Tombstones

You’re breakfast news, you’re
chewed by morning millions,
smiling, singled out, surrounded
by the blackened stumps of language,
words that sound like ashes in our ears.

We wash our hands and wring them,
shrug our shoulders, shake our heads
and take your teeth. We make a mess
inside the mouth that said we mustn’t,
tear you open, fill your head with holes.

We steal your smile and leave your
lonely tongue to feel its darkened way
around, to search for walls and edges,
smooth and sharp surroundings,
slippery certainty instead of bloody gaps.

And then we wonder why you lie there,
tongue-tied, wild-eyed, as if you’d died
and found the cave, your grave, robbed
silently, and sealed it up to anyone
who might be back for something else.

But this is just a headline, nothing more
than lines inside my head, imagined
space, a whited sepulchre, its mouth
shut tight in case your ghost gets out
and tells us things we do not want to hear.


When I read the story below, I wanted to tear at my clothes and myself, so immediately did I empathise with both Sophie and her parents. My fellow passengers on the train that morning just shrugged their shoulders, said, "There's probably a lot more to this than meets the eye" and turned the page. I couldn't turn away.

Nor can I absolutely condemn the clinicians and managers involved, because, as the passengers said, there's more to this story than I am reading. And as they are human beings, they will be living with more guilt than I could bear, and will be getting on with treating other children in the knowledge that they - wittingly or unwittingly - contributed to the death of a child. The simple answer for the rest of us is not to get into situations where we might have this effect. Don't take risks with your feelings and you won't come a cropper.

So I write "we" because I find myself floating between all of the players involved in this, trying to understand - not through research or reasoning but through imagination and feeling - what went on and what continues to go on, now that this story recedes into the archives of newspapers. Google her: a ghost lives on in countless on-line sources.

I have a terror of dentists, though far milder than this. When I had a crown fitted, I had to have a sedative that knocked me out so that I wouldn't have to feel anything.

And one of the things that makes it worst is when I lose my trust in a dentist. For some biased, prejudiced and superstitious reason, I seek out women to be my dentist, in the belief that it isn't in their nature to be callous, clumsy and careless. I am in between dentists: one - a man - spoke to me so bluntly that I couldn't face going back to him. His replacement - a woman - was much kinder and suggested the sedative. But she's left now, and it's been 18 months since I've dared to go near a dentist.

Now the mum of one of Ellie's friends from school, Janita, is treating the rest of our family. I'm told that she is incredibly diligent - and causes some necessary pain. So I will brace myself for the pain and book an appointment.

An NHS hospital has apologised for failing to provide an adequate standard of care for a schoolgirl who starved to death after all her milk teeth were extracted.

Sophie Waller, an eight-year-old with an extreme phobia of dental treatment, died in December 2005 after refusing to eat or drink following an operation to remove all her milk teeth at the Royal Cornwall hospital in Truro in November. An inquest into her death of found she had an undiagnosed psychological syndrome.

The inquest heard on its final day today that her hospital aftercare was not organised or managed properly.

Dr Emma Carlyon, the coroner for Cornwall, said the severity of her condition was not realised and this "prevented her from receiving the medical support that could have prevented her death". Dr Ellen Wilkinson, the medical director of Royal Cornwall Hospital NHS trust, apologised to Sophie's family. She said: "There were shortcomings in the communication between the health organisation and Sophie's parents."

The eight-year-old was referred to the hospital by the family's GP after cracking a tooth on a boiled sweet and starving herself for three days because she was terrified of a visit to the dentist.. During the operation doctors at the hospital decided to remove all her milk teeth to avoid later problems. Her mother said the decision had left her daughter "devastated" and she again refused to eat and drink.

The inquest at Truro city hall heard that Sophie had been sent home to be cared for by a community psychologist and her GP, but that the eight-year-old was not seen face-to-face by any medical staff after her discharge. Her medical notes were also sent to the wrong GP and no GP was directly contacted by the hospital regarding her case. There was confusion over how ill the girl was because her GP did not receive full details of her condition from the hospital.

The inquest heard that Sophie was so emaciated in the days before her death that her hair was falling out and her spine was clearly visible through her skin.

Dr Charles Holme, a consultant paediatrician, said Sophie's situation was so unusual that a GP should have been contacted directly and briefed on the case when she was discharged. A care plan should have been set up to weigh and check her regularly, he said. "It would have been easy to have just picked up the phone and spoken to a GP. That was not done," said Holme. “The GP should have been spoken to on discharge. It seemed to me to be an unsatisfactory way of doing things." Holme told the inquest that a full psychological assessment of Waller should have been carried out before the operation to remove all her milk teeth, which he described as "a very major procedure for a small child".

Dr Arnon Bentovim, a consultant child psychiatrist, told the inquest that doctors had failed to organise a proper care plan for the child. "There was a failure to ensure that her ongoing medical care was fully managed and planned," he said. "The concern about her that was shown on the ward was not reflected in the day-to-day care plan in the community. There needed to be a joint physical and psychological follow-up. It was optimistic to believe that the initial positive response was necessarily going to mean that this child would make a reasonable recovery." Bentovim said an opportunity to save Sophie was missed when her mother, Janet, contacted the hospital four days before her death and asked for her to be readmitted but was referred back to the community psychologist. "At the point when the parents phoned the ward, and were clearly anxious enough to do so, had that anxiety been picked up then there would have been an opportunity for the death to be prevented," he said.

Following the operation, Sophie had been kept on a drip before being formally discharged from the hospital. She died at home 11 days later from acute kidney failure caused by starvation and dehydration.