Killing Earl
Kay Day
(Reviewer - Dr. Alma Bond)
2005 Ocean Publishing
ISBN: 0971764190

A 12-year old girl names her pain. Should doctors treat her mind or her body?

Killing Earl is a journey through one family's turmoil caused by an unexpected move & a sick child. In a direct, humorous style, Kay Day tells the true story of her daughter Rebecca's mystery illness, & the family’s delayed relocation.

Killing Earl includes interviews with experts in medicine & psychology. Although Rebecca's problem was physical, there was also an element of depression brought on by her fear that no one believed her pain was real. To help herself cope with the agony, the ingenious child named it “Earl”, & dealt with it as though it were an assailant.

Sr. Associate Reviewer Dr. Alma H. Bond writes:

In Killing Earl, Kay Day writes a heart-wrenching tale of her daughter's seemingly interminable battle with unbearable pain in the lower right quadrant of her abdomen. Her suffering was so excruciating that Rebecca couldn't walk even a few steps without wincing. Riding over a small bump in the road was agonizing. Greatly intensifying her despair was the fact that people tended to dismiss unexplained physical symptoms as “psychological” in a pejorative sense, when objective tests fall short of documenting disease.

“The doctor thinks it is all in my head,” Rebecca wails (p. xiv). This in spite of the fact that she had appeared to be a perfectly normal child who was not particularly prone to anxiety before her illness struck.

Although her devoted mother took Rebecca to doctor after doctor, who prescribed test after test & medication upon medication, none were able to relieve the child's misery. Her appetite decreased & the normally slender child lost 15 more pounds. Her face was the color of snow. She moved slowly & laboriously, when she could move at all. Bedridden she was unable to attend school or tolerate seeing her friends (“Her social life was in a shambles” p. 4), or participate in any of the activities the athletic, highly intelligent, creative 12-year old had enjoyed before her illness.

Unsurprisingly, the child her grandmother called “the Sunshine Girl” became depressed & gloomy. Along with Rebecca, the rest of the family was put in a holding pattern, in which they were unable to join her father in the move he had to make to Florida as vice-president of his company. This forced him to commute weekly from Jacksonville, & greatly added to the mother's stress, depriving her of his support & physical help.

Although no life-threatening patterns were revealed by the extensive tests her daughter underwent, Kay felt that Rebecca's frustration, pain & fear were killing her as surely as a terminal illness. After she was well, the author learned that her daughter had been contemplating suicide.

When Rebecca first complained about her stomach hurting, she was taken to her pediatrician. He diagnosed the problem as a stubborn virus, prescribed fiber, & told them not to worry. This was the beginning of an endless pilgrimage to doctor after doctor, none of whom were any help. A second doctor recommended that she be taken off dairy products. Then Kay took her back to the first doctor, who recommended “More water and more fiber,” (p. 40). Rebecca was flipped from dietary changes to antacids to extensive tests, but none of the doctors were able to give a definitive diagnosis. By the end of the year, she had undergone a number of invasive tests, including x-rays of her abdomen, but nothing turned up that the doctors felt warranted a new approach.

A pediatric gastroenterologist ordered a comprehensive metabolic panel & flat x-rays. Neither procedure turned up any significant findings. Nevertheless, the panel turned out to be a turning point in Rebecca's illness, as the ever-watchful mother became aware of a few quirks on the metabolic panel, such as elevated bilirubin. She learned that Rebecca's neutrophils (the chief phagocytic white blood cells of the blood) were at the high end of the spectrum, & turned to the Internet for information about them.

The pediatrician recommend endoscopy & colonoscopy, with a biopsy of each of several small tissue samples. Another specialist concluded that there was evidence of inflammation, but said, “It will get better with time.” (p. 68). Kay studied the records & grew furious at the lack of communication with the doctors, & in their unspoken belief that the problem was “psychological” in nature. She surmised that despite the doctors' denials, the metabolic report offered the first tangible reasons for Rebecca's pain, & put to rest the idea that her illness was “only in her head”. The scope showed inflammation in both the first part & the farthest segment of the small intestine. The stomach biopsy showed excessive tissue formation or an increase in size.

Because the doctors were of no help, Kay became a reluctant lay expert on abdominal pain. She found out what she already knew from her daughter's experience, that this sort of pain is hard to diagnose & treat. A cyst was discovered in Rebecca's ovary which caused her pain, & the leakage of blood into her abdominal cavity caused problems. A kind doctor friend proposed a laparoscopy. Another doctor confirmed that Ovarian cysts are not uncommon in girls who are approaching puberty. Such cysts can bleed or rupture, or cause torsion where the ovary twists. To everyone's relief, he added that for all patients, pain is real until proven otherwise. He also cautioned that laparoscopy does not always work. Nevertheless, Rebecca & her family decided they had no choice but to go ahead. For Rebecca, although the process was lengthy & painful, it led to a happy ending.

Killing Earl is an interesting & sometimes humorous memoir. It gives practical advice about navigating today's medical establishment, as well as useful Internet links & tips for patient advocates.

The courage of both mother & daughter, who refused to give in to defeat, is the backbone of the book. It should bring encouragement to everyone who suffers from “undiagnosable” pain. Rebecca’s “mystery illness” affects over 86,000 American children every year. Up to date information about treatment for such cases is given. If it saves even one child from enduring the year of horror & agony that Rebecca & her family lived through, Killing Earl was well worth writing.

“I hope nobody ever has to deal with an Earl,” Rebecca said, & asked her mother to write this book. Killing Earl will help Rebecca’s wish come true.

More from Kay Day: A Poetry Break, an award winning collection of poems.
(07/03/05)

Dr. Alma Bond
2005©Alma Bond
A RebeccasReads.Com Sr. Associate Reviewer

A RebeccasReads author featured in Authors & Books

Reviewer's Bio:
Dr. Alma Halbert Bond is the author of ten published books, including:
The Deadly Jigsaw Puzzle;
The Tree That Could Fly;
Tales Of Psychology (2005);
I Married Dr. Jekyll And Woke Up Mrs. Hyde (2000);
The Autobiography Of Maria Callas, A Novel (1998);
On Becoming A Grandparent: A Diary of Family Discovery (1994);
Who Killed Virginia Woolf? A Psychobiography (1998);
Profiles of Key West (1996).

She recently recorded her new manuscript, Old Age Is A Terminal Illness, as an audio book.

She is also the author of a just published children's picture book called The Tree That Could Fly.

Dr. Bond teaches Psychology & Writing online at WriterSchool.