Saturday, 29 September 2007

Cleaner Polishes Off Patient

For several months, our nurses have been baffled to find a dead patient in the same bed every Friday morning" a spokeswoman for the Pelonomi Hospital (Free State, South Africa) told reporters. "There was no apparent cause for any of the deaths, and extensive checks on the air conditioning system, and a search for possible bacterial infection, failed to reveal any clues." However, further inquiries have now revealed the cause of these deaths. It seems that every Friday morning a cleaner would enter the ward, remove the plug that powered the patient's life support system, plug her floor polisher into the vacant socket, then go about her business. When she had finished her chores, she would plug the life support machine back in and leave, unaware that the patient was now dead. She could not, after all, hear the screams and eventual death rattle over the whirring of her polisher. "We are sorry, and have sent a strong letter to the cleaner in question. Further, the Free State Health and Welfare Department is arranging for an electrician to fit an extra socket, so there should be no repetition of this incident. The enquiry is now closed." - Cape Times, 13 June 1996.


This is the way the world was introduced to the story of South Africa's most careless cleaner, under the headline: "Cleaner Polishes Off Patients.". There was little reason to disbelieve the tale, as it not only cited a credible source (the Cape Times) and a date of appearance, but also quoted officials confirming the tale quite categorically, even down to the wonderful detail of an electrician fitting an extra socket.

Problem one: the story as it appeared throughout the world (and reproduced above) bore little resemblance to the original Cape Times story, and the original Cape Times story bore little resemblance to the story's first mention in print.

For most news media that carried it, the Cape Times report was regarded as sufficiently credible source, as it is a highly reputable and respected newspaper. However, thhis is how the story ran on page 1 of the Cape Times on June 13 1996:

Cleaner polishes off patient By Lindiz van Zilla BLOEMFONTEIN: Health authorities are investigating a series of deaths of patients who all died mysteriously in the same hospital bed over a period of several weeks. Staff at the Pelonomi Hospital here were baffled when each Friday, they would come across another dead patient. Checks on the air-conditioning system and the position of the bed in relation to the windows failed to provide any clues about the deaths, which occurred two years ago. The "killer disease" was uncovered when staff came across a cleaner who had unknowingly unplugged the life-support system to plug in her floor polisher. Every Friday she would enter the ward, plus her polisher into the socket meant for the life-support system and calmly go about her business. Upon completing her chores she would reconnect the life-support system, leaving no trace as to the cause of the patient's death. Despite reports of several deaths in this way, only one is being investigated by the Free State Health and Welfare Department. A hospital spokesperson said he did not know about the incident.

That sounds vaguely conclusive. But it doesn't quite hang together, does it?

It's partly because of space constraints that force most newspapers to compress stories that they do not consider of vital importance. In this case, one key sentence was left out of the original report. It went like this:

Yesterday, a department [of Health and Welfare] spokesman, Mr Victor Litlhakanyane, said: "Hospital staff haven't yet confirmed the incident, and we are still investigating it."

Combined with a hospital spokesperson not knowing of the incident, it would have set alarm bells ringing. With that little detail, it becomes clear that the rest of the story, at that stage, remained in the realm of rumour, speculation and hearsay. Yes, it's a pretty detailed story for mere speculation, while still being frustratingly vague. Could it be that the Cape Times picked it up from another source, and then merely made a few phone calls to confirm that it hadn't been made up by a rival source?

It could be, and it is the way it happened. The Cape Times' deputy news editor, Sybrand Mostert, spotted the story in Cape Town's Afrikaans-language daily newspaper, Die Burger. The story went like this (as found in Die Burger's online archive):


Page 8 11 June 1996 Pasient sterf glo na werker masjien uitprop BLOEMFONTEIN. Familie van 'n pasient wat in een van die waaksale van die Pelonomi Hospitaal hier gesterf het nadat 'n skoonmaker glo die masjiene wat die pasient aan die lewe moes hou, uitgeprop het, word versoek om na vore te kom. Die skoonmaker het glo die kragprop van haar vloerpoleerder by die muursok ingeprop. Dr. Craig Househam, Vrystaatse adjunk-direkteur-generaal van Gesondheid en Welsyn, het gese hy weet van die voorval van meer as 2 jaar gelede. Hy kon nie se of tugstappe teen die werker gedoen en of die familie van die pasient in die beweerde voorval vergoeding ontvang het nie. Aanvanklike gerugte het gelui meer as een pasient is binne 'n paar agtereenvolgende weke elke Vrydag in dieselfde bed oorlede. Toe personeel begin onraad vermoed, het hulle op die werker afgekom wat Vrydae haar vloerpoleerder inprop by die muursok wat vir die lewensnoodsaaklike masjiene bedoel is.

Translation:


Patient believed to have died after worker unplugged machine Bloemfontein: Family of a patient who died in one of the intensive care wards of the Pelonomi Hospital after a cleaner is understood to have unplugged the life support machine, have been requested to come forward. The cleaner presumably plugged her floor polisher into the wall power socket. Dr Craig Househam, the Free State's deputy director general of Health and Welfare, said he had known about the incident for the past two years. He could not say whether disciplinary steps had been taken against the cleaner or whether the family of the patient in the alleged incident had received any compensation. Initial rumours suggested that more than one patient had died in the same bed every Friday for consecutive weeks. When staff began suspecting something amiss, they discovered the worker who, every Friday, plugged her floor polisher into the wall socket intended for the life support machine.


Keep an eye on two key phrase there: "aanvankilike gerugte" and "beweerde voorval", which I've translated as "initial rumours" and "alleged incident".

It was assumed at the Cape Times that Die Burger had picked up the story from its sister newspaper in Bloemfontein, Die Volksblad, the only daily newspaper serving the whole Free State province. According to Judith Soal, one of the most Internet-savvy sub-editors (that's the South African equivalent of a copy editor) at the Cape Times at the time, Mostert "found it interesting, wasn't sure whether or not to believe it, decided to put a reporter on it".

The reporter takes up the story:

"I never got around to speaking to anyone at the Volksblad," Lindiz van Zilla advised me by e-mail. "I did however phone Pelonomi Hospital and spoke to a medical superintendent on duty who informed me of the ongoing investigation. The hospital did not indicate any knowledge of unusual deaths, but said they too had become aware of rumours - they were basing their investigation on these rumours... I personally don't believe the story - a 'genuine' urban legend."

A part-time sub-editor, who does not want to be named, then edited the story. He wasn't sure whether to believe it or not, but was told that it had been discussed and the decision had been made to use it.

Judith takes up the story, although she wasn't on duty that night:

"I think what made them decide to run it was that the hospital had said it was investigating, giving some credibility to the story... The story was much discussed, and it was decided to run it as a lightish thing, not shock horror, because it couldn't be verified... we gave it a fair amount of prominence because of the newsworthiness of the fact that such a story had got so far, and the bizzareness of it all. The original headline was quite straight - along the lines of 'xx die in hospital', and the revise sub [the senior copy editor who makes final revisions of sub-editors' work] changed it.

The revise sub, Don Mallett, explains:

"Actually I didn't sub or revise the story. However, I did hear my colleagues discussing it and I read it. When I heard someone sing out a headline about it later, I suggested the headline that eventually appeared. Someone else suggested something about "patients being unplugged" and the night editor asked the subs' room which we should use and they went for mine.

"I realised fully that the headline was insensitive and in poor taste, but felt this would be considerably cushioned by the facts that the story was a couple of years old, no patients or families were identified, and anyone affected would be far from the Cape Times area of circulation."

Judith continues: "The weird thing is that Pam, another sub here, was sent an e-mail weeks later, with a much-changed version of the story, but the original Cape Times headline."

Pam Sykes' version was word for word as recorded at the beginning of this section. She sent me a copy of the e-mail, which she had received at the beginning of August, from a contact in Montana, USA. By that time, obviously, it was already feverishly circulating on the Internet. At the time of writing this chapter (September 1999) the version circulating on the Internet remains word-for-word identical to the first modified version Pam received.

How did the story change so dramatically?

That is the first structural evidence that it is an urban legend. The attribution of spurious quotes to unnamed authorities, the radical transformation of the story in its re-telling, and then the rapid spread of the story as a result of its shock appeal, are all classic hallmarks of urban legend proliferation. It is impossible to trace the moment of transformation unless the individual responsible for the rewriting confesses.

The Cape Times reference was crucial. It was responsible for the next step up the ladder of credibility, when it came to the attention of John Hoyland, editor of the lighthearted Feedback column in the respected British popular science magazine New Scientist. He checked with the Cape Times, first speaking to an archivist, and "she was very emphatic the story was true". So he ran the story in Feedback - except that it was the Internet-modified version of the tale. For the sake of completeness, this is how it looked when it left his computer:


SOME readers may already have seen this story, which appeared originally in South Africa's Cape Times this summer, and is apparently true. We are passing it on for the unenlightened so that they may reflect on the fickleness of the hand of fate that shapes our destinies. "For several months, our nurses have been baffled to find a dead patient in the same bed every Friday morning," a spokeswoman for the Pelonomi Hospital (Free State, South Africa) told reporters. "There was no apparent cause for any of the deaths, and extensive checks on the air conditioning system, and a search for possible bacterial infection, failed to reveal any clues. "However, further inquiries have now revealed the cause of these deaths. It seems that every Friday morning, a cleaner would enter the ward, remove the plug that powered the patient's life support system, plug her floor polisher into the vacant socket, then go about her business. When she had finished her chores, she would plug the life support machine back in and leave, unaware that the patient was now dead. She could not, after all, hear the screams and eventual death rattle over the whirring of her polisher. "We are sorry, and have sent a strong letter to the cleaner in question. Further, the Free State Health and Welfare Department is arranging for an electrician to fit an extra socket, so there should be no repetition of this incident. "The inquiry is now closed."


Says John: "Apart from the intro, it's word for word what we got off the Net. The reason for saying 'some readers may have already seen this story' is that the story was apparently run earlier in Private Eye magazine, though I never saw it."

Since then, he says, a colleague had talked to the Cape Times again and, once more, they had "confirmed" the story - but this time faxed their original article to New Scientist. And lo and behold, it was a rather different story, at least in terms of attributions and confirmations.

"I don't mind admitting that I've been had," said John, who cooperated warmly in this reconstruction of events.

So where did it all start? The earliest print coverage came in the Bloemfontein newspaper Die Volksblad. On 11 June 1996, an article by Andreij Horn, an investigative journalist who was then their medical correspondent, appeared under the following headline:

Inligting gesoek oor gerug dat pasient dood is weens skoonmaker se optrede

Translation:
Information sought regarding rumour that patient died due to cleaner's actions

Now that doesn't have quite the same ring as "Cleaner polishes off patients", but then Die Volksblad had good reason to play this one low key. The story ran like this. Note that the simultaneous version from Die Burger was obviously lifted from here, and note too the subtle differences between the opening paragraphs, that gave the version from Die Burger an edge of added credibility and removed the powerful shadow of doubt that hangs over the original version (translated from the original Afrikaans):

Family of a patient who died in one of the intensive care wards of the Pelonomi Hospital after a cleaner is understood to have unplugged the life support machine, have been requested to come forward. The cleaner allegedly plugged her floor polisher into the wall power socket. Dr Craig Househam, the Free State's deputy director general of Health and Welfare, had earlier told Die Volksblad he knew about the incident, but that it had happened two-and-a-half years ago, and that Die Volksblad had already reported it. He could not say whether disciplinary steps had been taken against the cleaner or whether the family of the patient in the alleged incident had received any compensation. He first wanted to consult the records, since it had happened under the previous management. Die Volksblad could find no reference to the alleged incident in its own records. This follows repeated tip-offs from various sources over the past month that such an incident had in fact taken place at Pelonomi, and had been hushed up. Initial rumours suggested that more than one patient died in the same bed every Friday in consecutive weeks. When staff began suspecting something amiss, they discovered the worker who, every Friday, plugged her floor polisher into the wall socket intended for the life support machine. Yesterday the Department said that no record of such an incident could be traced. Ms Elke Grobler, public relations officer of the department, said the department knew that such rumours were doing the rounds. "The department requests the family of the patient that allegedly died, or anyone who knew something about this, to come forward, so that the allegations can be properly investigated." Anyone with information can phone the department on (051) 405-4818.
The word "allegedly" in the second sentence is translated from the Afrikaans phrase "na bewering", which Die Volksblad used in its report. Die Burger changed the word to "glo", which is a far softer word for "allegedly" and is closer to "believed to have" or "presumed to have", which removes the slight edge of incredulity that "allegedly" imparts to the story. In the eyes of health authorities, however, the story is identical, and they would have had no reason to reject the subsequent interpretation by Die Burger when approached by the Cape Times.

And no one phoned the Department with more information.

Says Andreij Horn, had the Department of Health and Welfare not made a specific appeal to the public, he would have dropped the story. It was obvious, he says, that it was an urban legend. He was extremely happy to recount his role and was most polite about the whole fuss. In a telephonic interview from Bloemfontein on November 12 1996, he said (translated from Afrikaans):

"When I first came across these rumours, I thought to myself this looks exactly like an urban legend. I approached the report from the point of view that it was an urban legend, but then the department said that, while they had no information about the incident, they wanted to hear from people who did. Nothing came of their appeal, but that was the angle that resulted in it becoming a worldwide urban legend.

"In investigating the story, I went to the top - the Department of Health and Welfare. I did not contact the hospital, because that is not the way the channels work here. The hospital is required to report any unusual incidents. If someone died under such circumstances, a judicial hearing would have to be held.

"Even if there had been a conspiracy to hush it up, it is such a sensational story that it could never in a million years be kept quiet. I have no doubt in my mind that, if the department has no record of an investigation into possible malpractice, it is an urban legend.

"To tell the truth, it was the department's commitment to transparency that gave momentum to the urban legend. They could have dismissed it as a fairy tale, but were prepared to allow the public to assist with the investigation. Had they not done that, my report would never have appeared. The fact that they took it semi-seriously gave momentum to the spread of the urban legend."

A key question in the evolution of an urban legend of this nature is, where did it come from? Clearly, it had been around for some time before Andreij decided to elevate it to print. He responded:

"We had been receiving calls for quite some time, I'd say two to three months, from people who asked us why we didn't write about this incident that they had heard happened at Pelonomi Hospital. When it reached my news editor for the second or third time, he said it might be worthwhile investigating the matter. Dr Househam was a classic example of how the story developed in people's heads: he had it in the back of his mind that it had happened more than two years ago, but during the previous administration, so he had no personal knowledge about it, and he thought he had read about it in Die Volksblad.

"You have to understand here that Die Volksblad is the most important news and information source in the Free State, and when people think they knew about something because they read it in the newspaper - the way people often retell urban legends - then in the Free State they assume they read it in Die Volksblad.

"We went to great lengths to try to track down a report of such an incident in our newspaper. All our stories are pasted on pages, which we went through carefully, and we have a card reference system that includes every story that has appeared in the paper since 1954. If it wasn't in that system, then it definitely had not appeared in our newspaper.

"I would estimate that I heard my first version of the story about three months before I wrote the report. I should have reacted sooner, but it was such an unlikely story to me, that I had no faith in the rumour whatsoever. Every version was precisely the same, except for the number of patients that had died. Sometimes it was just one, in other versions people said it had carried on for weeks, and in others up to 14 people had died. The more the bodies, the more indignant people were about how many people had to die before the authorities realised there was a problem.

"I cannot imagine such a thing happening in a South African hospital - that people can die in such a fixed pattern without the authorities investigating - no matter how cynical we become about the possible lowering of standards. It simply does not make sense. And I must add that the fact that the Free State health authorities were so willing to respond instantly was an indication to me of how seriously they take their responsibilities and their image. They are extremely conscientious."

By now, there can be no doubt we're talking urban legend. But does it behave like other urban legends? Are there variations on this theme? Sure there are; this is an urban legend, isn't it?

During August 1996 it took on another necessary characteristics of an urban legend (no, they didn't lynch the cleaning lady). Firstly, the story was told by a caller to the Johannesburg-based radio station 702 as having happened at Baragwanath Hospital (listed in the 1997 Guinness Book of Records as the largest hospital in the world) near Soweto. Ironically and tragically, life imitated UL a few weeks later when two babies died at Baragwanath after a power failure during which the emergency generators also failed due to running out of fuel - but this was the subject of a high-level investigation, officially confirmed, and is not an urban legend.

Secondly, in subsequent weeks I heard the story told as word-of-mouth, but having happened at the Johannesburg Hospital. It seems, however, that the Pelonomi version then took a firm grip on the public consciousness - partly thanks to the Internet - and all subsequent versions reverted to the original tale from Bloemfontein.

However, it is likely that it has been around for decades. Take, for instance, this posting from Christopher Becke to the Internet's alt.folklore.urban newsgroup on November 11 1996:

On HBO on Sunday morning was a movie starring George Wendt (of Cheers Fame) in some sort of Teacher role. The movie was called Plain Clothes (1988). In it, one of the characters is telling the other about the untimely demise of the husband (or was it the father) of another character. Apparently, the gentleman was hooked up in an iron lung, and the cleaning woman knocked out the plug with the vacuum cleaner. Although it wasn't a case of unplugging the one to plug in the other, I thought it may have provided a source for the now famous UL.


I've been told that the story was circulating in Wales in the early 1980s. It is also used as an example in debates among Jewish religious scholars about the acceptability of taking people off life support and allowing them to die naturally. The broadly accepted view is that, while one is not obliged to place someone on life support and can allow them to die naturally if there is little hope of saving them, the picture changes once someone is actually on life support.

According to the argument, it is unacceptable for any human being to cut off the life support machine - intentionally - regardless of how hopeless the situation may be, since a decision to end a life may only be taken by God. However, and this is exactly as it was put to me by one scholar, should "a cleaner accidentally unplug the machine to plug in a cleaning machine, you are not obliged to switch the machine back on again". Of course, this is a completely theoretical argument, as many of these theological arguments are, and the example is used merely to advance a hypothesis.

It is even possible that such hypothetical debates may have sparked the legend, but I have no evidence for that, either.

If they did, they would have to go back to at least the early Seventies or before, since they would have to pre-date the experience of an e-mail correspondent (somitcw@erols.com) who sent me this account on 21 July 1999:


About 1972 or 1973, while working for J.C.Penney Co. I heard a rumor that was sworn to be true. Many of the JC Penney stores had electronic cash registers that connected to an in-store controller. Every night when the stores closed, someone would prepare the in-store controller to transmit the sales receipts to one of the central computers. One central computer was at a site that I worked at in Forest Park, Georgia, USA. The central computer would phone several in-store controllers at a time and copy the receipts to tape. We would process the tape data on a different computer, create reports on different tapes, and then transmit the reports back to the stores before any re-opened the next morning. We were not the first site to do computer polling. When we started was when I heard the rumor: It turns out that when the process started, it worked well for several stores. At one store, it always failed on Friday night and the data had to be polled again on Saturday night for a double run. The store manager checked and his people were properly setting up the in-store controller for polling from the central computer, but the central computer could never receive data from the in-store controller on Friday nights. Finally, after much checking, the programmer in charge of the project flew in from New York. The programmer, store manager, and several other people would watch from the time that the clerk set up the in-store controller until the central computer started or failed polling. After a short time, the cleaning lady came in to vacuum. She noticed the group of people, but they told her to continue as always. She then went to the in-store controller, unplugged it and plugged in her vacuum cleaner. It was the only or easiest socket to get to. When she finished vacuuming, she would plug the in-store controller back in, it would boot up and was ready to handle cash registers, which meant that it was not ready for computer polling. It's been over 25 years since some programmers at J.C.Penney Co. told me the rumor as absolute fact. I still believe that it may be true, but wouldn't bet on it after hearing about the hospital floor polisher.

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