The Writer Who Succumbed After Setting Sail?

Albert B. Lowenfels, MD

Disclosures

November 25, 2013

The Case

The patient was a 65-year-old man -- a novelist from the Midwest -- who became ill on board the SS Santa Lucia, a cruise ship en route from New York to Panama, where he was to begin an unofficial goodwill tour of South America. Before he set sail, the patient attended a series of farewell parties, imbibing several cocktails before the ship departed.

He had been in excellent health until the day after the ship left New York, when he developed anorexia accompanied by lower abdominal cramps. Abdominal pain and tenderness were absent. His symptoms persisted, and the following day he seemed to improve after administration of magnesium sulfate. However, despite a return of his appetite, the patient continued to have cramping abdominal pain for which he was given morphine. Five days after the onset of abdominal cramps, when the ship docked in Panama, he was transferred to Colón Hospital, originally built to care for workmen constructing the Panama Canal.

In the hospital, the patient's health deteriorated. He soon developed tachycardia and fever, which rapidly progressed to delirium and eventually coma. He died in Colón Hospital about 8 days after the initial onset of illness. After his death, his body was transported by train to Gorgas Hospital, where an autopsy was performed.

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