WEBVTT - Episode 5: The Messenger 0:00:04.640 --> 0:00:06.880 My name is Hedley Thomas. 0:00:06.920 --> 0:00:09.520 Sick to Death is based on my book of the 0:00:09.600 --> 0:00:12.440 same name, and it's the true story of doctor Jan 0:00:12.520 --> 0:00:16.919 Patel's lies and manipulation and the herculean effort it took 0:00:16.960 --> 0:00:21.880 to finally stop him. We've used voice actors throughout this series, 0:00:22.160 --> 0:00:25.319 and on occasion the real people from the story have 0:00:25.440 --> 0:00:26.880 read their words for us. 0:00:28.000 --> 0:00:31.520 It is brought to you by Me and the Australian. 0:00:38.159 --> 0:00:43.200 Chapter nineteen The Messenger, eighteen March two thousand and four. 0:00:49.560 --> 0:00:52.800 Rob Messenger wanted to start with a few home truths. 0:00:53.360 --> 0:00:55.920 He looked up and smiled at his supporters in the 0:00:55.920 --> 0:01:00.320 public Gallery of State Parliament in George Street, Brisbane. It 0:01:00.400 --> 0:01:03.520 had been a hard slog to arrive in this place. 0:01:04.240 --> 0:01:05.679 He hoped it would be worth it. 0:01:06.920 --> 0:01:10.240 Nobody had ever accused Messenger of being born with a 0:01:10.280 --> 0:01:13.800 silver spoon in his mouth. At four thirty pm on 0:01:13.920 --> 0:01:18.200 eighteen March two thousand and four, as the National Party's 0:01:18.280 --> 0:01:22.200 new member for Burnett prepared to deliver his first speech, 0:01:22.600 --> 0:01:23.920 he felt unbeatable. 0:01:25.880 --> 0:01:28.679 I have to confess my journey to this historic chamber 0:01:28.800 --> 0:01:31.880 was not planned. As a child and teenager playing in 0:01:31.920 --> 0:01:34.720 the red did cane fields of South Clan. I never 0:01:34.760 --> 0:01:38.039 harbored dreams of becoming a politician, and I'll be the 0:01:38.080 --> 0:01:41.160 first to admit that I'm only standing here before you 0:01:41.280 --> 0:01:42.679 because of God's grace. 0:01:44.319 --> 0:01:47.640 With a nod to the gallery, Messenger explained how he 0:01:47.720 --> 0:01:51.800 drew inspiration from his father Dez when self doubt and 0:01:51.840 --> 0:01:56.680 fatigue set in. Des had been a cane cutter in Bunderberg. 0:01:57.680 --> 0:02:01.000 Like the Kannakas a century ago. He had the backbreaking 0:02:01.120 --> 0:02:04.200 job of cutting and loading tons of caine a day 0:02:04.320 --> 0:02:07.880 for a meager one dollar sixty a ton. Rob Messenger 0:02:07.960 --> 0:02:11.880 still marveled at how his father Deares managed to feed, clothe, 0:02:11.919 --> 0:02:14.480 and shelter him and his two brothers. 0:02:14.160 --> 0:02:15.240 Greg and Danny. 0:02:16.480 --> 0:02:19.520 When Messenger was a teenager, he danced and sang to 0:02:19.560 --> 0:02:23.800 the evocative lyrics of Australian band Ganga Jang's anthem sounds 0:02:23.840 --> 0:02:28.320 of them about growing up in Bunderberg. Out on the 0:02:28.360 --> 0:02:33.639 patio we'd sit and the humidity we'd breathe, We'd watch 0:02:33.680 --> 0:02:41.119 the lightning crackover cane fields, laugh and think this is Australia. 0:02:41.360 --> 0:02:45.320 He remembered his mother Irene, laughing and joking with the 0:02:45.360 --> 0:02:48.160 other women of the district while they picked tomatoes in 0:02:48.240 --> 0:02:53.040 thirty five degree tropical heat. Irene lived for Rob's regular 0:02:53.160 --> 0:02:56.560 visits to her bedside at Bunderberg Hospital in the weeks 0:02:56.600 --> 0:03:00.480 before she finally succumbed to a particularly aggressive bow cancer. 0:03:00.560 --> 0:03:05.240 In September two thousand and two. Messenger watched his well 0:03:05.280 --> 0:03:09.280 known mother die at the hospital after an eighteen month battle. 0:03:10.000 --> 0:03:13.680 He came to know the doctors and nurses. Some of 0:03:13.720 --> 0:03:18.760 them began confiding a few secrets and worries. The hospital 0:03:18.840 --> 0:03:21.520 was running on empty. It had been managed to a 0:03:21.560 --> 0:03:25.480 standstill and starved of funds as the district manager, Peter Leck, 0:03:25.720 --> 0:03:31.600 enforced rigid budgetary controls. Specialists and the best doctors were 0:03:31.720 --> 0:03:36.480 leaving disillusioned and distressed at the deteriorating levels of care. 0:03:37.560 --> 0:03:41.760 All the while, public announcements and press releases from Queensland 0:03:41.800 --> 0:03:46.720 Health's Brisbane headquarters spewed positive but wholly misleading guff about 0:03:46.720 --> 0:03:51.480 the hospital in which Messenger had been born. Messenger used 0:03:51.600 --> 0:03:54.760 his first speech to underline what he knew from his 0:03:54.920 --> 0:03:59.840 months on the campaign trail. The hospital was sick. It 0:04:00.320 --> 0:04:03.520 was a diseased limb of a very sick body, whose 0:04:03.520 --> 0:04:05.760 staff had been cowed into silence. 0:04:07.000 --> 0:04:10.320 These dedicated professionals must be allowed to tell the truth 0:04:10.520 --> 0:04:14.080 while avoiding any possibility of placing their careers with Queensland 0:04:14.120 --> 0:04:18.120 Health in jeopardy. These workers' stories must be heard and 0:04:18.279 --> 0:04:21.640 acted on if the people of the Bernet are ever 0:04:21.839 --> 0:04:25.279 to enjoy the level of health care that they richly deserve. 0:04:26.640 --> 0:04:29.719 The parless condition of the health system was a major 0:04:29.800 --> 0:04:33.320 feature of the state election campaign in early two thousand 0:04:33.360 --> 0:04:38.160 and four. The opposition coalition, of which Rob Messenger was 0:04:38.200 --> 0:04:41.880 a member, had paid for hard hitting advertisements depicting people 0:04:41.920 --> 0:04:46.280 who had waited years for straightforward surgery, while the Australian 0:04:46.320 --> 0:04:50.960 Medical Association ran a highly effective campaign to highlight secrecy 0:04:51.200 --> 0:04:55.600 and underfunding in the health system. Stung by the constant 0:04:55.680 --> 0:04:59.919 stories and revelations from clinicians about how patients were so 0:05:00.000 --> 0:05:04.159 offfering because the hospitals could not cope with demand, Premier 0:05:04.200 --> 0:05:08.600 Peter Beatty threw money at the problems. The waiting lists 0:05:08.640 --> 0:05:12.680 for surgery were a significant part of Beattie's electoral strategy. 0:05:14.200 --> 0:05:17.320 He pledged a one hundred and ten million dollar injection 0:05:17.480 --> 0:05:21.000 of extra funds to pay for thousands of extra operations. 0:05:22.200 --> 0:05:25.600 This new initiative will be the biggest effort to reduce 0:05:25.680 --> 0:05:30.440 elective waiting lists that Queensland has ever seen. People have 0:05:30.560 --> 0:05:33.039 made it clear to me over a period of time 0:05:33.400 --> 0:05:36.960 they want these lists tackled. We have done well, but 0:05:37.080 --> 0:05:40.440 clearly we can do better. We will be making health 0:05:40.600 --> 0:05:42.200 our number one priority. 0:05:43.560 --> 0:05:47.400 The Health Minister Wendy Edmund had retired from politics. By then, 0:05:48.240 --> 0:05:51.600 Beatty had kept a straight face while commending her as 0:05:51.680 --> 0:05:57.200 the country's best health minister. The new Health Minister, Gordon Nuttle, 0:05:57.360 --> 0:06:01.080 was telling his executive team to put every public hospital 0:06:01.120 --> 0:06:06.680 on notice the waiting lists were critical. In the internal 0:06:06.760 --> 0:06:11.479 confidential briefing paper he received after being sworn in, Nuttle 0:06:11.640 --> 0:06:15.440 was worn that Queensland Health had become extremely reliant on 0:06:15.560 --> 0:06:20.320 overseas trained doctors, who comprised thirty percent of the medical workforce. 0:06:21.680 --> 0:06:25.720 Employment of overseas trained doctors provides a short term solution 0:06:25.839 --> 0:06:29.440 to doctor shortages. However, this approach brings with it a 0:06:29.560 --> 0:06:32.040 range of skill and competence issues. 0:06:33.640 --> 0:06:38.120 Messenger hammered health issues as stubbornly and relentlessly as he 0:06:38.240 --> 0:06:42.800 had during his electoral campaign. He repeatedly called for an 0:06:42.920 --> 0:06:49.159 independent investigation into Bunderberg Hospital, its procedures and practices. The 0:06:49.279 --> 0:06:53.240 attempts by the Beatty government to silence him became farcical. 0:06:54.279 --> 0:06:57.200 At one point, Messenger had said. 0:06:57.760 --> 0:07:00.960 Rather than pulling back from this issue, I intend to 0:07:01.000 --> 0:07:02.280 turn up the blow torch. 0:07:03.400 --> 0:07:06.680 The metaphor was too much for Nuttle, who called for 0:07:06.760 --> 0:07:10.680 a formal investigation into whether Rob Messenger planned to commit 0:07:10.920 --> 0:07:18.640 arson or burn alive any bureaucrats. Messenger was industrious and 0:07:18.800 --> 0:07:22.720 highly effective. He uncovered figures showing the hospital had just 0:07:22.920 --> 0:07:27.160 one hundred and thirty six beds, eighty one fewer than 0:07:27.240 --> 0:07:32.560 in nineteen eighty nine, despite the region's steady growth. The 0:07:32.640 --> 0:07:36.560 door of his electorate office at Bagara, near Jayant Patel's 0:07:36.680 --> 0:07:40.680 home apartment, was always open to hospital staff with stories 0:07:40.680 --> 0:07:44.680 of crises. Doctors came to tell him how they had 0:07:44.720 --> 0:07:48.920 been forced to work twenty four hour shifts, compromising patient 0:07:49.000 --> 0:07:55.040 care through sheer exhaustion. The regular outpourings were embarrassing for Nuttle, 0:07:55.120 --> 0:07:58.720 and they were infuriating the new Director General of Health, 0:07:58.840 --> 0:08:02.840 doctor Steve Bucklin, who had angrily banged the desk and 0:08:03.000 --> 0:08:08.240 abused Messenger in one memorable meeting. During a short stint 0:08:08.280 --> 0:08:12.080 as acting Director of Nursing, Tony Hoffman was surprised to 0:08:12.120 --> 0:08:15.880 see Peter Leck, who read the speeches on the parliamentary 0:08:15.920 --> 0:08:20.320 website as soon as they had been posted, furiously denouncing 0:08:20.440 --> 0:08:25.840 something Messenger had said. Peter Leck and Darren Keating stood 0:08:25.880 --> 0:08:31.240 at the computer screen and ridiculed the politician. An unprecedented 0:08:31.360 --> 0:08:35.000 meeting of the executive staff was called by Lek to 0:08:35.080 --> 0:08:38.360 discuss what effect having a National Party member would have 0:08:38.520 --> 0:08:43.360 on the hospital. Lek expected Rob Messenger to create trouble. 0:08:44.040 --> 0:08:47.760 Lek wondered if the parliamentarian was upset about the hospital's 0:08:47.800 --> 0:08:52.720 treatment of his mother. Hoffman realized that Messenger had become 0:08:52.880 --> 0:08:56.960 a major thorn in their side. She liked his courage 0:08:57.000 --> 0:09:00.000 and stamina. He was like a dog with a bone 0:09:00.240 --> 0:09:05.040 in relentlessly exposing the hospital's ills. He spoke of patients 0:09:05.160 --> 0:09:10.360 dying unnecessarily due to a dangerous culture, borrowing from one 0:09:10.400 --> 0:09:14.559 of the maxims of Anglo Irish statesman, politician and philosopher 0:09:14.760 --> 0:09:18.080 Edmund Burke, a leading light in the House of Commons 0:09:18.120 --> 0:09:21.959 more than two hundred years ago. Messengers spoke of evil 0:09:22.040 --> 0:09:27.520 prospering while good men remained silent. Hoffman wondered if she 0:09:27.720 --> 0:09:30.280 might one day pluck up the courage to go to 0:09:30.360 --> 0:09:33.719 Messenger about Jayant Patel good. 0:09:33.520 --> 0:09:36.520 Men had done nothing. It might be left to a 0:09:36.559 --> 0:09:37.120 good woman. 0:09:47.960 --> 0:09:55.760 Chapter twenty The Catalyst, July two thousand and four. Dares 0:09:55.880 --> 0:09:59.480 Bramich liked to stay busy. If a job was worth doing, 0:09:59.559 --> 0:10:03.079 he wrecked it was worth doing straight away. A little 0:10:03.120 --> 0:10:06.240 after four point thirty pm on Sunday, twenty five July, 0:10:06.960 --> 0:10:11.040 Des Bramage, age fifty six, was doing one of those 0:10:11.080 --> 0:10:15.280 good deeds. It had been a glorious day in Agnus Water, 0:10:15.800 --> 0:10:18.199 a sleepy seafront community about. 0:10:18.000 --> 0:10:20.200 An hour and a half's drive from Bunderberg. 0:10:21.520 --> 0:10:25.439 Grammage, who ran an earth moving business with his son Mark, 0:10:25.960 --> 0:10:30.000 was beneath a caravan. He was helping to remove one 0:10:30.040 --> 0:10:33.320 of its tires for his youngest son Luke, before the 0:10:33.360 --> 0:10:36.319 sun disappeared. On one of the shortest days of the year. 0:10:37.360 --> 0:10:38.800 Mark was walking back to. 0:10:38.880 --> 0:10:41.760 The land rover to get some tools when the caravan 0:10:41.920 --> 0:10:46.040 fell from its supports. The muffled thud as the weight 0:10:46.160 --> 0:10:51.360 came down onto his father's chest sounded ominous. Mark looked 0:10:51.400 --> 0:10:54.360 back and saw his father conscious but gasping. 0:10:55.480 --> 0:10:57.680 He was clearly having trouble breathing. 0:10:58.720 --> 0:11:02.679 Unknown at the time, two of his ribs were badly fractured. 0:11:03.400 --> 0:11:06.959 A plural membrane lining the inside of the chest wall 0:11:07.160 --> 0:11:10.000 was torn on the right side. The upper part of 0:11:10.080 --> 0:11:14.720 his sternum was also fractured, probably damaging arteries running down 0:11:14.880 --> 0:11:18.720 either side of his breastbone. Mark rushed to get a 0:11:18.800 --> 0:11:21.400 jack from the car to try to lift the caravan 0:11:21.559 --> 0:11:23.480 off his dad's crushed chest. 0:11:24.120 --> 0:11:25.959 In the panic and fading light. 0:11:25.960 --> 0:11:29.720 On an afternoon that had become suddenly bleak and foreboding, 0:11:30.920 --> 0:11:34.120 he fumbled to grip and lift the heavy steel contraption. 0:11:35.559 --> 0:11:37.840 Thankfully, help arrived quickly. 0:11:38.880 --> 0:11:43.600 A local medic, doctor, Salassa Vouti, one of the town's 0:11:43.679 --> 0:11:48.960 overseas trained doctors, inserted a tube to help Bramwich breathe. 0:11:49.120 --> 0:11:52.679 The ambulance rushed to the accident site to provide emergency 0:11:52.720 --> 0:11:57.480 backup and transport. A rescue helicopter arrived to airlift him 0:11:57.520 --> 0:12:03.200 to Bunderberg Hospital. Quickly to his father's wife, pack. 0:12:03.080 --> 0:12:04.480 Your bags and go to the hospital. 0:12:04.480 --> 0:12:05.960 Tests dad's had an accident. 0:12:07.120 --> 0:12:10.679 Test trembled with worry as her friend, Agnes Smythe gunned 0:12:10.679 --> 0:12:15.520 the white commodore, beating the helicopter by fifteen minutes. Tess 0:12:15.600 --> 0:12:19.280 was told her husband had suffered severe internal injuries, but 0:12:19.440 --> 0:12:23.080 that the prognosis was good. Once he had been stabilized 0:12:23.160 --> 0:12:27.600 in the trauma room, there were tests and scans of 0:12:27.720 --> 0:12:31.720 his chest. Des was thirsty, and, with a nurse's approval, 0:12:31.800 --> 0:12:34.240 test gave him an ice cube to wet his mouth. 0:12:35.720 --> 0:12:38.480 One of the doctors told Tess there was no reason 0:12:38.640 --> 0:12:41.960 why a fit, middle aged man, a non smoker and 0:12:42.120 --> 0:12:46.080 non drinker would not make it. She was greatly comforted 0:12:46.120 --> 0:12:49.720 by the reassuring words. Even as they transferred her husband 0:12:49.760 --> 0:12:54.400 to the intensive care unit, she watched the nurses there 0:12:54.480 --> 0:12:57.600 hooking him up to machines to monitor and assist his. 0:12:57.600 --> 0:12:58.640 Heart and breathing. 0:13:00.080 --> 0:13:07.319 They gave him morphine intravenously and an oxygen mask. Tess, 0:13:07.559 --> 0:13:10.880 who was born in the Philippines, and Des had wed 0:13:10.920 --> 0:13:16.280 a decade earlier. Tess was DES's third wife. They often 0:13:16.360 --> 0:13:19.920 joked about how, at age thirty three, she was younger 0:13:19.960 --> 0:13:24.160 than Mark, even though she was step grandmother to Mark's kids. 0:13:25.160 --> 0:13:29.079 Des and Tess had not looked back. The Bramich father 0:13:29.240 --> 0:13:32.600 and son business was doing well. The couple had great 0:13:32.679 --> 0:13:37.040 friends in the town where everybody knew each other. Their 0:13:37.120 --> 0:13:41.880 young daughter, Maria acquiet beauty with Tess's brown skin and 0:13:42.040 --> 0:13:48.120 smoldering dark eyes was a family treasure. Now At one am, 0:13:48.440 --> 0:13:52.679 Tess kept a vigil in the hospital. When Dez suggested 0:13:52.720 --> 0:13:55.880 that she should leave to get some sleep, the staff agreed, 0:13:56.280 --> 0:14:00.840 although they were more concerned about his rest. When Tess 0:14:00.880 --> 0:14:03.960 returned at six a m. And saw him smiling in 0:14:04.000 --> 0:14:06.960 bed with most of the color returned to his face, 0:14:07.400 --> 0:14:08.480 her spirits rose. 0:14:09.800 --> 0:14:10.800 By nine a m. 0:14:11.240 --> 0:14:14.439 Some of his extended family were perched around his bed 0:14:14.559 --> 0:14:20.720 in the ICU, Des spoke to Mark's visibly distressed wife, Fatima. 0:14:21.120 --> 0:14:22.840 Don't cry, I'm all right. 0:14:23.720 --> 0:14:27.040 He was making jokes at his own expense and wise 0:14:27.080 --> 0:14:29.760 cracking about being far too young to die. 0:14:30.280 --> 0:14:32.480 I'm like a cat, I have nine lives. 0:14:33.400 --> 0:14:36.120 After X rays and a cup of tea, he spoke 0:14:36.160 --> 0:14:39.880 about the accident. His son beamed when Des said that 0:14:40.080 --> 0:14:42.960 had it not been for Mark, the crush from the 0:14:43.040 --> 0:14:46.920 caravan would have put him in a coffin. Tony Hoffman 0:14:47.120 --> 0:14:50.840 was touched by the natural affection and love enveloping her patient, 0:14:51.360 --> 0:14:55.720 who exerted a cheerfulness she put down to genuine family contentment. 0:14:56.880 --> 0:15:01.760 She chatted freely to DEAs and Tess, their daughter, ten 0:15:01.840 --> 0:15:05.360 year old Maria, gazing at her Dad with those liquid 0:15:05.400 --> 0:15:09.640 eyes was gorgeous. Hoffman gave her a soft white toy, 0:15:10.040 --> 0:15:12.240 the seal that she kept in the bottom of the 0:15:12.320 --> 0:15:15.600 filing cabinet for young children who came into the unit. 0:15:16.960 --> 0:15:20.400 At times like this, Tony Hoffman regretted some of the 0:15:20.480 --> 0:15:24.440 choices she had made. Hoffman wished things had turned out 0:15:24.440 --> 0:15:27.800 differently with some of the men she had loved. Her 0:15:27.880 --> 0:15:31.880 career had been fulfilling, but at home after the shift ended, 0:15:32.240 --> 0:15:37.160 she sometimes felt desperately lonely. By the time Tess returned 0:15:37.200 --> 0:15:41.600 from lunch, the bed in the ICUU was empty. She 0:15:41.680 --> 0:15:44.240 was immediately worried, but Des was fine. 0:15:44.600 --> 0:15:45.520 He was doing so. 0:15:45.600 --> 0:15:48.680 Well that he had been wheeled into the surgical ward 0:15:50.000 --> 0:15:53.360 that afternoon. After he had been helped into the chair 0:15:53.440 --> 0:15:57.080 beside his bed, test stayed and chatted with him until evening. 0:15:59.680 --> 0:16:03.240 When she returned early the next morning, twenty seven July, 0:16:03.920 --> 0:16:05.800 Des was in a bad way. 0:16:06.720 --> 0:16:09.480 Dahl, I really didn't have a good sleep last night 0:16:09.840 --> 0:16:11.360 because I was in pain all night. 0:16:12.600 --> 0:16:17.040 Tess was confused. She had been assured that the morphine 0:16:17.120 --> 0:16:21.880 trickling into his veins would deaden the pain. She examined 0:16:21.920 --> 0:16:25.440 the intravenous connection and saw that it had become loose 0:16:25.680 --> 0:16:26.720 and it was dripping. 0:16:27.640 --> 0:16:29.680 Could you just please fix that properly? 0:16:31.040 --> 0:16:34.440 They waited impatiently for a junior doctor to come by 0:16:34.760 --> 0:16:37.000 and Reattach the line. 0:16:37.240 --> 0:16:39.080 Des was encouraged. 0:16:38.560 --> 0:16:42.200 To walk around the hospital corridors with a physiotherapist and 0:16:42.320 --> 0:16:45.800 an assistant. He hobbled in pain as they supported him 0:16:45.840 --> 0:16:49.360 under his armpits, then returned to bed and spoke by 0:16:49.400 --> 0:16:54.000 telephone to his worried mother and sister. When the Bunderberg 0:16:54.120 --> 0:16:57.720 News Males reporter arrived, Des recounted the accident. 0:16:58.720 --> 0:16:59.560 Mike is my hero. 0:17:01.440 --> 0:17:04.880 Tess returned from lunch to discover that he had suddenly 0:17:04.960 --> 0:17:09.880 collapsed and been rushed back to the intensive care unit. Hoffmann, 0:17:10.400 --> 0:17:15.320 shocked at how rapidly he had deteriorated, calmly organized her staff. 0:17:16.280 --> 0:17:19.479 The nurses rushed to save his life. Des could not 0:17:19.600 --> 0:17:23.959 breathe and his blood pressure had plummeted. His heart was racing, 0:17:24.040 --> 0:17:27.840 and the pain in his chest had become unbearable. He 0:17:27.920 --> 0:17:32.520 was slipping in and out of consciousness. Doctor if Ta 0:17:32.520 --> 0:17:37.119 Carr Eunus, one of the anesthetists, was attempting to resuscitate 0:17:37.200 --> 0:17:41.000 him with the help of three nurses. Doctor Martin Carter, 0:17:41.359 --> 0:17:45.440 the anesthetist in charge of the ICU, was clear. 0:17:46.080 --> 0:17:48.640 If the patient is going to need blood products, he'll 0:17:48.680 --> 0:17:49.840 need to be flown out. 0:17:51.160 --> 0:17:55.640 Carter decided that as Bramwich might need thoracic surgery, long 0:17:55.720 --> 0:17:59.439 term ventilatory support and access to a blood bank, he 0:17:59.520 --> 0:18:04.120 should be rush to one of the larger hospitals in Brisbane. 0:18:04.320 --> 0:18:07.160 There were urgent efforts to find a bed in Brisbane. 0:18:07.480 --> 0:18:10.639 Prince Charles Hospital was full that a bed might be 0:18:10.680 --> 0:18:16.080 available at Princess Alexandra Hospital. The Royal Flying Doctor Servis 0:18:16.280 --> 0:18:21.200 was ready for the mercy mission. Hoffman relayed the message 0:18:21.240 --> 0:18:25.480 from the bed coordinators in Brisbane to doctor Carter, doctor 0:18:25.600 --> 0:18:30.120 Jim Gaffield and doctor James Boyd, a principal house officer 0:18:30.200 --> 0:18:37.600 working under doctor Jayant Patel's supervision. Hoffman was ecstatically. 0:18:36.800 --> 0:18:39.000 Relieved They've got a bed. 0:18:40.600 --> 0:18:43.359 She could see that des Bramwich needed to be in 0:18:43.400 --> 0:18:48.440 a hospital which practiced thoracic surgery. Under no circumstances did 0:18:48.480 --> 0:18:51.119 she want to see Bramwich fall into the hands of 0:18:51.240 --> 0:18:57.040 Jayant Patel, the director of surgery, had been absent from 0:18:57.040 --> 0:18:58.400 the hospital for all of. 0:18:58.400 --> 0:18:59.280 May and June. 0:18:59.680 --> 0:19:02.800 He had had taken study leave and holidays to return 0:19:02.840 --> 0:19:06.520 to Jamnagar in India to see his mother, and then 0:19:06.600 --> 0:19:09.639 to Portland in the United States to spend time with 0:19:09.760 --> 0:19:15.480 his family. The run of complications, the conflict in the wards, 0:19:15.560 --> 0:19:20.040 and the fears of the staff had disappeared. Doctor Patel's 0:19:20.119 --> 0:19:24.639 holiday was a blessing for all. Tony Hoffman recalled the 0:19:24.680 --> 0:19:29.240 plight of Una Conners, whom Patel operated on for cancer 0:19:29.320 --> 0:19:33.080 of the sigmoid colon in April. The woman had to 0:19:33.080 --> 0:19:37.199 be rushed back by ambulance after a complete evisceration of 0:19:37.240 --> 0:19:42.560 the wound and her intestines being almost fully exposed. Hoffman 0:19:42.640 --> 0:19:46.800 had grown unusually fond of Desbramach and his family in 0:19:46.840 --> 0:19:49.640 the few hours she had spent with them in the ICU. 0:19:50.520 --> 0:19:55.080 But his perilous condition was worsening. As doctor Eunice tried 0:19:55.119 --> 0:19:58.160 to put in a central line to convey drugs, the 0:19:58.160 --> 0:20:03.959 gravely ill man experienced ventricular standstill. His heart was refusing 0:20:04.000 --> 0:20:09.520 to pump blood. Doctor Gaffield asked Patel to look at 0:20:09.520 --> 0:20:13.280 the X rays of his chest. Patel seized the offer 0:20:13.440 --> 0:20:16.800 and in his booming voice, started undoing the plans to 0:20:16.920 --> 0:20:18.919 transfer Brammage from Bunderberg. 0:20:19.960 --> 0:20:22.000 The patient doesn't need to go to Brisbane. He isn't 0:20:22.000 --> 0:20:24.640 sick enough. If we can't care for such simple things 0:20:24.680 --> 0:20:27.280 as fractured ribs, there is no point in doing any 0:20:27.280 --> 0:20:28.840 sort of drama surgery at the hospital. 0:20:30.400 --> 0:20:33.720 Hoffman, stricken with fear, waited. 0:20:33.359 --> 0:20:38.040 For Gaffield to take charge. Brammage was doctor Gaffield's patient. 0:20:38.680 --> 0:20:41.359 Doctor Carter had already come to the view that the 0:20:41.400 --> 0:20:47.560 best course was urgent transfer. Doctor Eunice agreed arrangements had 0:20:47.600 --> 0:20:52.680 been made, but Patel's dominant personality was assuming control. 0:20:54.040 --> 0:20:57.080 He doesn't need to be transferred. I've been a cardiothoracic 0:20:57.119 --> 0:21:00.320 surgeon for twenty years. If he needs anything, can do 0:21:00.359 --> 0:21:00.880 it here. 0:21:01.720 --> 0:21:05.800 He repeated the confident boasts to members of Bramich's family, 0:21:05.880 --> 0:21:09.600 as Hoffmann quietly pleaded for the transfer to go ahead. 0:21:10.280 --> 0:21:14.760 Please Dr Gaffield fin this man through to Brisbane, even 0:21:14.840 --> 0:21:18.200 if you think he doesn't need a cardiothoracic surgeon. I'm 0:21:18.240 --> 0:21:21.600 really afraid that he's going to die. 0:21:21.760 --> 0:21:26.720 Dr Gaffield replied, No, that won't happen. He won't die. 0:21:28.160 --> 0:21:31.199 He said he wanted to do a CT scan to 0:21:31.240 --> 0:21:35.480 provide definitive information for the handover to the surgeons in Brisbane, 0:21:36.680 --> 0:21:40.600 Patel disappeared back into the operating theater to perform a 0:21:40.680 --> 0:21:43.639 colonoscopy on a patient, but in the course of that 0:21:43.800 --> 0:21:48.760 procedure he perforated the bow. He insisted his injured patient 0:21:48.800 --> 0:21:51.879 should have a CT scan of the bowl before the 0:21:51.960 --> 0:21:53.240 gravely ill Brammage. 0:21:54.000 --> 0:21:58.520 Patel yelled a perforated both takes precedence over a non 0:21:58.640 --> 0:22:00.640 urgency scan at all times. 0:22:01.400 --> 0:22:04.720 The latest botch up a rarity for most doctors, but 0:22:04.840 --> 0:22:08.679 a common occurrence for Petel, meant that another doctor was 0:22:08.800 --> 0:22:12.800 needed to help him repair the bow. Tony Hoffman asked 0:22:12.840 --> 0:22:15.720 doctor Martin Carter, who was due to leave, to give 0:22:15.760 --> 0:22:18.880 a lecture to accompany Bramwich for the CT scan. 0:22:19.600 --> 0:22:20.200 He agreed. 0:22:21.000 --> 0:22:24.119 By the time they returned to the intensive care unit, 0:22:24.440 --> 0:22:29.120 the scan showed three liters of blood pooling in Bramich's chest. 0:22:30.040 --> 0:22:33.240 As Hoffman left the intensive care unit at seven point 0:22:33.240 --> 0:22:36.719 thirty pm to go home, the Royal Flying Doctor aircraft 0:22:36.840 --> 0:22:40.840 was being ready for the trip to Bunderberg. Hoffman had 0:22:40.840 --> 0:22:44.000 stayed back for three hours to ensure des Bramwich would 0:22:44.000 --> 0:22:47.359 get away for the help he so desperately needed. She 0:22:47.520 --> 0:22:50.720 walked to the hospital car park. Confident that Bramwich would 0:22:50.800 --> 0:22:55.920 survive in Brisbane despite his problems, Hoffman felt sure he 0:22:55.960 --> 0:22:58.879 would wake up in the morning. Three hundred and seventy 0:22:58.960 --> 0:23:13.320 kilometers from tell chapter twenty one, the stabbing, late July 0:23:13.680 --> 0:23:14.639 two thousand and. 0:23:14.520 --> 0:23:20.600 Four, Oh did mister Brammage get off all right? 0:23:22.240 --> 0:23:25.320 Outside the hospital elevator At the start of her shift 0:23:25.359 --> 0:23:28.359 the morning after the frantic efforts to save his life 0:23:28.520 --> 0:23:31.880 and move him to Brisbane, Tony Hoffman had bumped into 0:23:31.920 --> 0:23:36.240 doctor Martin Carter. She popped the question. After a quick 0:23:36.280 --> 0:23:37.680 exchange of pleasantries. 0:23:38.720 --> 0:23:40.520 No, he died. 0:23:42.040 --> 0:23:45.720 When the Flying Doctor had finally arrived after ten pm 0:23:45.880 --> 0:23:49.760 with flight nurse Anita Carr and doctor Jackie Butler. Their 0:23:49.840 --> 0:23:52.600 patient was closer to death than he had ever been. 0:23:53.960 --> 0:23:57.280 Patel had remained in control and declared him to be 0:23:57.400 --> 0:24:01.600 too sick to be transferred. As Bramich died a little 0:24:01.600 --> 0:24:05.800 after midnight, despite frantic resuscitation efforts by doctor if T 0:24:05.920 --> 0:24:11.240 Carr Eunice, the nurses were in tears. The Flying Doctor 0:24:11.240 --> 0:24:16.920 staff wept. Tess, Maria and Mark huddled together, shocked, crying 0:24:17.280 --> 0:24:22.800 and wondering what had gone wrong. Hoffman was devastated, she 0:24:23.040 --> 0:24:25.800 thought of the beautiful little girl who no longer had 0:24:25.800 --> 0:24:30.480 a father. She guessed immediately that Patel's decision to halt 0:24:30.520 --> 0:24:34.359 the transfer was all about Patel and his determination to 0:24:34.480 --> 0:24:38.480 flaunt himself. It had little to do with the welfare 0:24:38.560 --> 0:24:48.119 of patients. Despite mounting evidence of needless deaths and injuries, 0:24:48.400 --> 0:24:52.159 the director of surgery remained delusional about his own abilities. 0:24:53.280 --> 0:24:57.639 The death of Bramich was the turning point. Hoffman decided 0:24:57.720 --> 0:25:00.879 from that moment to do everything in her power to 0:25:01.000 --> 0:25:05.480 highlight Petel's lethal menace. She told Martin Carter. 0:25:06.040 --> 0:25:08.760 We have to do something about this, so we cannot 0:25:08.840 --> 0:25:10.439 let this happen any longer. 0:25:11.520 --> 0:25:14.240 She went to her office and broke down in tears. 0:25:14.760 --> 0:25:18.480 The Bunderberg newsmail that day had a bright picture story 0:25:18.520 --> 0:25:22.959 about des Bramich's near death experience. He was sitting up 0:25:23.000 --> 0:25:27.160 in the photograph, looking larger than life. In the article, 0:25:27.280 --> 0:25:28.320 Bramwich says. 0:25:28.880 --> 0:25:30.879 I thought I was going to die because I couldn't 0:25:30.880 --> 0:25:33.960 get any air. It never hit me until the next morning, 0:25:34.119 --> 0:25:36.040 the reality of it that I was in the hands 0:25:36.040 --> 0:25:38.400 of the gods. 0:25:38.400 --> 0:25:42.920 Doctor Martin Strawn, a general physician in private practice who 0:25:43.040 --> 0:25:46.240 worked part time as a visiting medical officer at the 0:25:46.280 --> 0:25:50.240 hospital saw Hoffman sobbing and gently asked what was wrong. 0:25:51.600 --> 0:25:54.720 She told him about the Bramwich case and the circumstances 0:25:54.720 --> 0:25:58.439 of several other deaths, and she recounted the startling rates 0:25:58.480 --> 0:26:03.840 of wound breakdowns and complications. She told him how doctor 0:26:03.920 --> 0:26:07.720 Carter referred to Patel behind his back as doctor Death, 0:26:08.840 --> 0:26:12.480 how the nurses were distraught with worry for the patients, 0:26:12.880 --> 0:26:16.359 how in the renal unit he had flouted basic anti 0:26:16.400 --> 0:26:21.639 contamination standards, and how the director of medicine, doctor Peter Meak, 0:26:21.920 --> 0:26:26.959 refused to let Patel anywhere near his patients. Doctor Strawn 0:26:27.080 --> 0:26:29.359 promised to go away and talk to some of his 0:26:29.440 --> 0:26:31.919 colleagues about Patel and his competence. 0:26:33.119 --> 0:26:35.360 Two days later, he told her. 0:26:36.280 --> 0:26:39.640 There's widespread concern, but nobody is willing to stick their 0:26:39.680 --> 0:26:40.400 neck out yet. 0:26:41.960 --> 0:26:46.720 The untimely death of des Bramitch galvanized the nurses. Several 0:26:46.720 --> 0:26:50.560 of those nurses who had witnessed the last agonizing hours 0:26:50.600 --> 0:26:56.040 of his life, Karen Fox, Vivian Tapiolis, Daniel Aitken and 0:26:56.240 --> 0:27:00.639 Sandra Sharp, were appalled at the turn of events. The 0:27:00.920 --> 0:27:03.919 ICU staff mourned in the beginning and then they became 0:27:04.000 --> 0:27:07.320