ust 12, arriving about 4:45 pm to go to see a ballet. ALWAYS DRINKING Mrs. Weston told how her daughter was always drinking water and eating ice cream, talked of losing five pounds‘ more, but the doctor told her‘ not to worry even when she already lost 10 pounds. She complained of vomitting like ‘she’d had a gall bladder attack, but came back to visit and play lcroquet the next Sunday. When asked to go and see her par- ents’ doctor she said, “I will give him (Socol) another chance,” the mother testified. Mrs. Mallory at the time couldn't remember her mother’s birthday was August 19. Her mother said this was strange since her daughter never for- got her mother’s birth-day in her life. Mrs. Mallory had been working toward a Bach- elor of Arts a university at night school, but the last win- ter had given up her work be- cause of being too tired to go on. Mrs. Weston said. ‘ He then"told of having an‘ upsetting conversation with Dr. Socol, of which he couldn’t re- member very much except that “Dr. Socol sensed my constern- ation”. He told of Dr. Socol saying something like Joan had called walf once too often. “I couldn’t understand somebody repeatedly criticizing her doc- tor, but wouldn’t change”. he \said. At this point in the inquest Dr. Socol was recalled to the HOURS: Closed Monday. Tues. - Thurs. 9-5 Fri. 9-7 Sat. 9-1 884-1107 “lier Inental fllness record may have masked her final ill- ness to the doctors who were treating her,” concluded Dr. 50001. The final witness in the in- quest was the Toronto Univers- ity medical expert Dr. Killin- ger. He said stressful situa- tions could aggravate mild or latent diabetes conditions. He said diabetes usually comes on gradually. It was unusual for diabetes to happen suddenly, but it does happen. He also said an infec- tion could aggravate a diabet- es situation. If insulin had been admin- istered at the time Mrs. Mallory was admitted to YCH it would have made a difference, he said. In answer to further questions about whether or not she would have recovered, he said it was difficult for him to make a positive statement on thiS, but generally the earlier treatment was administered the more likely there would be 31 favorable result. ‘ MUST ORDER TESTS Expert Killinger said any hos- pital test that is done has to be ordered by the patient’s doc- tor. He said admission tests for diabetes weren’t carried out by hospitals as a matter of rou- tine in his experience. He said Mrs. Mallory’s consumption of raw sugar in “Coke” would add a component to the develop- ;ment of diabetes. “With any anxiety situation you can have a series of symp- toms that can mask an organic problem,” Killinger testified. “I would have expected there would have been a smell of acetone on her breath. But Killinger said the injury Mrs. Mallory had to the left side of the brain might have been caused by a fall during a faint- ing spell. but in his opinion it hadn't any effect on her fatal diabetes condition. 75% MORTALITY He said the mortality rate in such 1 case as Mrs. Mallory’s at 10 o lock in the morning was labou. 75%. The insulin treat-‘ ‘ment given was quite standard‘ and the replacement of her body fluid was normal proced- ure. The only thing he could have wished to add to the treatment would have been e1- ectrocardiograms. His opinion was that the “at-i titude toward the patient de- veioped over (a period of) time through experience with her mental problem and it prevent- ed immediate in depth investi- gation at the hospital." He differed in his opinion in that he felt Mrs. Mallory’s brain swelling may have been due to lack of oxygen after her cardiac arrest. Asked what he would have thought that night at YCH if presented with a patient who was incoherent, yelling for help, restleSS and requiring bed rails, he said, “A set of circum- stances like that would indicate to me there was something bas- ically wrong that I would want to look at.” He said Mrs. Mallory’s condi- tion may have come on rapidly over as little as a couple of days. “This (her condition) would take several days to pro- gress to the stage it was, that is, having the highest possible test reading,” he said, reiterat- ing he was surprised the ace- tone wasn’t smelled on her breath. "Two days is the minimum time required to produce this total picture," he said, while the psychiatric drugs she was taking could cause dryness of mouth and lead a person habit- ually to drink something to moisten the mouth. KESWI'CK: Former North Gw- illimbury Reeve and York Coun- ty Warden Joe Dales thinks regional government is a flop and should be scrapped. Dales said regional government was a creation of the province and is too expensive. He was speaking at a citizens’ meeting in the Opt- imists Hall. SOMETHING WRONG THE LIBERAL, Richmond Hill, Ontario, Thursday, Dec. 16, 1971 II treat your clothes and yourself ‘ to a new electric dryer Put a ray of sunshine in your washday with a new electric dryer. Clothes come out fresh, fluffy and easy tosiron (some may need no ironing at all!). You're saved the worry of waiting for the weather, or the work of lugging a heavy wash to the line. Next washday, let an electric dryer take a load off your handsâ€"and off your mind. 4 YONGE ST. SOUTH live better electrically Richmond Hill Hydro Electric Commission SAM COOK, CHAIRMAN BRYDON ELLIS, MANAGER 884-4466