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These are letters written by Penelope Dingle to her friend Francine Scrayen, a homeopath who discouraged Ms Dingle from getting proper medical treatment for rectal cancer. Ms Dingle died on August 25, 2005. The Coroner was not impressed by Ms Scrayen.
WITHOUT PREJUDICE I WRITE YOU THIS LETTER
November 29 2004
This is Penelope Brown writing.
As you can see from the date below, the following letter was written some time ago. I have waited to see if you would contact me. But I have waited in vain. So be it.
March 27 2004
This is a letter about accountability and responsibility. Things that are missing altogether in your attitude towards to me. The tone of your card makes this quite clear. You make no reference to the matter that you are accountable as a professional for the fact that your treatment protocol failed after you told me you could cure me.
I am sincerely disappointed that three quarters of your card is spent justifying why I have heard nothing from you. And I am astounded that you think I may be interested in hearing that you were upset with me. I quote: "It was really upsetting to me to hear you have been upset with me as much as you are, because…"
What happened during the 7 months you treated me for cancer is very serious.
You appear to feel excused from making any effort towards me. You write:
"…so for me it would all depend on you if there was any future contact. And this is still the way I feel about it today."
And do not think that these next lines absolve you.
"I wish you all the best in the world, and I am really sorry I haven't been able to give you that."
You write - "First of all it is so good to hear you are doing well!"
As you have made no effort to find out the truth for yourself, and as I am the only source of information that is reliable, it is time you were apprised of the facts.
Perhaps, you may then even contemplate apologising.
My prognosis is very poor. Statistically, I am not expected to live more than 2 - 4 years. With the sort of metastatic spread I had during your treatment, and the fact that more lymphs were affected, I am not expected to survive for long.
The MRI scan taken in April 2003 was read accurately by the surgeon Cameron Platell, and the consulting GP.
It was read inaccurately by you.
The lymphs you informed me were simply overworked were already cancerous. The ovary you informed me was swollen due to another cyst was also cancerous. At this point, my uterus and second ovary were healthy and unaffected. I presume you remember - you examined the scans yourself.
I have had to have a total hysterectomy. You know this because I informed you during one of the conversations we had while I was in hospital, although your card makes no mention of it.
I am now going through early onset menopause.
I can never bear children.
You are responsible for this outcome.
Considering the fact that my original treatment with you was aimed at getting me a pregnancy, and taking into account your assurances that I would fall pregnant and have a healthy child after my cancer was cured, this is all the more grievous and shocking.
During the 7 months you treated me exclusively, the tumour grew in size to 10cms long and 8 cms wide and my uterus, second ovary and more lymphs became cancerous. Because of the size of the tumour, it was no longer possible for the surgeon to perform a complete resection. As a result, I have a margin at the sacral bone of only 1mm, and very close margins in the pelvis. In cases like mine, there is a 70% - 80% likelihood that metastatic spread will reoccur.
In the end, the tumour completely blocked my bowel.
Two litres of faecal matter had built up, causing that area of my bowel to stretch to 3 times its normal size. The surgeon said it was at breaking point like a big "balloon".
Had I performed the enema you instructed me to do, the surgeon told me it would have split my bowel. Had this happened, in my weakened state it would have been unlikely I could have survived the massive infection that would have ensued.
The surgeon said "if your bowel had split, you would have died. I could not have saved you."
I'd like you to ponder this.
Had I waited another 48 hours as you instructed me, for the remedy to work and "for the stop to go," I would have died. The surgeon said I could not have survived another 48 hours, which means I would have died on Monday October 13, 2003.
Ponder on this too.
Due to my severely weakened state and huge weight loss, it was not known if surgery was still possible. I am extremely lucky it was.
When I was admitted to hospital, the surgeon told me I was severely dehydrated and severely malnourished and that I was already dying of malnutrition.
I religiously followed your nutritional protocol and your advice about water intake.
I weighed, once the fecal matter was removed, just 38 kilograms.
When you saw me several days before I admitted myself to hospital, I said, 'Look at me, I'm just skin and bones.'
Your only remark was, 'you'll put it all back on again.'
The surgeon had to 'wash' out the fecal matter while I was on the table during the operation. Due to this, there was a risk of infection and due to the massive surgery, a high risk of postoperative complications. I have been informed I am extremely lucky there weren't. Had there been, my recovery would have been extremely slow.
The surgery was so massive and my condition so weakened I was told my convalescence would take one year.
I am very lucky that the surgeon was able to save my anus, and that I am not on a permanent colostomy bag. As it is, because the tumour had grown, he had to remove the 'reservoir' in my bowl, and this means I do not have complete control of my excretory functions. In other words, I regularly defecate into my underwear. It will take five years before this condition is rectified.
I am very lucky the surgeon did not have to remove my bladder, and that I do not have a permanent urostomy.
I am very lucky my vagina was not cancerous.
All these organs were situated close by to the spread, and it was expected they too would be affected.
I understood these things were likely as they prepped me for my operation, and had no way of knowing until I awoke from surgery, whether or not I may be permanently disabled.
The pain I endured for 5 months was not mostly "between my ears" as you regularly informed me.
I have since learned it is well known medically that rectal cancer is the most painful cancer you can get. It is also extremely difficult to control the pain or to palliate. If it returns and localises in the rectal area, it is generally believed that there can be no quality of life due to pain and the pain can be agonising.
Having been through 5 months of such pain under your care, I know this to be true.
During my 18 day hospital stay, I endured excruciating pain. I was assigned a team of pain specialists, but they were unable to control it, even with massive doses of painkillers. This was due to a medical condition that occurs when a person has suffered chronic pain for any lengthy period.
By enduring 24-hour pain for 5 months, I ran a very high risk of permanent damage to my nerves, and this would have meant significant, incurable pain for the rest of my life.
I am extremely lucky that this did not occur.
You told me many stories about your husband and his over-reaction to pain. As I was also an Aries, you advised me that like him, I over-reacted to pain. You gave me a 5-dollar note with the word 'phantom' written on it. You told me that my pain was a 'phantom' product of my imagination. You described your own experience with sciatica and informed me that until I had experienced the sort of pain you'd had then, I would not know what real pain was.
The majority of my pain, you informed me, was in my own mind.
You saw me sobbing with pain during our contacts.
One night, after my bowel obstructed, I called because I could not stand the agony, and your professional advice was 'go take a bath.' I endured over 120 hours of agony, before I went against your advisement, used morphine and got myself to hospital in an ambulance.
During the months you treated me, the hot water bottles you encouraged me to use as my main method of pain control burned my skin and ruptured my blood vessels. But my pain was so severe, it felt like relief. My entire coccyx area is blue and purple.
You waited about 12 months, trying to treat me, before you suggested I have my internal bleeding diagnosed.
I have since learned that any sort of internal bleeding must be investigated immediately, as it can be a sign that something is seriously wrong. As an alternative health practitioner you should have known this and acted accordingly.
When I first began internal bleeding (ie bleeding from the anus) it is probable I would have been 90% curable by surgical resection alone.
I have suffered some of the worst depression I have ever experienced during the past 6 months.
Some more Facts
In March 2003, I had signed on with and paid a doctor, intending to follow his protocol for 6 weeks, and then have my progress assessed with another MRI. If things were not working, under his advisement, I was to consider surgery again. As you were aware, homeopathy was only one of many alternative methods I intended to use.
But, you told me,
"I shouldn't be saying this to you. I'm going out on a limb. But classical homeopathy will cure you."
You told me, however, that I must use the homeopathy alone, or you would be unable to prescribe your treatment accurately. You told me Dr Barnes's protocol would interfere with the homeopathy, as would the intravenous Vitamin C, I was having. As would painkillers. Even our suggestions of other treatments such as massage, chiropractic, reflexology, herbalists and other protocols to run concurrently etc. were rejected by you. You also prescribed the diet I was to follow.
I believed you and cancelled all my other treatments. Unlike you, the other practitioners never said they could cure me.
If you had said homeopathy might give me a cure and it might not, that it was impossible to tell, do you really think I would have risked your protocol? I would not have. I would have considered homeopathy as a support therapy only, as I had originally intended.
You told me I was not to check my progress with MRI's or scans while under your care because tests such as these were likely to undermine my 'positive thinking.'
You told me to wait until after Christmas 2004 before getting another MRI done.
Had I had my progress responsibly monitored whilst undergoing your treatment, I would have seen metastasis was occurring and known not to continue.
As it was, I trusted your professional assessment that all was going well, right until the very end when I disobeyed you for the first time in 7 months and admitted myself to hospital. In doing so, I saved my life.
You told me, "you have no idea what part you are playing, do you?"
After some time, you eventually told me a psychic of extremely high calibre had informed you that a patient would come to you with cancer who would completely commit to you to be cured using classical homeopathy alone. You would treat this patient and cure them of cancer. In this way, classical homeopathy would be recognised and its cause advanced in Australia. You told me that I was this patient. And that this was my special role. You also said Peter would be instrumental in discovering some kind of cancer cure. This is very manipulative.
If you are vague about any of these facts, I kept detailed and accurate diaries in which I've also recorded hundreds of our conversations. You told me I would be writing a book. Therefore, I faithfully wrote everything down.
Where is Your Science? Where is Your Clinical Evidence?
You advised me to perform various procedures that caused me intense physical pain. When I told you my pain was too great to continue some of these treatments, you insisted I must continue them for your protocol to work.
Getting me to inject olive oil into my anus once a day.
Getting me to insert plugs of velvet soap into my rectum so that "the stop would go", when my bowel was completely blocked by the tumour. When I questioned the validity of this procedure, you advised me it was necessary.
When I told the surgeon about these treatments he said they were just plain "cruel!"
You were against medical pain control.
As a result I endured ongoing agonising pain. You limited my pain control because you said medical pain relief interfered with your ability to prescribe your homeopathics.
When I was suffering acute spasms due to the tumour blocking my bowel, you heard me screaming with pain during several consultations and did not suggest pain control or medical intervention.
In fact you suggested the enema that would have split my bowel and killed me.
When the Silver Chain nursing staff advised an immediate injection of morphine to control my pain you told me in a phone consult not to have the injection. I spent 5 days in acute agony with a blocked bowel without any pain relief.
Listen to This
I have spent the past six months not only dealing with the fact I'll never have children and dealing with the symptoms of sudden onset menopause, not only reeling from what is now a poor prognosis, plus recovering from a massive operation, I also feel utterly emotionally shattered from our relationship. Devastated. There are no words to express this.
Suffice it to say I am suffering on all accounts and that this suffering has at times felt beyond my endurance. Never before have I felt these sorts of emotions.
To top it all Off
It is sad, isn't it, that the very reason I consulted you in the first place was to get help falling pregnant. And due to you, I've had to have a hysterectomy.
How Dare You
I am shocked to my very bones by the contents of your card. It is full of nothingness. I could not believe what I was reading. What On Earth Are You Thinking?
I felt ashamed for you.
Actions speak louder than words. You told me numerous stories illustrating your moral behaviour when the chips were down. Well, the chips are down. And I do not think much of your behaviour.
A little Question for you to Consider
Do you think you did anything wrong?
And Another One
Do you think you Let Me Down both as a friend and as a patient?
I have great concerns about your ability to treat other patients with cancer. Have you told any of your cancer patients that as a direct result of your treatment I was dying of cancer and malnutrition?
Am I angry with you? You bet I am.
Making it Clear
You are responsible for your advice as a practitioner.
As your patient I trusted and followed your professional advice and you were negligent in your duty of care.
Now you have the facts. Let's see if you can take care of them.
Nov 29 2004
This letter has been written with complete attention to the facts, with honesty, and out of the utter conviction that you need to hear what I have to say.
I must now address the fact that you have not apologised. Nor assumed any responsibility, despite the terrible consequences of your treatments.
You know me to have a forgiving nature when I am placed in a position to forgive. But acts of injustice and cowardice I abhor.
On October 12 2003, just prior to my operation, I phoned you from emergency.
You said 'If you have the operation, you know I will not be able to continue treating you.'
You patently tried to dissuade me from having the surgery.
My sister Toni was with me in emergency and I repeated this to her.
She was horrified that you would professionally advise me to reject the operation when I obviously had to have it.
I cannot believe it myself!
From a clinical perspective, what was your reasoning? Upon what physical symptoms did you base your assumption that the operation was unnecessary?
I would like this question answered, please.
During one of the first phone calls we had after my operation, you said to me. 'Penelope, I did not get you to sign a release form.'
I remember getting off the phone and thinking, 'she is afraid.'
Your behaviour towards my sister Toni when she spoke to you in the hospital car park confirmed my feelings.
I remember I was uncomfortable and upset after several phone calls you made to me in hospital. I didn't like the odd quality of your calls, and questioned you - 'What is the matter? Are you afraid of me? What is it you want from me?'
It was then you said that you felt it would be better if you did not call me and that you would wait until I called you.
And this is what you hid behind for six months until you sent me that shameful card.
Whilst family and friends rallied to help while I went through a helpless and difficult convalescence, where were you?
For six months, no word came. Not a bunch of flowers. Not a note. Not the tiniest glimpse of kindness or concern.
Friends were cooking meals and delivering them, helping Peter with housework, running errands, nursing me, reading to me and keeping me company as I lay unable to care for myself.
You, who had prescribed my treatment and were instrumental in all were nowhere to be seen.
Why, when you told me while I was lying in my hospital bed, that it was imperative I take particular remedies directly after my operation to protect me against metastasis, did you bring my pills to the hospital, visit with me, holding my hand whilst my sister held my other hand, and then keep the so-called vital pills in your handbag and leave without giving them to me?
When I got Peter to search for them - on my hospital cabinet - in my hospital cabinet - hadn't Francine given them to him? Was he sure? - they were nowhere to be seen.
When I phoned you, you told me you thought it was best that you didn't give them to me in front of my sister.
Did you fear my sister?
You told me I was to order the appropriate pills from the pharmacy. At this point it hurt me even to hold the phone and I was unable to do anything unattended. But you set Peter and I this little task. When I asked if the pills were commonly available you said they may need to be ordered in.
That meant I would have to wait at least 4 - 7 days or get Peter to drive all the way out to you to pick them up.
Why, when you told me I must take the remedies as soon as possible, was your fear about my sister seeing you pass me the remedy, more important to you than my health?
You had been prescribing to me for 2 years, more or less, so I ask you, look at your behaviour and ask yourself from where was it born - love of me?
Concern for your patient as a health practitioner?
Or simply cowardice and self-preservation?
When my sister confronted you in the hospital car park I was shocked at your answers to her. You refused to meet my family and discuss with them fairly what had happened to me.
It is a moral act to stand by what you believe is right. To stand up for what you have followed and informed others is correct and pure.
You had been willing to believe in your protocol and its ability to cure me to the very last. Even in the final hours before emergency surgery you bade me continue with your protocol or all would be lost.
It was I who refused your directive to wait 48 more hours for the 'stop to go', and so saved my own life.
You still believed up to that point in all you were doing.
So ask yourself, why did you run from the opportunity to stand by what you believed in?
Unless you were afraid…
When my sister requested you meet with my family, where was your courage then? Courage I believed you had…. During the course of two years of consultations you had told me many 'teaching' stories illustrating facets of your own character - stories from your childhood, stories from your professional life and stories from your family. These stories concerned your ability to resist kudos and temptation in order to observe a strict moral code and do what was fair and right. Stories full of your morality and courage.
As I see it, the Francine I met in your stories would have faced two choices.
1) To either stand strong against criticism and anger, believing that what she had done professionally was right and good;
2) to stand and admit fault and culpability.
You did neither.
You chose a third way.
You ran away into silence.
During your six months of silence and then in that single card, you have revealed more to me about your moral self than your stories ever did.
I have seen utter cowardice and immorality in your behaviour toward me, one whom you called friend and encouraged to trust you in all ways.
You will say - 'What of yourself? Do you take no responsibility?'
In the following ways, I do:
I considered you completely trustworthy as a health professional and as a friend and I trusted that you knew what you were doing
I believed you when you illustrated, via exciting stories, your capacity to get successful results in treating cancer
I believed you when you told me you could cure me
I believed you when you told me that I was getting well
I believed you when you told me I was a 'medical miracle'
I believed you when you told me that pain, no matter how awful, was part of my 'healing process'
On your advice, I did not take adequate pain relief
I allowed you to persuade me to perform painful and demeaning procedures in the hope that the healing benefits you promised me would be their outcome
I followed your advice that I should not have any form of medical monitoring until January/February 2004, after which time you said your treatments would have cured me
So that my positive frame of mind was not undermined I followed your advice that I should not consult with medical personnel unless they approved of your protocol and what you were doing
I followed your advice to use homeopathy
I believed you when you said you would not allow an emergency situation to arise and relied on you to let me know when and if an operation might be necessary
I followed your advice to put off telling family and friends about my condition in case their 'fears' undermined my positive frame of mind
I believed you when you said, 'now that you have chosen homeopathy, you know there is no turning back. It is you against the world'
I followed advice you gave that isolated me from family, friends and the medical establishment
I take responsibility for placing my trust in a health professional who was not trustworthy.
I am ready to speak. The question remains, are you ready to listen?
If you do not respond to this letter within two weeks of receiving it, I will be contacting you.
I remain sincerely,
I believed your friend, the 'psychic' and I believed your own 'psychic' premonitions about my health unquestioningly when you used it to dictate your line of treatment