DES MOINES, Iowa -- If Dick Meredith's niece had known the whole truth about how he died at a state mental institution in September, she would have deleted this sentence from his obituary: "We are forever thankful to the loving members of the Clarinda Treatment Community who cared for Richard, loved him, and in a very real sense became extended members of our family."
Dana Vasey boils with anger when she thinks about those words, which she wrote in mid-September.
At the time, she said, she didn't realize that her uncle's death was a horrific case of choking, that inspectors blamed it on staff carelessness, or that state administrators tried to keep the family in the dark.
Vasey and her mother, Cleojean Olson, now see Meredith's final moments as an echo of the crippling thing that an earlier generation of state officials did to him. In 1955, administrators at the Clarinda Mental Health Institute had a doctor perform a radical brain surgery on him, records show. The procedure, called a lobotomy, severed connections in his brain, turning the quirky, shy young man from Des Moines into a virtual toddler. He would never again be able to carry on a coherent conversation.
Olson, who was Meredith's older sister, said officials never consulted their parents before ordering the lobotomy.
"I keep wondering, why was it Dick?" she said. "Why, of all people, did this happen to him? He never hurt anybody."
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These days, the anxious and repetitive behaviors Meredith developed as a teenager probably would be treated with pills and outpatient counseling. Such problems would not lead to institutionalization, much less brain surgery. But after the lobotomy, any hope that Meredith could live on his own evaporated forever.
For decades, Meredith was shuffled from hospitals to nursing homes to residential facilities. Some of them were awful places, Olson said. Some were OK. In his last decade, he finally seemed to find comfort and peace at the mental institute in Clarinda. The facility once was a sprawling mental hospital with hundreds of patients. Now, it cares for a few dozen people, many of them elderly.
The fact that Meredith survived to 82 was remarkable, given the severity of his disability. So when he died on Sept. 1, the family had no reason to doubt administrators' explanation that he had suffered a heart attack. The officials told the family that Meredith had a "choking episode" earlier in the day, but that the staff had cleared his airway, Olson said.
"They made it sound like he'd have been up and running if it hadn't been for this heart issue," she said.
The family learned the truth on Nov. 23, when they picked up The Des Moines Register. The newspaper reported that inspectors had fined the facility $8,250 for giving a peanut-butter sandwich to a resident whose doctor had ordered a diet of pureed food because the man had trouble swallowing.
The resident, "was found by the staff, slumped over at a dining table, gray in color and unresponsive," the story said. His windpipe was clogged with peanut butter. He could not be revived.
The facility's dietitian told inspectors that the staff "just forgot" to label which meals were supposed to go to specific residents, the inspectors' report said. But another staff member said she'd been told it was all right to skip the labels.
The Register article cited a statement from the Department of Human Services that called the Sept. 1 death "an isolated incident." The department, which runs the institution, said it had brought in dietary experts to review the meal service, and it said unspecified "personnel action has been taken" in the wake of the death.
'It was like he was a throwaway'
The inspectors' report didn't name the resident. It didn't have to. The date of death matched Meredith's, and his relatives knew he was prone to wolfing down food if left unattended. They were almost certain the article was about him.
Vasey said she made numerous calls to the Department of Human Services, many of which went unreturned. At one point, she said, she got hold of an administrator at Clarinda and asked him whether the dead resident mentioned in the Register story was her uncle.
"He said, 'I haven't read the paper. I don't know what you're talking about,'" she recalled.
Finally, she said, a department spokeswoman confirmed that Meredith was the subject of the inspection report. "I asked her, 'When were you going to let the family know that he died because of a staff error? When were you going to tell us that?'"
Meredith was a big man, standing more than 6 feet tall and at times weighing more than 200 pounds, his sister said. He could be a challenge to handle when he became frustrated or frightened, his family said.
But he also could be sweet and affectionate when he was comfortable, which he often was at the modern version of the Clarinda facility. Several years ago, state officials sought to transfer him elsewhere as they continued to pare down the institution's population, Olson said, but she persuaded them to let him stay.
Vasey ruefully recalled how shortly after her uncle's death, she drove to Clarinda to pick up old records and express the family's appreciation to the institution's staff.
"I was like, 'Thank you so much for taking such good care of Richard, la-de-da-de-da,'" Vasey said. "And they were all sitting there, knowing what happened, and they didn't say anything. It was like he was a throwaway - just a mental patient who'd spent almost his whole life in an institution, so who cares?"
State won't discuss death with public
Department Director Charles Palmer has since indicated he is willing to meet with the family, though Olson said that offer was put on hold after she said she intended to bring her lawyer along.
Olson, who was her brother's legal guardian, recently wrote a letter to the department, giving state officials permission to discuss the case with the Register. They declined to do so.
"The department does not speak to individual cases" publicly, spokeswoman Amy Lorentzen McCoy wrote in an email to the Register. "We realize this may displease some individuals or families, but we believe it's important for all Iowans we serve to trust that DHS will protect their confidentiality and not play out their individual circumstances in the press."
Olson scoffed at that explanation. She wondered whose privacy officials are protecting - a dead man's, or their own?
Olson is consulting a lawyer to see if a lawsuit is feasible. She doesn't need money.
What she needs, she said, is for state officials to take responsibility and to be honest with the public they're supposed to serve.
"I don't understand why they're doing all this dancing around. It would be so much easier to do the right thing," she said.
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