By Ray Stern
By New Times
By Amy Silverman
By Stephen Lemons
By Stephen Lemons
By Monica Alonzo
By Chris Parker
By New Times
Though they'd had a great time, the Keoghs took ill after their adventure.
Mrs. Keogh recovered quickly, but her husband did not.
Antibiotics didn't help. Distressed by the nagging illness and unable to get a timely appointment with a neurologist, Keogh checked into the emergency room at the Mayo Clinic on October 10, 2001.
"Clinically, he appears well," Dr. Marcella Torres wrote of that visit. "I do not think he has evidence of a parasitic infection."
Dr. Torres noted the possibility of an undiagnosed infection, perhaps hepatitis or a number of other illnesses.
But another Mayo doctor pointed out that Keogh's test results had been "completely normal . . . I spent considerable time trying to reassure the patient that there does not appear to be any serious illness that is being overlooked."
That doctor wrote that if further testing also came up negative, "We may need to seek psychiatric consultation to help with the patient's rather profound anxiety."
Months passed without appreciable improvement.
During the session, according to Keogh's medical records, he stood up from the exam table and shuffled over to a chair. Ashen-faced, he became progressively more confused, flexing his arms, clenching his fists and remaining unresponsive for minutes.
Keogh urinated on himself during this episode, which Dr. Clark referred to as a grand mal seizure.
The doctor immediately had Keogh admitted into the hospital for observation and testing, including a test for cysticercosis. The latter was a good possibility because of the Keoghs' trip to rural Mexico.
Symptoms of the infection include seizures and general mental confusion which was just what Keogh had been complaining about.
Two MRI studies of Keogh's brain taken at the time turned up nothing unusual, and doctors say the worms surely would have showed up on the slides.
But, for some reason, doctors apparently didn't immediately analyze the results of the antibody test for the parasites. (Dr. Clark did not return a call from New Times, nor did he contact Mrs. Keogh for permission to speak about the case.)
Keogh was at the hospital for three days. He claimed not to remember his seizures and asked continually to go home, though the nurses in his wing wrote glowingly of him as a friendly gentleman.
An intern wrote on the day of Keogh's discharge that a possible diagnosis "includes cysticercosis (trip to Mexico and pork ingestion) versus brain tumor versus brain abscess versus encephalitis versus chronic meningitis."
In other words, no one knew what was ailing the patient.
One month later, in March 2002, Karlene Keogh called 911 when her husband had two seizures at their home similar to the one he had been stricken with at St. Joe's.
Kevin Keogh was readmitted to the hospital on March 11, 2002, in an "extremely agitated and confused" state. Doctors immediately ordered another test to see if Keogh had the worms in him.
This time, they had the results within hours.
According to Dr. Clark, an "equivocal, but very suspicious" finding for cysticercosis had arisen in the test.
What "equivocal" meant was that the results were just short of being able to say for sure that Keogh was carrying the worms.
Clark put Keogh on Albendazole, a drug used to kill the pork tapeworm, and Dilantin, a powerful medication used to control seizures.
The patient returned to St. Joe's a month later for a follow-up visit.
Afterward, Dr. Clark wrote that Keogh "still has symptoms, but minimized them. He states they are resolved. His wife, in the room, does take issue with a lot of his comments. . . . Major denial about his symptoms. Probable seizure disorder, temporal lobe. Possible [cysticercosis]."
All the while, Keogh continued to keep his medical troubles from everyone at City Hall, except for a few trusted colleagues.
Around that time, it was reported that two financial services had awarded Phoenix Sky Harbor Airport its highest credit rating a great victory for the city in the aftermath of the 9/11 attacks.
"I am elated and believe we deserve this rating," Keogh told a reporter.
Treiman concluded, "My impression is that this patient has epilepsy, manifested as two complex partial seizures, probably secondary to cysticercosis, even though his MRI scans have been normal."
According to a medical journal, such seizures "cause impaired consciousness and arise from a single brain region. . . . During a complex partial seizure, the patient may not communicate, respond to commands, or remember events that occurred. [But] some patients may continue to perform complex motor behaviors such as operating a car."
Writes Dr. Orrin Devinsky, an editor of the Web site epilepsy.com, "Even though the person's eyes are open and they may make movements that seem to have a purpose, in reality nobody's home. Some people do things during these seizures that can be dangerous or embarrassing, such as walking into traffic or taking their clothes off."
Karlene Keogh says symptoms of her husband's mystery illness would subside for stretches after he completed the drug regimen for cysticercosis and continued on the Dilantin.