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Speaker 1: My name is Hedley Thomas. In two thousand and five,

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Speaker 1: my reporting exposed shocking medical negligence at the heart of

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Speaker 1: a major healthcare system. An overseas trained surgeon who was

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Speaker 1: nicknamed Doctor Death by the nurses, doctors and hospital administrators

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Speaker 1: left patients mutilated, incapacitated, even dead. Sick to Death is

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Speaker 1: based on my book of the same name, and it's

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Speaker 1: the true story of doctor Jan Patel's lies and manipulation

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Speaker 1: and the herculean effort it took.

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Speaker 2: To finally stop him.

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Speaker 1: We've used voice actors throughout this series and on occasion

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Speaker 1: the real people from this story have read their words

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Speaker 1: for us.

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Speaker 2: It is brought to you by me and the Australian.

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Speaker 1: Chapter one, Happy Days, January two thousand and two. Jared

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Speaker 1: Neville put the last bag in the family car as

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Speaker 1: his wife Lorraine urged the three children to hurry downstairs.

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Speaker 1: A fit, middle aged public health physician for Queensland Health,

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Speaker 1: Jared ran beside the Brisbane River most mornings, even in

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Speaker 1: the subtropical humidity of summer, before going to work to

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Speaker 1: plan policy for the well being of a few million men,

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Speaker 1: women and children. They were known, in accordance with the

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Speaker 1: corporate vernacular as clients. The years had been kind to Jared.

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Speaker 1: He remained free of the stress of providing clinical care

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Speaker 1: in an organization starved of funds, while his friends, many

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Speaker 1: of them fellow graduates of the University of Queensland's medical

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Speaker 1: school in the leafy grounds of Hurston, had opted for

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Speaker 1: careers in operating the US with late night callouts, long hours,

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Speaker 1: and eventually private rooms. As highly paid specialists, Jered enjoyed

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Speaker 1: a steady public service routine. He was adept at his

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Speaker 1: office job, never shirking unpopular assignments, such as telling his

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Speaker 1: political masters the unpalatable reality about the effect of their policies.

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Speaker 2: He would never reach the top of.

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Speaker 1: A highly politicized bureaucracy, nor did he aspire to. They

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Speaker 1: made a handsome couple, Jared and Lorraine, a tall and

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Speaker 1: softly spoken teacher. She met Jared when he was a

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Speaker 1: rural GP five years after his graduation. Their motto might

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Speaker 1: have been permanence and stability. They were stylish but not flashy,

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Speaker 1: professional but not elitist. They were Catholic, with middle class values,

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Speaker 1: healthy children, secure careers, and a comfortable, newly renovated house

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Speaker 1: on a hill in the Brisbane middle class suburb of

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Speaker 1: Tuwong Laura aged fourteen, Eleise ten and Michael eight needed

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Speaker 1: little encouragement to leave their Brisbane home at the height

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Speaker 1: of the summer heat wave. Across the city, thousands of

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Speaker 1: people without air conditioning were seeking refuge in shopping centers

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Speaker 1: and cinemas. Temperatures were about to soar into the high

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Speaker 1: thirties with only limited relief from the scattered showers and

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Speaker 1: afternoon storms. The Nevils were going somewhere infinitely more appealing.

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Speaker 1: In two hours, they would arrive at King's Beach in

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Speaker 1: Caloundra for the start of an annual holiday ritual exploring

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Speaker 1: rock pools, swimming in the surf, lazing around the pool

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Speaker 1: and choosing from the dinner specials at nearby restaurants. As

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Speaker 1: Jered knows, the car one of the perks of his

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Speaker 1: package with Queensland Health, down the neatly paved driveway and

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Speaker 1: turned left onto Milton Road for the drive north. The

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Speaker 1: rain felt uneasy. Usually the Neville family would stay at

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Speaker 1: Pandanas Court in Caloundra for the Christmas holidays. Their familiarity

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Speaker 1: over the years with the old block of units closest

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Speaker 1: to the beach was part of the fun. Returning to

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Speaker 1: Pandanas was a bit like visiting a favorite Auntie. Notwithstanding

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Speaker 1: her flaws, she was safe and would not produce any surprises.

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Speaker 1: When Lorraine had called months earlier to make the usual

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Speaker 1: holiday booking, the woman at Henzel's real estate agency explained

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Speaker 1: that Pandanas would not be available this time. The old

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Speaker 1: block was being redeveloped and Auntie was to receive an

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Speaker 1: overdue facelift. Instead, Lorraine was offered a unit in Monterey Lodge,

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Speaker 1: a block not known to her. The plan was to

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Speaker 1: spend a week there, dash back to Brisbane the following Saturday,

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Speaker 1: unload the car, water the garden, check the mail, feed,

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Speaker 1: the children, return calls, load the car again, and drive

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Speaker 1: across the city to catch the afternoon ferry from Cleveland

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Speaker 1: to Stradbroke Island for a further seven days holidaying. Lorrain's

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Speaker 1: first impression of unit three at Monterey Lodge confirmed her unease.

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Speaker 1: The living space was long, dark and narrow. The floor

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Speaker 1: throughout seemed to be hard concrete with a thin wood

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Speaker 1: veneer surface. The place felt auste and uninviting. Before they

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Speaker 1: had begun to unpack. Before Lorrain could take in the

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Speaker 1: natural beauty of the water beyond the buildings. She had regrets.

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Speaker 1: As Lorraine tried to bury her misgivings and put on

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Speaker 1: a bright face, and Jered carried the bags inside. Elise

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Speaker 1: ran to the second bedroom and squealed with delight. As expected,

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Speaker 1: there was a set of bunks. They were unspectacular, lightly

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Speaker 1: framed and well used. They stood exactly one point four

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Speaker 1: to three meters high in one corner of the room.

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Speaker 1: The top bunk had been promised days earlier to Elise,

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Speaker 1: who excitedly told her friends and reminded Michael and Laura

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Speaker 1: that she would soon be towering over them morning and night.

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Speaker 1: A bright girl with sparkling blue eyes, a cherubic face,

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Speaker 1: and a gift for bringing calm and laughter into awkward situations.

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Speaker 1: Elise looked at the top bunk and beamed. She clambered

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Speaker 1: up and bounced on the mattress. A trundle bed had

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Speaker 1: been stored under the lower bed. The rain dragged it

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Speaker 1: out on the Saturday afternoon and put it against the wall,

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Speaker 1: forming an L shape with the bunks. The rain frowned

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Speaker 1: at the glass top table in the room. It was

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Speaker 1: an accident. Waiting to happen. She carried it into the

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Speaker 1: main bedroom, where she and Jared would be sleeping. Next,

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Speaker 1: she hauled a low set of wooden bedside draws from

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Speaker 1: the main bedroom to the children's room. As Lorraine had feared,

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Speaker 1: the unit was hot, its bricks absorbed heat throughout the day,

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Speaker 1: The windows missed the best of the sea breezes, and

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Speaker 1: there were no ceiling fans. Lorraine put one of the

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Speaker 1: electric fans she had brought from Brisbane on the bedside draws.

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Speaker 1: At least the children would be comfortable as they slept.

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Speaker 1: Lorraine took one more precaution before satisfying herself that she

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Speaker 1: had made the best of things. She spread quilts and

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Speaker 1: blankets along the floor below the bunk beds. Michael, who

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Speaker 1: would be in the bottom bunk, was a restless sleeper,

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Speaker 1: though neither he nor Elise had any history of falling

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Speaker 1: out of bed, but just in case, the quilts might

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Speaker 1: soften an unlikely accidental fall. The family woke to a

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Speaker 1: glorious Sunday morning and devoted it to the beach and

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Speaker 1: the pool. Lorraine's worries eased as the sun disappeared behind

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Speaker 1: the glasshouse mountains. The family walked to Bullcock Beach for

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Speaker 1: fish and chips at a sidewalk table. After they returned

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Speaker 1: to the unit, Michael went to bed first. He was

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Speaker 1: sleeping soundly by nine pm when Lorraine.

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Speaker 2: Checked on him.

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Speaker 1: Elise, nestled beside her mother on the sofa, stayed contentedly,

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Speaker 1: reading her novel. From time to time, she looked up

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Speaker 1: at the TV. An hour after Michael had turned in,

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Speaker 1: Elise was ready for bed. She kissed her parents and

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Speaker 1: smiled as Lorraine tucked her in for a second night

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Speaker 1: in the top bunk. Lorraine, who had made a point

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Speaker 1: of picking the children's clutter off the floor to prevent

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Speaker 1: a stumble in the dark, did not notice something amiss

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Speaker 1: as she turned out the lights. The family had no

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Speaker 1: experience with bunk beds. The safety rails that prevent a

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Speaker 1: child from rolling out were not there, as they were

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Speaker 1: on holidays. Laura was allowed to stay up with her

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Speaker 1: parents until the late movie ended. Shortly before midnight, they

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Speaker 1: all went to bed, and within minutes everyone was sleeping.

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Speaker 1: At one fifty am, the rain woke up. Suddenly, Jered

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Speaker 1: sat upright. They had both heard it, a loud noise,

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Speaker 1: a heavy thud. In the seconds that followed moaning noises

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Speaker 1: drifted from the bedroom, and instantly the rain guessed what

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Speaker 1: had happened. Oh my god, Jared, I think Alisea has

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Speaker 1: fallen out of bed. They hurried to the bedroom, where

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Speaker 1: Elise was lying curled up on her right side. She

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Speaker 1: was on the quilt on the floor, with her head

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Speaker 1: towards the narrow shelf and doorless cupboard in the room.

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Speaker 1: The rain frantically moved the small drawers with the fan

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Speaker 1: on top so Shit and Jared could both fit in

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Speaker 1: the room more easily to tend their stricken child. Lorraine

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Speaker 1: needed immediate affirmation that Elise had not broken any limbs.

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Speaker 2: Elise, are you okay?

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Speaker 3: Can you move your arms and legs?

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Speaker 1: Elise could move her limbs, but Lorraine's relief was tempered

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Speaker 1: by a new fear. Elise was in great pain. In

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Speaker 1: the half light, she cried out.

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Speaker 4: My head hurts.

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Speaker 1: Jared tried to contain his own anxiety in the gloomy

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Speaker 1: bedroom as Elise lay on the floor with her Winnie

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Speaker 1: the Pooh Teddy bear rubbing her head and whimpering softly.

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Speaker 1: He took charge. He was the doctor. He might not

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Speaker 1: have practiced medicine for eighteen years but he knew something

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Speaker 1: about head injury. He spoke in as measured a tone

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Speaker 1: as he could manage.

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Speaker 2: Try and keep calm. I'll take her to our bed

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Speaker 2: and have a look at her.

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Speaker 1: Jared checked Elise's limbs, neck, chest and stomach for breaks

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Speaker 1: or pain. He carried her to the main bedroom and

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Speaker 1: brought the mattress from her top bunk. They lay her

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Speaker 1: down on it on the floor in their room. She

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Speaker 1: continued moaning in obvious pain. She was touching the left

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Speaker 1: side of her head.

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Speaker 4: My head hurts a lot here.

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Speaker 1: Lorraine, shaking with worry and fear, wanted to rush Elise

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Speaker 1: to hospital. She was becoming frantic. Gered resisted. He doubted

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Speaker 1: Elise had been unconscious after the fall. He persuaded Lorraine

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Speaker 1: that they could safely watch her in the unit for

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Speaker 1: the time being. Stop panicking, Everything will be okay, Alise

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Speaker 1: piped up.

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Speaker 4: Yes, mummy, don't panic for making me worry. I'm sorry,

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Speaker 4: everything would be all right. No, it won't, mum, There's

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Speaker 4: something really wrong.

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Speaker 1: Chapter two, The Shift January two thousand and two. Andrew

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Speaker 1: Donovan looked at the clock on the wall above one

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Speaker 1: of the Cloundra Hospital ward beds. It was almost three am.

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Speaker 1: He sighed with relief. He wouldn't wish the graveyard shift

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Speaker 1: on his worst enemy. He knew exactly how long he

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Speaker 1: had been going without arrest, having come on duty at

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Speaker 1: eight am the previous day. Who was at the nineteen

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Speaker 1: hour mark of a twenty four hour shift. Donovan, a

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Speaker 1: father of two young children, was exhausted. He would never

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Speaker 1: touch alcohol while it worked, but the effect of his

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Speaker 1: fatigue equated to a blood alcohol reading of zero point

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Speaker 1: zero five percent. Long distance truck drivers could be forced

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Speaker 1: off the road if found working dangerously long hours. Economic

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Speaker 1: necessity and demanding bosses forced the drivers to stay awake

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Speaker 1: with amphetamines as they hurtled down the country's highways. Airline

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Speaker 1: operators had much more to lose. The repercussions from carnage

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Speaker 1: caused by a mack truck colliding with a family car

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Speaker 1: when nothing compared with those that might follow a Boeing

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Speaker 1: seven four seven plowing into a mountain due to pilot fatigue.

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Speaker 1: Australian pilots were permitted a maximum number of hours in

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Speaker 1: the cockpit on long haul flights, after which strict regulations

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Speaker 1: stipulated a lengthy rest in the bunks nurses too, were

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Speaker 1: banned from working excessive hours, yet doctors like Donoman in

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Speaker 1: Queensland's public hospitals were given no choice. At this time

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Speaker 1: of year, when many of the senior doctors were holidaying

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Speaker 1: with their own families, those on the bottom rung were

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Speaker 1: in greater demand than usual. The chronic shortage of doctors

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Speaker 1: nationally was worse in Queensland, which had the lowest number

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Speaker 1: of registered doctors per head of population of any state

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Speaker 1: or territory. There were about two thousand, five hundred more

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Speaker 1: doctors in Victoria, a state with a similar population but

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Speaker 1: without the challenges unique to Queensland of decentralization, poor working conditions,

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Speaker 1: and remote and indigenous communities. Andrew Donovan had few complaints.

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Speaker 1: He would do the hours a rite of passage and

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Speaker 1: move up the ranks. He was not the most junior

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Speaker 1: doctor in Queensland, but he was the least experienced doctor

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Speaker 1: to be put in charge of the eighty bed Caloundra

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Speaker 1: Hospital overnight. For the duration of this shift, he was

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Speaker 1: the only doctor on duty. A quietly ambitious thirty seven

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Speaker 1: year old Donovan did not look like a newcomer to medicine,

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Speaker 1: but he only began studying medicine in his late twenties.

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Speaker 1: His confidence and age sometimes made his patients suspect wrongly

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Speaker 1: that he was experienced. Just two years after receiving his

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Speaker 1: Bachelor of Medicine and Bachelor of Surgery from the University

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Speaker 1: of Queensland, he was making clinical decisions without having to

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Speaker 1: defer to senior colleagues. Donovan had worked in hospitals known

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Speaker 1: as God's Waiting Rooms because they catered to a large

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Speaker 1: population of elderly retirees who had moved to the Sunshine

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Speaker 1: Coast for its warm climate, beaches and lawn bowls. As

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Speaker 1: a junior house officer, almost the lowest ranking doctor on

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Speaker 1: the scale, he had treated worn out knees, supporting the

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Speaker 1: overweight and the sedentary. He had treated gynecological issues common

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Speaker 1: to elderly women who had born children. During rotations in pediatrics,

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Speaker 1: orthopedics and esthetics, obstetric skynecology and emergency medicine. He had

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Speaker 1: seen dozens of bright eyed babies at the start of

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Speaker 1: life and the old and frail who was soon to depart.

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Speaker 1: Maybe they sensed in his bedside manner a contagious energy

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Speaker 1: and enthusiasm for medicine. After driving taxis to pay his

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Speaker 1: way through medical school. He had large bills and a

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Speaker 1: meager salary, but he was doing what he loved. His

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Speaker 1: colleagues had noted the positive feedback from his patients. Somewhere

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Speaker 1: within the Queensland Health bureaucracy, a secret document headed review

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Speaker 1: of emergency services Sunshine Coast Health Service District flagged potential

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Speaker 1: dangers at Caloundra Hospital. The review had been compiled by

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Speaker 1: a small team of experts who had been investigating the resources,

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Speaker 1: safety and performance of emergency departments along the coastal Strip.

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Speaker 1: It was conducted on a confidential basis. Its author, doctor

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Speaker 1: William Rodgers, found that the Caloundra Emergency department needed a

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Speaker 1: minimum of four principal house officers. A principal house officer

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Speaker 1: is a doctor in a third year of practical experience postgraduate. Further,

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Speaker 1: their responsibility should not be stretched to looking after inpatients

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Speaker 1: as well as those coming into the emergency department during

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Speaker 1: normal working hours. Doctor Donovan, who knew nothing of the

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Speaker 1: three month old report and its unheeded recommendations, was two

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Speaker 1: years away from being made a principal house officer. When

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Speaker 1: he began his faithful shift in early January, he had

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Speaker 1: responsibility for the entire hospital. The nurses in the emergency department,

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Speaker 1: Beverly Duncan and Diane Forbes, who had come on duty

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Speaker 1: at ten forty five pm, were taking a break after

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Speaker 1: a busy few hours. The patients were presenting with relatively

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Speaker 1: minor ailments, and certainly none with emergencies. Most simply sought

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Speaker 1: free treatment. Uniquely, with beds in short supply and resources

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Speaker 1: strictly limited, the hospital also had a bizarre practice. It

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Speaker 1: did not admit children. Chapter three We Need Help January

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Speaker 1: two thousand and two. Elise was talking a little as

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Speaker 1: Lorraine held an ice pack to her head. Around three am.

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Speaker 1: She became agitated, flailing her arms and crying out with

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Speaker 1: the pain. Laura and Michael, who had woken in the

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Speaker 1: frantic commotion after the fall, looked on helplessly. Elise vomited.

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Speaker 1: It was the last sign Jared needed. He knew then

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Speaker 1: that she had to go to hospital urgently and would

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Speaker 1: probably need a CTE or computerized tomography scan with detailed

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Speaker 1: two dimensional computer enhanced X ray images. A ct scan

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Speaker 1: could highlight any abnormalities such as bleeding in Elisa's brain

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Speaker 1: or a fracture in her skull. He was about to

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Speaker 1: tell the Rain of his decision. She beat him to

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Speaker 1: it as a least moaned and complained about the yucky

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Speaker 1: taste of vomit in her mouth.

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Speaker 4: Right, we're going to the hospital now.

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Speaker 1: Lorrain was emphatic as she cleaned Elisa's face and clothes

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Speaker 1: and quickly got changed. Jered's appearance of calm had dissolved.

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Speaker 1: Now he too was shaking. The fear was sensed by

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Speaker 1: Laura and Michael, who huddled together on the trundle bed.

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Speaker 1: They were frightened for release and worried about being in

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Speaker 1: the unfamiliar unit alone. Jane cradled Elise in the back

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Speaker 1: seat of the car as her head rested on a

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Speaker 1: pillow that had been snatched up on the way out,

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Speaker 1: Jared drove to the nearby Clownd Republic Hospital in West Terrace,

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Speaker 1: but later would not even remember the route he took.

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Speaker 1: He jabbed the illuminated night bell outside the emergency department

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Speaker 1: until Beverly Duncan answered through the intercom and then opened

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Speaker 1: the door. Jered quickly explained what had happened. A fall,

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Speaker 1: a head striking a hard floor, ongoing pain, headache, vomiting.

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Speaker 1: They were directed to a room in the emergency department,

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Speaker 1: where Elise lay very quiet on the bed during a

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Speaker 1: brief examination by Duncan, a United Kingdom trained nurse, who

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Speaker 1: scrawled details on a clipboard and peered at the frightened

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Speaker 1: child's pupils while shining a torch. Elisa's pulse rate measured

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Speaker 1: fifty four a low reading. An oxymeter on her finger

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Speaker 1: measured her oxygen saturation levels. As Duncan made small talk

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Speaker 1: with Jared, he explained that he was a nonpracticing doctor,

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Speaker 1: one of the sixty thousand staff of Queensland Health.

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Speaker 2: They were colleagues.

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Speaker 1: Duncan noted a child who was quietly spoken and unhappy.

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Speaker 4: Where does it hurt? I'm aching all over, but many

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Speaker 4: I've got a headache.

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Speaker 1: Duncan found the aching all over answer strange. There was

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Speaker 1: no obvious deformity to any limbs, no swelling, and no

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Speaker 1: specific pain suggestive of a fracture. Lorraine was asked to

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Speaker 1: leave the room to fill in forms at the front counter.

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Speaker 2: I can hardly write as I'm shaking so.

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Speaker 1: Much, Duncan, it seemed to Lorraine ignored her and walked away,

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Speaker 1: leaving the distraught mother wondering what she had done to

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Speaker 1: receive a cold reception. At three twenty five am with

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Speaker 1: an injured child, Lorraine returned to the assessment room to

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Speaker 1: remark to Jered the lack of empathy. She weighed their options.

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Speaker 1: They were in an open, functioning emergency department staffed by

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Speaker 1: health professionals. Complaining might be counterproductive. It could lead to

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Speaker 1: a lease being ignored. The alternative of leaving to find

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Speaker 1: other medical help seemed impossible, so they waited. Doctor Andrew

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Speaker 1: Donovan was at a bench writing up his notes for

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Speaker 1: another patient, a man in a wheelchair, When Duncan explained

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Speaker 1: the basics a ten year old girl on holidays a

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Speaker 1: fall from a top bunk, generalized aches and pains, vomiting,

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Speaker 1: no loss of consciousness. In the central area of the

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Speaker 1: emergency department, Nurse Duncan, doctor Donovan, and Nurse Diane Forbes

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00:22:52,200 --> 00:22:58,000
Speaker 1: discussed Elsa's vital signs. The chit chat seemed interminable to Lorraine,

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Speaker 1: who was near breaking point. Sensing no urgency among the staff,

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Speaker 1: she pleaded with Jared, who still felt guilty for keeping

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Speaker 1: Elise in the Monterey unit for the first hour. She

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Speaker 1: wanted Jared to beg for action. Jared directed a question

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Speaker 1: to the nurse Forbes, who was sitting back at the

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Speaker 1: nursing station.

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Speaker 2: How long will the doctor be Please? Is anyone going

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Speaker 2: to come and see my daughter? We are very worried.

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Speaker 2: My wife is very concerned. Can you come now, at

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Speaker 2: least for her sake?

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Speaker 1: Nurse Forbes had heard the questions a thousand times before.

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Speaker 1: Everyone wanted to be seen yesterday. It was as if

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Speaker 1: nobody else mattered or even existed. The patients, emotional and

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Speaker 1: sometimes abusive, had no idea how busy the staff were,

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Speaker 1: and knew nothing about the pressures of competing priorities like paperwork. No,

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Speaker 1: there was no point in arguing. Forbes nodded towards the

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Speaker 1: bench where doctor Donovan was writing notes.

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Speaker 4: He's just that will be with you. Shortly as the.

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Speaker 1: Doctor walked into the assessment room, time was running out.

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Speaker 2: For Elise.

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Speaker 1: A drop or two of blood had already seeped into

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Speaker 1: her left ear.

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Speaker 2: The fall from the bunk.

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Speaker 1: Had fractured Elisa's skull and damaged the middle meningeal artery

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Speaker 1: in her brain. Without surgery to drain the blood, which

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Speaker 1: might have been obvious during a thorough examination, the growing

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Speaker 1: clot would force the soft tissue in Elisa's brain against

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Speaker 1: the immovable bones in her skull. If left untreated, her

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Speaker 1: brain could herniate, causing catastrophic injury. Chapter four, The Nursing Life.

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Speaker 1: Tony Hoffmann went to the thesaurus just to be sure. Maverick.

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Speaker 1: She liked the word, but as with many nicknames, it

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Speaker 1: could be misconstrued. What else might it mean? Independent, nonconformist individual. Yes,

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Speaker 1: Hoffman had to agree that she was something of a maverick.

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Speaker 1: The nickname had been given to her in circumstances that

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Speaker 1: were moderately controversial. As the senior nurse in charge of

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Speaker 1: Bunderberg based hospitals combined intensive care and coronary care units.

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Speaker 1: Since her arrival in two thousand, Hoffman made a strong

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Speaker 1: case over unsafe hours being worked by her staff. Most

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Speaker 1: of the fifteen nurses in the intensive care unit were exhausted.

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Speaker 1: The fatigue, which stemmed from their early morning starts and

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Speaker 1: late finishes, was affecting clinical care. A tired nurse could

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Speaker 1: be dangerous, particularly in the ICU or intensive care unit,

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Speaker 1: where the critically ill patients had the most tenuous hold

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Speaker 1: on life. The nurses were not meant to leave the

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Speaker 1: bedsides of patients being helped to breathe by ventilating equipment.

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Speaker 1: It only took a short lapse in concentration or momentary

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Speaker 1: inattention for a fatal mistake to be made. Without farsaw rancor,

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Speaker 1: Hoffman had argued a case for more nurses and safer hours.

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Speaker 1: Glennis Goodman, the director of nursing at the hospital, took

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Speaker 1: Hoffman's submission to the next level. Eventually, the logic and

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Speaker 1: common sense of the argument were accepted, more nurses were employed,

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Speaker 1: the dangerous shifts were abolished. The patients in the ICU

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Speaker 1: did not know that a fundamental change to the nursing

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00:26:48,400 --> 00:26:52,399
Speaker 1: roster gave them better odds of survival, but the staff knew.

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00:26:53,720 --> 00:26:57,320
Speaker 1: Hoffman won immediate and long lasting respect from the other

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Speaker 1: nurses for her willingness to back them as as well

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Speaker 1: as the patients. Tony Hoffman was a rarity, a middle

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Speaker 1: manager prepared to raise her head above the parapet and

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Speaker 1: speak out against convention and systems that had been imposed

382
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Speaker 1: by her superiors and grudgingly accepted.

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Speaker 2: By the staff.

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Speaker 1: But in Queensland Health, an organization run down by political

385
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Speaker 1: interference and financial neglect, Hoffman's style of robust, outspokenness was

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00:27:27,720 --> 00:27:32,919
Speaker 1: rarely rewarded. The mavericks who agitated for something outside the

387
00:27:32,960 --> 00:27:40,600
Speaker 1: square were usually the first to be muzzled. Rebel, loner, misfit.

388
00:27:41,240 --> 00:27:44,679
Speaker 1: Although it pained Hoffman to admit it, she probably was

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Speaker 1: a loner, maybe even a misfit. She did not have

390
00:27:49,040 --> 00:27:53,200
Speaker 1: a boyfriend, yet all her best friends were married. They

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00:27:53,280 --> 00:27:57,160
Speaker 1: spent every spare moment with their children, talking about their children,

392
00:27:57,280 --> 00:28:02,000
Speaker 1: or planning events around their children. Her younger sister, Marie,

393
00:28:02,160 --> 00:28:05,680
Speaker 1: was run off her feet with her two kids. At

394
00:28:05,760 --> 00:28:10,359
Speaker 1: times when the demands of parenthood seemed limitless, Hoffman felt

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00:28:10,400 --> 00:28:16,040
Speaker 1: fortunate to have avoided those responsibilities. When the challenges in

396
00:28:16,119 --> 00:28:20,679
Speaker 1: the ICU were unrelenting and the deadlines for her university

397
00:28:20,720 --> 00:28:25,439
Speaker 1: assignments seemed impossible, she consoled herself that her life's journey

398
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Speaker 1: was as it should be. At least she had her freedom.

399
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Speaker 1: At least she had the time after work to devote

400
00:28:33,000 --> 00:28:38,320
Speaker 1: to study, even if there were occasional bouts of loneliness. Still,

401
00:28:38,960 --> 00:28:42,720
Speaker 1: pragmatism could not change the fact that Hoffman loved children

402
00:28:42,880 --> 00:28:47,240
Speaker 1: and regretted not having her own. Although several of her

403
00:28:47,240 --> 00:28:50,880
Speaker 1: long term boyfriends would have made her happy as partners

404
00:28:50,920 --> 00:28:56,160
Speaker 1: for life, Hoffman had always hesitated when things became serious.

405
00:28:57,000 --> 00:29:01,480
Speaker 1: Marriage frightened her it seemed like the end of the world.

406
00:29:02,880 --> 00:29:06,560
Speaker 1: As a girl growing up in Ingleburn, southwest of Sydney,

407
00:29:06,680 --> 00:29:09,720
Speaker 1: she had missed her father Warwick during his long road

408
00:29:09,760 --> 00:29:13,000
Speaker 1: trips pulling freight in the truck owned by the family

409
00:29:13,080 --> 00:29:18,600
Speaker 1: business W and M. Hoffman Transport. She was fifteen when

410
00:29:18,640 --> 00:29:22,960
Speaker 1: her father decided to try his hand at growing potatoes, pumpkins,

411
00:29:23,080 --> 00:29:27,960
Speaker 1: tomatoes and cabbages. Hoffman briefly resented him for taking the

412
00:29:28,040 --> 00:29:31,120
Speaker 1: family from the outskirts of Sydney to a little community

413
00:29:31,160 --> 00:29:35,000
Speaker 1: halfway between Brisbane and to Woomba, where almost everyone had

414
00:29:35,080 --> 00:29:39,680
Speaker 1: unusual European surnames and spoke with a strange accent. On

415
00:29:39,840 --> 00:29:42,880
Speaker 1: her first day at Lockyer Valley State high one of

416
00:29:42,920 --> 00:29:46,480
Speaker 1: the students assumed she was a child of itinerant fruit pickers.

417
00:29:47,800 --> 00:29:50,760
Speaker 1: Will you be staying just a little while, he asked

418
00:29:50,760 --> 00:29:55,920
Speaker 1: the newcomer, I hope so. Tony sniffed, and the class bood.

419
00:29:57,320 --> 00:30:01,560
Speaker 1: Her first instinct had always been to speak her moutherd rebel,

420
00:30:02,040 --> 00:30:08,240
Speaker 1: renegade dissident. Over time, the open spaces, summer days spent

421
00:30:08,320 --> 00:30:11,040
Speaker 1: swimming in the local water holes and camping with her

422
00:30:11,080 --> 00:30:14,360
Speaker 1: new boyfriend made her grateful for the move away from Sydney.

423
00:30:15,440 --> 00:30:18,240
Speaker 1: At the end of year twelve, she chose nursing. It

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00:30:18,360 --> 00:30:23,680
Speaker 1: offered accommodation, study and a salary. Having been accepted by

425
00:30:23,680 --> 00:30:27,120
Speaker 1: the three major public hospitals in Brisbane, she opted for

426
00:30:27,200 --> 00:30:33,160
Speaker 1: the Princess Alexandra Hospital. Hoffman hated nursing as a young woman.

427
00:30:33,640 --> 00:30:37,080
Speaker 1: She missed her animals, her younger brothers Andrew and Matthew,

428
00:30:37,120 --> 00:30:41,320
Speaker 1: and her baby's sister Marie. In the first six months,

429
00:30:41,360 --> 00:30:44,080
Speaker 1: she thought she had experienced the worst things a nurse

430
00:30:44,160 --> 00:30:47,960
Speaker 1: might be expected to do, everything from changing the dressings

431
00:30:47,960 --> 00:30:52,080
Speaker 1: on severed limbs to helping pack a deep abdominal wound

432
00:30:52,120 --> 00:30:57,000
Speaker 1: in which the intestines could be seen glistening. She received

433
00:30:57,080 --> 00:31:00,000
Speaker 1: another surprise when one of the nurse educators stood up

434
00:31:00,120 --> 00:31:03,440
Speaker 1: up and asked the class how do you wipe a

435
00:31:03,520 --> 00:31:08,160
Speaker 1: patient's bottom. At the time, Hoffman knew little about what

436
00:31:08,240 --> 00:31:12,400
Speaker 1: she was letting herself in for. After three years of

437
00:31:12,440 --> 00:31:15,880
Speaker 1: work and study, she traveled overseas for three months and

438
00:31:15,920 --> 00:31:19,920
Speaker 1: then returned to nurse in Tasmania. By nineteen eighty one,

439
00:31:20,000 --> 00:31:22,560
Speaker 1: she had gone back to the United Kingdom to do

440
00:31:22,720 --> 00:31:28,440
Speaker 1: Midwiffrey at Taunton in Somerset. While she was there, Hoffman

441
00:31:28,640 --> 00:31:33,520
Speaker 1: was woken by the telephone at five seventeen am one day.

442
00:31:33,640 --> 00:31:37,120
Speaker 1: She snuggled deeper under the copboards, hoping the telephone was

443
00:31:37,200 --> 00:31:39,680
Speaker 1: ringing for one of the other nurses who shared the

444
00:31:39,720 --> 00:31:44,320
Speaker 1: hospital's accommodation. A short while later, someone was turning the

445
00:31:44,360 --> 00:31:48,440
Speaker 1: handle on her door. You need to ring home, the

446
00:31:48,480 --> 00:31:53,960
Speaker 1: supervisor told her in a grave tone. Tony's mother, Mari,

447
00:31:54,440 --> 00:31:56,840
Speaker 1: answered the telephone at the family.

448
00:31:56,440 --> 00:31:59,160
Speaker 5: Farm andrew Stead.

449
00:32:00,080 --> 00:32:01,360
Speaker 6: He had a motorbuk accident.

450
00:32:02,640 --> 00:32:06,480
Speaker 1: Tony's younger brother had been visiting wineries near Stanthorpe with

451
00:32:06,560 --> 00:32:09,720
Speaker 1: friends when he struck a powerpole while rounding a corner.

452
00:32:10,440 --> 00:32:13,360
Speaker 1: He had suffered a major chest wound and died at

453
00:32:13,400 --> 00:32:17,880
Speaker 1: the scene. Partly as a result of the accident, Hoffman

454
00:32:18,000 --> 00:32:23,280
Speaker 1: realized that she wanted to specialize in intensive care. Although

455
00:32:23,320 --> 00:32:26,800
Speaker 1: the patients wheeled into the ICU were often near death,

456
00:32:27,160 --> 00:32:32,360
Speaker 1: they had at least been stabilized, unlike in the emergency department,

457
00:32:32,680 --> 00:32:36,280
Speaker 1: where the doctors and nurses struggled with drugs and electric

458
00:32:36,360 --> 00:32:40,280
Speaker 1: paddles to maintain life. The prognosis of patients in the

459
00:32:40,560 --> 00:32:45,400
Speaker 1: ICU could be more accurately predicted. There was relative calm

460
00:32:45,560 --> 00:32:50,000
Speaker 1: in the ICU, which was necessarily staffed by the best

461
00:32:50,080 --> 00:32:56,120
Speaker 1: doctors and visited regularly by specialists. Hoffman took great satisfaction

462
00:32:56,280 --> 00:32:59,920
Speaker 1: in standing beside patients as they stared death in the face,

463
00:33:00,960 --> 00:33:05,600
Speaker 1: then seeing them return to their families. She obtained her

464
00:33:05,640 --> 00:33:09,800
Speaker 1: first qualification in intensive care at King's College Hospital in

465
00:33:09,840 --> 00:33:13,280
Speaker 1: London and went on to work in the intensive care

466
00:33:13,360 --> 00:33:17,479
Speaker 1: wards at the Harley Street Clinic in London. Later she

467
00:33:17,600 --> 00:33:22,880
Speaker 1: was to work at Tasmania's Lonceston General Hospital. Wanderlust took

468
00:33:22,920 --> 00:33:25,719
Speaker 1: her to read in Saudi Arabia, where she was a

469
00:33:25,760 --> 00:33:29,840
Speaker 1: senior nurse for six years. The children in the pediatric

470
00:33:29,960 --> 00:33:34,120
Speaker 1: wards quickened the ticking of her biological clock. She was

471
00:33:34,240 --> 00:33:37,800
Speaker 1: thirty and in a secret relationship with a Saudi man.

472
00:33:38,800 --> 00:33:41,480
Speaker 1: If ever, she was going to surprise her family and

473
00:33:41,600 --> 00:33:42,800
Speaker 1: friends by marrying.

474
00:33:43,120 --> 00:33:43,960
Speaker 2: It was then.

475
00:33:45,320 --> 00:33:49,719
Speaker 1: When Hoffman returned alone again from Saudi Arabia after the

476
00:33:49,720 --> 00:33:54,400
Speaker 1: First Gulf War. She settled in Caloundra, a relaxed beachside

477
00:33:54,440 --> 00:33:58,320
Speaker 1: town on the Sunshine Coast. She threw herself into her

478
00:33:58,360 --> 00:34:02,920
Speaker 1: studies by correspondents, working towards gaining qualifications as a Bachelor

479
00:34:02,960 --> 00:34:07,320
Speaker 1: of Nursing from Monash University. By the middle of two thousand,

480
00:34:07,360 --> 00:34:09,960
Speaker 1: when she pipped one other singer nurse on the short

481
00:34:10,000 --> 00:34:12,440
Speaker 1: list to win the job as nurse manager of the

482
00:34:12,760 --> 00:34:17,640
Speaker 1: ICU at Bunderberg Base Hospital, Hoffman had found a substitute

483
00:34:17,640 --> 00:34:23,160
Speaker 1: for children and married life. Happily, Hoffman had moved north

484
00:34:23,200 --> 00:34:27,400
Speaker 1: to the sugartown of Bunderberg. It was home now. She

485
00:34:27,480 --> 00:34:31,080
Speaker 1: spent most nights and weekends in her rented cottage in

486
00:34:31,160 --> 00:34:35,839
Speaker 1: Grimsted Street, surrounded by textbooks, and determined to graduate from

487
00:34:35,880 --> 00:34:40,920
Speaker 1: Monash University with the Masters in Bioethics, She decided that

488
00:34:41,040 --> 00:34:45,120
Speaker 1: her thesis would examine how health professionals involved in treating

489
00:34:45,200 --> 00:34:50,400
Speaker 1: critically ill patients were subjective in determining quality of life.

490
00:34:50,560 --> 00:34:54,640
Speaker 1: In Hoffman's experience as a nurse, perceptions about quality of

491
00:34:54,680 --> 00:34:58,760
Speaker 1: life too often depended on the individual values of the carers,

492
00:34:59,080 --> 00:35:03,759
Speaker 1: the doctors and the nurses instead of the patient. She

493
00:35:03,920 --> 00:35:07,439
Speaker 1: believed that a young and fit doctor who ran marathons

494
00:35:07,480 --> 00:35:11,400
Speaker 1: would be less likely to appreciate how an elderly cripple

495
00:35:11,560 --> 00:35:15,239
Speaker 1: might have an acceptable quality of life merely watching grandchildren

496
00:35:15,360 --> 00:35:20,399
Speaker 1: run around the yard. Tony Hoffman decided that decisions about

497
00:35:20,520 --> 00:35:23,480
Speaker 1: quality of life were best left to the patients and

498
00:35:23,520 --> 00:35:28,120
Speaker 1: their next of kin. She enjoyed excellent working relationships with

499
00:35:28,200 --> 00:35:31,480
Speaker 1: the doctors, but she hated it when they justified poor

500
00:35:31,560 --> 00:35:35,240
Speaker 1: care leading to death as a path to a better outcome.

501
00:35:36,560 --> 00:35:40,440
Speaker 1: How would they know, she asked. As far as Hoffman

502
00:35:40,600 --> 00:35:44,040
Speaker 1: was concerned, every life was precious, no matter how poorly

503
00:35:44,080 --> 00:35:48,440
Speaker 1: compromised the patient's health. She believed that the best possible

504
00:35:48,520 --> 00:35:52,160
Speaker 1: care should be provided until the patient drew a final breath.

505
00:35:53,960 --> 00:35:57,640
Speaker 1: The hospital on Bourbon Street beside the Burnette River had

506
00:35:57,680 --> 00:36:01,760
Speaker 1: seen backward when she first arrived, and in many ways

507
00:36:01,880 --> 00:36:05,480
Speaker 1: it was. The medical staff was largely made up of

508
00:36:05,640 --> 00:36:09,759
Speaker 1: overseas trained doctors, some of whom could barely be understood

509
00:36:09,800 --> 00:36:14,120
Speaker 1: because of their broad accents or their inadequate command of English.

510
00:36:15,760 --> 00:36:20,440
Speaker 1: The district manager, Peter Leck, had no clinical qualifications, but

511
00:36:20,520 --> 00:36:23,280
Speaker 1: he knew the key to success for him was staying

512
00:36:23,320 --> 00:36:28,719
Speaker 1: within budget. The strict financial parameters were well understood by

513
00:36:28,760 --> 00:36:33,759
Speaker 1: administrators who were remote from the patients. The easiest way

514
00:36:33,840 --> 00:36:36,480
Speaker 1: to deal with a problem was to dismiss it with

515
00:36:36,520 --> 00:36:39,200
Speaker 1: the excuse that there was no money to fix it.

516
00:36:40,880 --> 00:36:45,120
Speaker 1: Lek's job was not necessarily a job for life. A

517
00:36:45,200 --> 00:36:48,400
Speaker 1: budgetary blowout or a failure to get on top of

518
00:36:48,440 --> 00:36:52,400
Speaker 1: these surgery waiting lists could mean the sack. On the

519
00:36:52,480 --> 00:36:56,000
Speaker 1: other hand, the doctors and nurses were united in the

520
00:36:56,040 --> 00:36:59,760
Speaker 1: belief that public hospitals were for the sick and injured.

521
00:37:01,239 --> 00:37:06,000
Speaker 1: The unforgiving economic rationalism of Premier Peter Beat's Labour government

522
00:37:06,520 --> 00:37:10,640
Speaker 1: Health Minister Wendy Edmond and her top bureaucrats in Queensland

523
00:37:10,680 --> 00:37:15,880
Speaker 1: Health Headquarters in Brisbane was distressing. Staff who for years

524
00:37:15,920 --> 00:37:18,919
Speaker 1: had been dedicated to the public system were giving up,

525
00:37:19,280 --> 00:37:23,600
Speaker 1: preferring to work in the better funded private sector. As

526
00:37:23,719 --> 00:37:28,399
Speaker 1: more and more demoralized clinicians quit, those left behind were

527
00:37:28,480 --> 00:37:35,560
Speaker 1: increasingly pressured by administrators. The hospitals were infused with business strategies,

528
00:37:36,560 --> 00:37:41,440
Speaker 1: where once the medical superintendent concentrated on patient outcomes, the

529
00:37:41,520 --> 00:37:48,000
Speaker 1: new priority was cutting costs and increasing potential revenues. Nowhere

530
00:37:48,040 --> 00:37:51,360
Speaker 1: was this more obvious than at Bunderberg Base Hospital. In

531
00:37:51,440 --> 00:37:54,160
Speaker 1: the months leading up to the arrival of doctor j

532
00:37:54,440 --> 00:37:59,800
Speaker 1: NT Patel. The administrators were measuring performance not by lives saved,

533
00:38:00,200 --> 00:38:04,359
Speaker 1: but by dollars saved. The hospital had become a lean,

534
00:38:04,800 --> 00:38:18,000
Speaker 1: mean business.

535
00:38:15,760 --> 00:38:18,080
Speaker 2: Chapter five grimm.

536
00:38:21,760 --> 00:38:25,680
Speaker 1: In January two thousand and two, before doctor Charles Nankeovell

537
00:38:25,840 --> 00:38:28,960
Speaker 1: walked away for the last time from the Bunderberg Hospital

538
00:38:29,000 --> 00:38:32,160
Speaker 1: on Boorbon Street, he hoped that the crisis in healthcare

539
00:38:32,200 --> 00:38:36,600
Speaker 1: he was witnessing and repeatedly warning his managers about might

540
00:38:36,640 --> 00:38:41,239
Speaker 1: still be corrected if the administrators who controlled budgets and

541
00:38:41,320 --> 00:38:45,760
Speaker 1: human resources truly valued their highly skilled and passionate director

542
00:38:45,800 --> 00:38:49,800
Speaker 1: of surgery. Now was the time to show it to him.

543
00:38:50,560 --> 00:38:53,760
Speaker 1: He hoped someone from head office would ring and say,

544
00:38:54,239 --> 00:38:57,880
Speaker 1: we hear your leaving. We're sad about that. Would you

545
00:38:58,040 --> 00:39:03,680
Speaker 1: like to talk to us? Nobody called. Nankeavell had been

546
00:39:03,719 --> 00:39:06,680
Speaker 1: pushed to the brink of a physical and nervous breakdown.

547
00:39:07,640 --> 00:39:11,320
Speaker 1: Despite the excessive hours he had been working, the patients

548
00:39:11,360 --> 00:39:15,560
Speaker 1: were suffering. They were waiting too long for surgery. Nankavell

549
00:39:15,680 --> 00:39:18,920
Speaker 1: was regularly spending fourteen hours a day at the hospital,

550
00:39:19,360 --> 00:39:22,160
Speaker 1: then being woken at home and asked to come in

551
00:39:22,200 --> 00:39:27,280
Speaker 1: for a critical case or unexpected emergency. The weekends offered

552
00:39:27,320 --> 00:39:32,000
Speaker 1: no relief. Nankeavell had to work most Saturdays and Sundays

553
00:39:32,560 --> 00:39:35,960
Speaker 1: as one of two hospital surgeons serving a growing and

554
00:39:36,200 --> 00:39:40,200
Speaker 1: aging population of almost eighty thousand people, most of whom

555
00:39:40,239 --> 00:39:46,000
Speaker 1: were not privately insured. Nankavell needed urgent backup. He had

556
00:39:46,040 --> 00:39:49,959
Speaker 1: pleaded his case with everyone from his district manager Peter Leck,

557
00:39:50,520 --> 00:39:55,800
Speaker 1: to the head of Queensland Health, doctor Rob Stable. Nankeavell

558
00:39:55,880 --> 00:39:59,359
Speaker 1: wrote to Doctor Stable in a confidential MIMO in late

559
00:39:59,400 --> 00:40:00,720
Speaker 1: two thousand and won.

560
00:40:03,080 --> 00:40:06,120
Speaker 3: I had my resignation letter ready one year ago. As

561
00:40:06,160 --> 00:40:08,719
Speaker 3: it turned out, the same day I signed my resignation,

562
00:40:09,120 --> 00:40:12,160
Speaker 3: Dr Anderson was stood down so was not handed in.

563
00:40:13,600 --> 00:40:15,920
Speaker 3: I stayed on in Bunderberg an extra twelve months to

564
00:40:15,960 --> 00:40:18,080
Speaker 3: try to help the patients here and with hope that

565
00:40:18,160 --> 00:40:22,960
Speaker 3: things might improve. I suffered enormous physical and mental exhaustion

566
00:40:23,080 --> 00:40:25,960
Speaker 3: and was operating on patients when I was totally unfit.

567
00:40:26,760 --> 00:40:29,480
Speaker 3: I will not allow any other person to go through this.

568
00:40:29,480 --> 00:40:33,080
Speaker 3: This very ugly episode is well known throughout Queensland and

569
00:40:33,080 --> 00:40:35,400
Speaker 3: it's a big turn off for surgeons thinking of coming

570
00:40:35,400 --> 00:40:40,160
Speaker 3: to Bunderberg. Our clinicians meetings with Queensland Health have identified

571
00:40:40,160 --> 00:40:42,840
Speaker 3: the problems with the Department of Surgery as the number

572
00:40:42,920 --> 00:40:46,960
Speaker 3: one problem affecting the Bunderberg Base Hospital. For several years,

573
00:40:47,640 --> 00:40:51,600
Speaker 3: there's been no effective response to our concerns this is

574
00:40:51,680 --> 00:40:54,520
Speaker 3: flabbergast of the staff. We seem to have no effective

575
00:40:54,520 --> 00:40:59,360
Speaker 3: communication with Queensland Health. Clearly identified issues are not addressed

576
00:40:59,360 --> 00:41:02,400
Speaker 3: and we don't seem to get appropriate feedback on why not.

577
00:41:04,120 --> 00:41:10,040
Speaker 1: Nankevell warned of numerous examples of unnecessarily delayed diagnoses of cancer,

578
00:41:10,560 --> 00:41:16,120
Speaker 1: massively overbooked clinics, an emergency department in a shambles, and

579
00:41:16,160 --> 00:41:20,160
Speaker 1: an inability to meet guidelines for the surgical waiting lists,

580
00:41:20,800 --> 00:41:24,840
Speaker 1: but his MIMO was to no avail. Instead, his letters

581
00:41:24,880 --> 00:41:30,120
Speaker 1: and telephone calls branded Nankevell as a complaining clinician. There

582
00:41:30,200 --> 00:41:33,440
Speaker 1: was no extra funding because nobody was prepared to insist

583
00:41:33,480 --> 00:41:38,319
Speaker 1: that extra funds be provided. Nankeavell was livid. Whenever the

584
00:41:38,400 --> 00:41:42,880
Speaker 1: quality assurance data arrived from the statisticians in the administration.

585
00:41:44,200 --> 00:41:47,759
Speaker 1: They would dwell on statistics showing, for example, that his

586
00:41:48,000 --> 00:41:51,640
Speaker 1: patients stayed an average of four point three days, when

587
00:41:51,680 --> 00:41:56,480
Speaker 1: in Brisbane the average was slightly less. Constant pressure was

588
00:41:56,560 --> 00:42:01,040
Speaker 1: exerted to move the patients through faster. Time is money,

589
00:42:01,560 --> 00:42:04,960
Speaker 1: but Nanko Bell's priority was to make his patients better.

590
00:42:05,640 --> 00:42:09,520
Speaker 1: If that meant a longer stay, so be it. He

591
00:42:09,560 --> 00:42:13,480
Speaker 1: should not have been surprised by his failure to achieve change.

592
00:42:13,960 --> 00:42:17,440
Speaker 1: The culture of Queensland Health was being distorted by a

593
00:42:17,480 --> 00:42:22,520
Speaker 1: management model that described the patients as clients. It was

594
00:42:22,560 --> 00:42:26,960
Speaker 1: a culture which nurtured the creation of committees. Rarely was

595
00:42:27,000 --> 00:42:31,640
Speaker 1: anything resolved. Decisive action on even minor matters was frowned upon.

596
00:42:32,239 --> 00:42:36,440
Speaker 1: Clinicians were expected to prepare a submission or a business case.

597
00:42:37,640 --> 00:42:43,000
Speaker 1: The pointlessness of it all infuriated Nanka Bell. After careful consideration,

598
00:42:43,200 --> 00:42:46,320
Speaker 1: he eventually decided not to follow through with a plan

599
00:42:46,400 --> 00:42:50,600
Speaker 1: to tell all to the local newspaper, the Bunderberg Newsmail.

600
00:42:51,880 --> 00:42:54,240
Speaker 3: If I tell the truth to the media, I get sacked.

601
00:42:54,280 --> 00:42:57,640
Speaker 3: But if people in administration spin doctor the media, they

602
00:42:57,680 --> 00:42:58,320
Speaker 3: get promoted.

603
00:43:00,040 --> 00:43:05,440
Speaker 1: Kevell had examined Queensland Health's Code of Conduct. In one part,

604
00:43:05,600 --> 00:43:06,760
Speaker 1: it states.

605
00:43:07,320 --> 00:43:11,280
Speaker 7: All employees are reminded that irresponsible discussion of any matters

606
00:43:11,320 --> 00:43:15,960
Speaker 7: regarding the health service, facilities, staff, and most importantly, patients

607
00:43:16,360 --> 00:43:17,920
Speaker 7: is regarded as an offense.

608
00:43:19,480 --> 00:43:23,520
Speaker 1: Nankevell regarded that statement as a gag. He dubbed the

609
00:43:23,560 --> 00:43:28,400
Speaker 1: Code of conduct the Code of Silence. Doctor John Youngman,

610
00:43:28,480 --> 00:43:32,680
Speaker 1: the second most senior administrator in the Queensland Health Organization,

611
00:43:32,960 --> 00:43:36,880
Speaker 1: responded to Nankeavell's and Bunderberg's crisis with a brief letter

612
00:43:37,160 --> 00:43:41,239
Speaker 1: which made scant mention of the unsafe working practices that

613
00:43:41,400 --> 00:43:45,960
Speaker 1: Nankeovell suspected would kill either him or a patient. When

614
00:43:46,000 --> 00:43:50,600
Speaker 1: he received doctor Youngman's letter, doctor Nankevell decided the hospital

615
00:43:50,719 --> 00:43:51,720
Speaker 1: was a lost cause.

616
00:43:52,920 --> 00:43:55,080
Speaker 3: That's it. I'm finished, I'm out of here.

617
00:43:56,080 --> 00:44:00,320
Speaker 1: His immediate predecessor, doctor Peter Anderson, had suffered a worse

618
00:44:00,440 --> 00:44:05,640
Speaker 1: fate for being outspoken about life threatening problems. Anderson and

619
00:44:05,719 --> 00:44:10,040
Speaker 1: the director of medical services, vascular surgeon doctor Brian Thiel,

620
00:44:10,440 --> 00:44:15,080
Speaker 1: had built up a strong surgery department. Thel hadn almost

621
00:44:15,160 --> 00:44:20,040
Speaker 1: magical touch. Even after major operations. His patients were always

622
00:44:20,080 --> 00:44:23,239
Speaker 1: in relatively great shape when taken from a theater to

623
00:44:23,400 --> 00:44:28,920
Speaker 1: the ICU. Tony Hoffman marveled at their robust condition, but

624
00:44:29,040 --> 00:44:33,320
Speaker 1: the constant struggle against an administration they regarded as closed

625
00:44:33,360 --> 00:44:38,760
Speaker 1: and secretive eventually wore both specialists down. They abandoned the hospital.

626
00:44:39,680 --> 00:44:42,960
Speaker 1: When Anderson went public in the Bunderberg News Mail to

627
00:44:43,080 --> 00:44:46,600
Speaker 1: warn of the dangers posed by exhausted surgeons, he was

628
00:44:46,640 --> 00:44:50,440
Speaker 1: subjected to a scathing attack by Health Minister Wendy Edmund

629
00:44:50,800 --> 00:44:51,880
Speaker 1: in state parliament.

630
00:44:53,120 --> 00:44:56,319
Speaker 8: I can understand doctor Anderson's need to constantly criticize the

631
00:44:56,360 --> 00:44:59,919
Speaker 8: Bunderberg Hospital administration since they are the ones who exp

632
00:45:00,040 --> 00:45:03,000
Speaker 8: bosed his double dipping into service to the public patients

633
00:45:03,000 --> 00:45:04,600
Speaker 8: whom he was employed to care for.

634
00:45:06,239 --> 00:45:10,960
Speaker 1: It was a typical Queensland Health ploy discredit the whistleblower

635
00:45:11,000 --> 00:45:15,320
Speaker 1: by raising untested claims, then create a diversion from the

636
00:45:15,480 --> 00:45:19,640
Speaker 1: fundamental problems plaguing the system, and make sure other staff

637
00:45:19,680 --> 00:45:22,399
Speaker 1: who might have been thinking of going public no they

638
00:45:22,440 --> 00:45:27,680
Speaker 1: will face public censure. After the departures of doctor Anderson

639
00:45:27,800 --> 00:45:31,560
Speaker 1: and doctor Nankervell, a new Director of Surgery came to

640
00:45:31,600 --> 00:45:36,120
Speaker 1: the job, doctor Sam Baker. He too tried to ensure

641
00:45:36,200 --> 00:45:40,200
Speaker 1: management understood how dangerous the hospital had become because of

642
00:45:40,239 --> 00:45:43,800
Speaker 1: its focus on the bottom line instead of outcomes for patients.

643
00:45:45,200 --> 00:45:50,160
Speaker 1: In an internal assessment memo, Dr Baker was very candid.

644
00:45:50,880 --> 00:45:54,480
Speaker 5: There is little direction for management with regards to strategic direction.

645
00:45:55,160 --> 00:45:58,440
Speaker 5: They refused to clearly define the hospital's operational role and

646
00:45:58,440 --> 00:46:02,319
Speaker 5: delivery of services and the critical massive medical staff required

647
00:46:02,480 --> 00:46:05,880
Speaker 5: to meet this role. They appear more interested in making

648
00:46:05,920 --> 00:46:08,320
Speaker 5: targets than delivery of quality healthcare.

649
00:46:09,800 --> 00:46:13,920
Speaker 1: Doctor Chris Jelloff an anesthetist at the hospital, was deeply

650
00:46:13,960 --> 00:46:16,960
Speaker 1: concerned for the well being of the staff and the patients.

651
00:46:18,040 --> 00:46:21,239
Speaker 1: He had seen Nankervell deteriorate to the point where he

652
00:46:21,400 --> 00:46:24,880
Speaker 1: looked like a beaten man, broken by the punishing hours

653
00:46:24,920 --> 00:46:28,600
Speaker 1: he had to work. Doctor Jelloff was also in a

654
00:46:28,600 --> 00:46:32,200
Speaker 1: bad way due to the demands. He was sure that

655
00:46:32,280 --> 00:46:35,960
Speaker 1: his own decision making processes were impaired. He could not

656
00:46:36,160 --> 00:46:41,239
Speaker 1: sleep despite being exhausted. His appetite had waned, but the

657
00:46:41,320 --> 00:46:45,520
Speaker 1: hospital's waiting lists for surgery were lengthening and management had

658
00:46:45,600 --> 00:46:51,640
Speaker 1: little interest in excuses. Doctor Jelloff decided over Easter two

659
00:46:51,640 --> 00:46:54,640
Speaker 1: thousand and two that his fatigue and the lack of

660
00:46:54,719 --> 00:47:00,520
Speaker 1: staff made it unsafe to continue operating and anesthetizing. He

661
00:47:00,680 --> 00:47:04,000
Speaker 1: canceled any surgery that could safely wait for a couple

662
00:47:04,000 --> 00:47:08,400
Speaker 1: of days. He was told to come to Peter Lex office.

663
00:47:08,640 --> 00:47:12,680
Speaker 1: Peter Leck, who had the anesthetus' personal file on his desk,

664
00:47:12,800 --> 00:47:15,800
Speaker 1: began the conversation with an unusual.

665
00:47:15,360 --> 00:47:19,160
Speaker 5: Question, Chris, just by the way, remind me of your

666
00:47:19,239 --> 00:47:21,479
Speaker 5: visa status as.

667
00:47:21,400 --> 00:47:25,439
Speaker 1: A United Kingdom trained doctor. Doctor Jeloff's visa to live

668
00:47:25,440 --> 00:47:28,799
Speaker 1: in Australia was tied to his contract as an overseas

669
00:47:28,840 --> 00:47:33,680
Speaker 1: trained doctor, Queensland Health had special leverage over the imports.

670
00:47:34,560 --> 00:47:39,000
Speaker 1: They were also cheaper to employ. Jeloff felt threatened by

671
00:47:39,040 --> 00:47:42,600
Speaker 1: the district manager. He was certain Lek had asked the

672
00:47:42,600 --> 00:47:45,040
Speaker 1: odd question at the start of a meeting about the

673
00:47:45,080 --> 00:47:48,799
Speaker 1: cancelations of surgery to warn Jelof that his livelihood and

674
00:47:48,840 --> 00:47:52,040
Speaker 1: aspirations to live in Australia were now on the line.

675
00:47:53,160 --> 00:47:56,960
Speaker 1: Under different circumstances, Jeloff might have felt bound to go

676
00:47:57,080 --> 00:48:01,719
Speaker 1: back to theater notwithstanding his exhaustion, But as he had

677
00:48:01,800 --> 00:48:05,880
Speaker 1: recently married his Australian girlfriend, a fact Lek was not

678
00:48:06,000 --> 00:48:10,520
Speaker 1: aware of. Doctor Jeloff no longer relied on Queensland Health

679
00:48:10,560 --> 00:48:14,400
Speaker 1: as a visa sponsor. He left the meeting and he

680
00:48:14,520 --> 00:48:18,800
Speaker 1: told doctor Baker about how Lek had tried to intimidate him.

681
00:48:19,200 --> 00:48:21,080
Speaker 5: Jesus Christ, that's a bit rough.

682
00:48:22,120 --> 00:48:26,320
Speaker 1: Baker was surprised. Jelloff could not stomach it for much longer.

683
00:48:27,040 --> 00:48:31,160
Speaker 1: He quit in late two thousand and two after repeated

684
00:48:31,280 --> 00:48:35,600
Speaker 1: but unheeded pleas to management for help. Dr Baker too

685
00:48:35,640 --> 00:48:40,920
Speaker 1: decided the hospital was unsalvageable. He moved on in November

686
00:48:40,960 --> 00:48:46,800
Speaker 1: two thousand and two. On thirteen February two thousand and three,

687
00:48:46,840 --> 00:48:50,399
Speaker 1: some six weeks before doctor Jay Patel would arrive from

688
00:48:50,440 --> 00:48:53,960
Speaker 1: the United States to fill the newly vacated Director of

689
00:48:54,040 --> 00:48:58,960
Speaker 1: Surgery position at Bunderberg Base Hospital, seven specialist surgeons on

690
00:48:59,040 --> 00:49:02,359
Speaker 1: the local Medical Advisory Committee wrote a MIMO.

691
00:49:03,040 --> 00:49:04,800
Speaker 2: The MIMO was condemnatory.

692
00:49:05,320 --> 00:49:12,080
Speaker 7: It raised the dictatorial, unresponsive, myopic, and inflexible approach of

693
00:49:12,239 --> 00:49:16,520
Speaker 7: management who have little regard or respect for specialists, their

694
00:49:16,600 --> 00:49:18,680
Speaker 7: needs or aspirations.

695
00:49:22,719 --> 00:49:29,040
Speaker 1: Chapter six, My Brilliant Career, Portland, Oregon, United States, January

696
00:49:29,040 --> 00:49:34,960
Speaker 1: two thousand and two. As thick snow blanketed the wide

697
00:49:35,040 --> 00:49:38,920
Speaker 1: lawn fronting his two story house in Beaverton, a suburb

698
00:49:39,000 --> 00:49:42,640
Speaker 1: of professionals and middle class millionaires on the edge of Portland,

699
00:49:43,000 --> 00:49:48,600
Speaker 1: doctor jarnt Nukandre Patel, aged fifty one and newly unemployed,

700
00:49:48,680 --> 00:49:54,239
Speaker 1: reflected on his troubled past. It never snowed in Jamnagar.

701
00:49:55,040 --> 00:49:58,359
Speaker 1: When the heavens above the dusty, overcrowded city in the

702
00:49:58,360 --> 00:50:02,960
Speaker 1: far west of India's Gooja Province brought the seasonal monsoon rains,

703
00:50:03,480 --> 00:50:08,040
Speaker 1: impoverished farmers celebrated their good fortune. There would be another

704
00:50:08,120 --> 00:50:11,760
Speaker 1: harvest food for the family and the prospect of money

705
00:50:11,800 --> 00:50:14,720
Speaker 1: from the maize to buy essentials for the next crop.

706
00:50:16,040 --> 00:50:18,960
Speaker 1: Too much rain and there would be floods, death and

707
00:50:19,000 --> 00:50:24,240
Speaker 1: destruction on a massive scale. Hundreds, sometimes thousands of lives

708
00:50:24,280 --> 00:50:27,120
Speaker 1: would be swept away with the flimsy homes and ragged

709
00:50:27,120 --> 00:50:32,080
Speaker 1: belongings of the province's poorest wretches. Their misery would feature

710
00:50:32,160 --> 00:50:36,040
Speaker 1: prominently in the local media for a few days. Loved

711
00:50:36,040 --> 00:50:39,960
Speaker 1: ones would mourn. There would be renewed calls from ambitious

712
00:50:40,040 --> 00:50:44,759
Speaker 1: legislators and community leaders for an inquiry into lacks building standards.

713
00:50:45,360 --> 00:50:48,480
Speaker 1: Somebody might flag a new approach to shanty housing to

714
00:50:48,600 --> 00:50:52,920
Speaker 1: keep the most disadvantaged out of harm's way, but ultimately

715
00:50:53,160 --> 00:50:56,640
Speaker 1: nothing would change. It just made everyone feel a little

716
00:50:56,640 --> 00:51:00,120
Speaker 1: better in the teeth of tragedy before moving on. This

717
00:51:00,280 --> 00:51:04,800
Speaker 1: was their fate. Not only did Jamnagar never see snow,

718
00:51:05,160 --> 00:51:09,080
Speaker 1: its doctors, some of the most privileged and respected citizens

719
00:51:09,120 --> 00:51:12,440
Speaker 1: in the province, were never subject to the same accountability

720
00:51:12,480 --> 00:51:16,960
Speaker 1: as the Hoi peloi. Doctor Patel sometimes wondered whether he

721
00:51:17,000 --> 00:51:19,560
Speaker 1: would not have been better off had he stayed in

722
00:51:19,640 --> 00:51:26,319
Speaker 1: his homeland. His superior family name, caste, academic excellence and

723
00:51:26,440 --> 00:51:30,759
Speaker 1: status as a specialist surgeon meant something among his own people. There,

724
00:51:32,200 --> 00:51:36,600
Speaker 1: colleagues at the MP Shah Medical College and Guru Govin

725
00:51:36,719 --> 00:51:40,799
Speaker 1: Singh Hospital had never dared question his judgment or aptitude

726
00:51:40,800 --> 00:51:45,360
Speaker 1: with a scalpel. The patients did not complain. Deaths and

727
00:51:45,440 --> 00:51:49,520
Speaker 1: injuries were an inevitable consequence for the patients of every

728
00:51:49,560 --> 00:51:54,359
Speaker 1: hard working surgeon. What part of this unquestionable logic did

729
00:51:54,360 --> 00:52:00,400
Speaker 1: the American regulators of medicine and surgery not understand? The

730
00:52:00,520 --> 00:52:05,320
Speaker 1: latest gratuitous insult had cut doctor Patel deeply. He knew

731
00:52:05,320 --> 00:52:07,960
Speaker 1: it must have been a source of gossip among his

732
00:52:08,120 --> 00:52:12,360
Speaker 1: friends and colleagues in the medical community. At least the

733
00:52:12,440 --> 00:52:17,040
Speaker 1: Little Bme Report, published twice a year by the Oregon

734
00:52:17,120 --> 00:52:21,000
Speaker 1: Board of Medical Examiners for the benefit or in doctor

735
00:52:21,040 --> 00:52:25,719
Speaker 1: Patel's case, public shaming of registered and paid up practitioners,

736
00:52:25,760 --> 00:52:29,000
Speaker 1: would not be read in Jamnagar, where he was still

737
00:52:29,080 --> 00:52:30,880
Speaker 1: hailed as a genius.

738
00:52:31,880 --> 00:52:37,440
Speaker 9: Statement of purpose. The Board of Medical Examiner's Report is

739
00:52:37,560 --> 00:52:42,759
Speaker 9: published to help promote medical excellence by providing current information

740
00:52:42,880 --> 00:52:48,400
Speaker 9: about laws and issues affecting medical licensure and practice in Oregon.

741
00:52:49,320 --> 00:52:53,280
Speaker 1: Doctor Philip F. Parsley had written the lead article.

742
00:52:53,000 --> 00:52:57,160
Speaker 9: Headlined responsibility rests with surgeon.

743
00:52:58,040 --> 00:52:59,160
Speaker 2: It sounded ominous.

744
00:53:00,320 --> 00:53:05,640
Speaker 9: In medicine, the physician is captain of the ship, and

745
00:53:05,719 --> 00:53:10,040
Speaker 9: the Board of Medical Examiners takes a strong position that

746
00:53:10,280 --> 00:53:14,960
Speaker 9: doctors are responsible for the patients under their care, whether

747
00:53:15,040 --> 00:53:18,760
Speaker 9: that care is rendered directly or delegated to others.

748
00:53:20,680 --> 00:53:23,759
Speaker 2: There was another heading, board Actions.

749
00:53:24,680 --> 00:53:29,319
Speaker 1: The first column contained six names. There he was the

750
00:53:29,400 --> 00:53:33,479
Speaker 1: third name down. Nobody could have missed the dishonorable mention

751
00:53:33,600 --> 00:53:37,160
Speaker 1: of Jamdagar's finest in the Professional Journal of the Medical

752
00:53:37,239 --> 00:53:38,279
Speaker 1: Regulatory Body of.

753
00:53:38,200 --> 00:53:44,960
Speaker 9: Oregon, Patel Gyant m Mdeine one, Portland, Oregon.

754
00:53:46,239 --> 00:53:51,480
Speaker 1: The entry disclosed an active order of vilifying and unambiguous

755
00:53:51,520 --> 00:53:54,640
Speaker 1: text made by the Board of Medical Examiners in the

756
00:53:54,719 --> 00:53:58,920
Speaker 1: late two thousand forbidding doctor Patel from performing a wide

757
00:53:59,080 --> 00:54:03,520
Speaker 1: range of surgery. It could have been much worse, though,

758
00:54:04,120 --> 00:54:08,120
Speaker 1: A dreadful toll of death and permanent life shortening injuries

759
00:54:08,120 --> 00:54:10,920
Speaker 1: suffered by patients of Patel in the years since he

760
00:54:11,000 --> 00:54:15,359
Speaker 1: began practicing in Portland in nineteen eighty nine when unreported

761
00:54:15,440 --> 00:54:19,880
Speaker 1: by the newsletter, but the carnage had been noted in small,

762
00:54:19,960 --> 00:54:25,120
Speaker 1: disparate parts elsewhere. There were the findings of a confidential

763
00:54:25,360 --> 00:54:29,160
Speaker 1: internal audit of the outcomes from surgery of seventy nine

764
00:54:29,280 --> 00:54:35,719
Speaker 1: of doctor Petel's patients. There were the subsequent investigative files

765
00:54:35,880 --> 00:54:39,200
Speaker 1: of the Board of Medical Examiners. There were the legal

766
00:54:39,239 --> 00:54:43,319
Speaker 1: depositions of the walking wounded, whose financial settlements gave doctor

767
00:54:43,360 --> 00:54:47,120
Speaker 1: Pateel the dubious distinction of being the most successfully sued

768
00:54:47,120 --> 00:54:52,360
Speaker 1: physician of his employer, the huge Kaiser Permanente Healthcare Group.

769
00:54:53,320 --> 00:54:56,600
Speaker 1: And there were his colleagues who had expressed alarm at

770
00:54:56,600 --> 00:55:02,440
Speaker 1: the lethal repercussions of his work. Impossibly complex procedures that

771
00:55:02,480 --> 00:55:05,400
Speaker 1: should never have been attempted had led to patients like

772
00:55:05,719 --> 00:55:12,120
Speaker 1: Marie Messcha, a retired restaurant owner with pancreatic cancer, dying unnecessarily.

773
00:55:13,000 --> 00:55:16,520
Speaker 1: Patel had cut a critical vein and artery while trying

774
00:55:16,560 --> 00:55:21,480
Speaker 1: to reach her tumor, causing massive blood loss. Messecha needed

775
00:55:21,520 --> 00:55:24,960
Speaker 1: transfusions of more than three times her body's volume of

776
00:55:25,000 --> 00:55:29,600
Speaker 1: blood as other doctors tried desperately to save her life.

777
00:55:29,640 --> 00:55:33,399
Speaker 1: Her blood, the post mortem report said, was pulling off

778
00:55:33,440 --> 00:55:38,080
Speaker 1: the bed and onto the floor before she died that afternoon. Later,

779
00:55:38,239 --> 00:55:43,080
Speaker 1: when her daughter, Sandra Ickott, asked Kaiser Permanente staff about

780
00:55:43,080 --> 00:55:47,760
Speaker 1: Patel's competence. She was reassured that he was an outstanding

781
00:55:47,840 --> 00:55:52,640
Speaker 1: specialist doctor. Patel knew his surgical career in the United

782
00:55:52,719 --> 00:55:56,880
Speaker 1: States was finished when the BME report published a clue

783
00:55:56,920 --> 00:56:01,080
Speaker 1: to the truth about his surgery. In the months that followed,

784
00:56:01,120 --> 00:56:05,080
Speaker 1: he came under mounting pressure to resign from Kaiser Permanente

785
00:56:05,280 --> 00:56:12,480
Speaker 1: to avoid further humiliation and dismissal Jamnagar's most arrogant medical export,

786
00:56:12,600 --> 00:56:15,680
Speaker 1: resolved to take his talents to a fresh pool of

787
00:56:15,719 --> 00:56:21,359
Speaker 1: admiring peers wherever they might be. He regarded himself as

788
00:56:21,400 --> 00:56:26,480
Speaker 1: a stellar surgeon who had been grievously wronged. Before the

789
00:56:26,520 --> 00:56:30,759
Speaker 1: snow melted outside his Beaverton mansion, he began using the

790
00:56:30,800 --> 00:56:37,120
Speaker 1: Internet to look for opportunities abroad. The huge international demand

791
00:56:37,280 --> 00:56:41,400
Speaker 1: for experienced doctors had spawned dozens of recruitment companies with

792
00:56:41,560 --> 00:56:47,880
Speaker 1: sophisticated web based forums, search fields, and even online application forms.

793
00:56:48,960 --> 00:56:52,360
Speaker 1: It costs Petel nothing to start sowing the seeds for

794
00:56:52,440 --> 00:56:55,200
Speaker 1: a new start in a country which knew nothing of

795
00:56:55,320 --> 00:56:59,799
Speaker 1: his background. Patel read again the testimonials of some of

796
00:56:59,800 --> 00:57:05,040
Speaker 1: his former colleagues mentors like Kaiser Permanente, chief of Surgery

797
00:57:05,680 --> 00:57:08,400
Speaker 1: then retired Edward A.

798
00:57:08,400 --> 00:57:09,040
Speaker 2: Aarronilo.

799
00:57:11,600 --> 00:57:15,399
Speaker 6: I feel that wherever he works, or whomever he works for,

800
00:57:15,840 --> 00:57:19,960
Speaker 6: will be the beneficiary of his excellent skills and knowledge,

801
00:57:20,360 --> 00:57:23,720
Speaker 6: and will be all the better for it. He will

802
00:57:23,760 --> 00:57:27,760
Speaker 6: be an asset to any group, hospital or organization.

803
00:57:29,000 --> 00:57:33,320
Speaker 1: Patel particularly like that last line. He could not have

804
00:57:33,320 --> 00:57:42,880
Speaker 1: put it more succinctly himself. Sick to Death is written

805
00:57:43,000 --> 00:57:48,240
Speaker 1: and presented by me Hedley Thomas, the Australian's national Chief correspondent.

806
00:57:48,840 --> 00:57:54,160
Speaker 1: Claire Harvey is The Australian's editorial director. Audio editing, production

807
00:57:54,600 --> 00:57:58,440
Speaker 1: and music have been done by Jasper Leik, with assistance

808
00:57:58,520 --> 00:58:04,040
Speaker 1: from Leah Sammage and Neil Sutherland. Our producer is Christen Amias.

809
00:58:04,280 --> 00:58:10,920
Speaker 1: Production management by Stephanie Coombs, artwork by Sean Callenan. Thanks

810
00:58:10,960 --> 00:58:16,840
Speaker 1: to Ryan Osland, Matthew Connan, Karina Berger, Ellie Dudley, David Murray,

811
00:58:17,200 --> 00:58:22,600
Speaker 1: Dominique McDermott, Zach Sculander and all our family, friends and

812
00:58:22,800 --> 00:58:26,800
Speaker 1: colleagues who helped in this series and contributed voice acting

813
00:58:27,320 --> 00:58:30,480
Speaker 1: and special thanks to Tony Hoffman.

814
00:58:30,480 --> 00:58:31,720
Speaker 2: And Rob Messenger.

815
00:58:32,440 --> 00:58:36,720
Speaker 1: Subscribers to The Australian Here New episodes of Sick to

816
00:58:36,800 --> 00:58:41,760
Speaker 1: Death first at Sick to deathpodcast dot com and on

817
00:58:42,040 --> 00:58:48,760
Speaker 1: Apple Podcasts. You can get exclusive access to photographs, videos, timelines,

818
00:58:48,960 --> 00:59:11,439
Speaker 1: and more at the website