Speaker 1: My name is Hedley Thomas. In two thousand and five,
Speaker 1: my reporting exposed shocking medical negligence at the heart of
Speaker 1: a major healthcare system. An overseas trained surgeon who was
Speaker 1: nicknamed Doctor Death by the nurses, doctors and hospital administrators
Speaker 1: left patients mutilated, incapacitated, even dead. Sick to Death is
Speaker 1: based on my book of the same name, and it's
Speaker 1: the true story of doctor Jan Patel's lies and manipulation
Speaker 1: and the herculean effort it took.
Speaker 2: To finally stop him.
Speaker 1: We've used voice actors throughout this series and on occasion
Speaker 1: the real people from this story have read their words
Speaker 1: for us.
Speaker 2: It is brought to you by me and the Australian.
Speaker 1: Chapter one, Happy Days, January two thousand and two. Jared
Speaker 1: Neville put the last bag in the family car as
Speaker 1: his wife Lorraine urged the three children to hurry downstairs.
Speaker 1: A fit, middle aged public health physician for Queensland Health,
Speaker 1: Jared ran beside the Brisbane River most mornings, even in
Speaker 1: the subtropical humidity of summer, before going to work to
Speaker 1: plan policy for the well being of a few million men,
Speaker 1: women and children. They were known, in accordance with the
Speaker 1: corporate vernacular as clients. The years had been kind to Jared.
Speaker 1: He remained free of the stress of providing clinical care
Speaker 1: in an organization starved of funds, while his friends, many
Speaker 1: of them fellow graduates of the University of Queensland's medical
Speaker 1: school in the leafy grounds of Hurston, had opted for
Speaker 1: careers in operating the US with late night callouts, long hours,
Speaker 1: and eventually private rooms. As highly paid specialists, Jered enjoyed
Speaker 1: a steady public service routine. He was adept at his
Speaker 1: office job, never shirking unpopular assignments, such as telling his
Speaker 1: political masters the unpalatable reality about the effect of their policies.
Speaker 2: He would never reach the top of.
Speaker 1: A highly politicized bureaucracy, nor did he aspire to. They
Speaker 1: made a handsome couple, Jared and Lorraine, a tall and
Speaker 1: softly spoken teacher. She met Jared when he was a
Speaker 1: rural GP five years after his graduation. Their motto might
Speaker 1: have been permanence and stability. They were stylish but not flashy,
Speaker 1: professional but not elitist. They were Catholic, with middle class values,
Speaker 1: healthy children, secure careers, and a comfortable, newly renovated house
Speaker 1: on a hill in the Brisbane middle class suburb of
Speaker 1: Tuwong Laura aged fourteen, Eleise ten and Michael eight needed
Speaker 1: little encouragement to leave their Brisbane home at the height
Speaker 1: of the summer heat wave. Across the city, thousands of
Speaker 1: people without air conditioning were seeking refuge in shopping centers
Speaker 1: and cinemas. Temperatures were about to soar into the high
Speaker 1: thirties with only limited relief from the scattered showers and
Speaker 1: afternoon storms. The Nevils were going somewhere infinitely more appealing.
Speaker 1: In two hours, they would arrive at King's Beach in
Speaker 1: Caloundra for the start of an annual holiday ritual exploring
Speaker 1: rock pools, swimming in the surf, lazing around the pool
Speaker 1: and choosing from the dinner specials at nearby restaurants. As
Speaker 1: Jered knows, the car one of the perks of his
Speaker 1: package with Queensland Health, down the neatly paved driveway and
Speaker 1: turned left onto Milton Road for the drive north. The
Speaker 1: rain felt uneasy. Usually the Neville family would stay at
Speaker 1: Pandanas Court in Caloundra for the Christmas holidays. Their familiarity
Speaker 1: over the years with the old block of units closest
Speaker 1: to the beach was part of the fun. Returning to
Speaker 1: Pandanas was a bit like visiting a favorite Auntie. Notwithstanding
Speaker 1: her flaws, she was safe and would not produce any surprises.
Speaker 1: When Lorraine had called months earlier to make the usual
Speaker 1: holiday booking, the woman at Henzel's real estate agency explained
Speaker 1: that Pandanas would not be available this time. The old
Speaker 1: block was being redeveloped and Auntie was to receive an
Speaker 1: overdue facelift. Instead, Lorraine was offered a unit in Monterey Lodge,
Speaker 1: a block not known to her. The plan was to
Speaker 1: spend a week there, dash back to Brisbane the following Saturday,
Speaker 1: unload the car, water the garden, check the mail, feed,
Speaker 1: the children, return calls, load the car again, and drive
Speaker 1: across the city to catch the afternoon ferry from Cleveland
Speaker 1: to Stradbroke Island for a further seven days holidaying. Lorrain's
Speaker 1: first impression of unit three at Monterey Lodge confirmed her unease.
Speaker 1: The living space was long, dark and narrow. The floor
Speaker 1: throughout seemed to be hard concrete with a thin wood
Speaker 1: veneer surface. The place felt auste and uninviting. Before they
Speaker 1: had begun to unpack. Before Lorrain could take in the
Speaker 1: natural beauty of the water beyond the buildings. She had regrets.
Speaker 1: As Lorraine tried to bury her misgivings and put on
Speaker 1: a bright face, and Jered carried the bags inside. Elise
Speaker 1: ran to the second bedroom and squealed with delight. As expected,
Speaker 1: there was a set of bunks. They were unspectacular, lightly
Speaker 1: framed and well used. They stood exactly one point four
Speaker 1: to three meters high in one corner of the room.
Speaker 1: The top bunk had been promised days earlier to Elise,
Speaker 1: who excitedly told her friends and reminded Michael and Laura
Speaker 1: that she would soon be towering over them morning and night.
Speaker 1: A bright girl with sparkling blue eyes, a cherubic face,
Speaker 1: and a gift for bringing calm and laughter into awkward situations.
Speaker 1: Elise looked at the top bunk and beamed. She clambered
Speaker 1: up and bounced on the mattress. A trundle bed had
Speaker 1: been stored under the lower bed. The rain dragged it
Speaker 1: out on the Saturday afternoon and put it against the wall,
Speaker 1: forming an L shape with the bunks. The rain frowned
Speaker 1: at the glass top table in the room. It was
Speaker 1: an accident. Waiting to happen. She carried it into the
Speaker 1: main bedroom, where she and Jared would be sleeping. Next,
Speaker 1: she hauled a low set of wooden bedside draws from
Speaker 1: the main bedroom to the children's room. As Lorraine had feared,
Speaker 1: the unit was hot, its bricks absorbed heat throughout the day,
Speaker 1: The windows missed the best of the sea breezes, and
Speaker 1: there were no ceiling fans. Lorraine put one of the
Speaker 1: electric fans she had brought from Brisbane on the bedside draws.
Speaker 1: At least the children would be comfortable as they slept.
Speaker 1: Lorraine took one more precaution before satisfying herself that she
Speaker 1: had made the best of things. She spread quilts and
Speaker 1: blankets along the floor below the bunk beds. Michael, who
Speaker 1: would be in the bottom bunk, was a restless sleeper,
Speaker 1: though neither he nor Elise had any history of falling
Speaker 1: out of bed, but just in case, the quilts might
Speaker 1: soften an unlikely accidental fall. The family woke to a
Speaker 1: glorious Sunday morning and devoted it to the beach and
Speaker 1: the pool. Lorraine's worries eased as the sun disappeared behind
Speaker 1: the glasshouse mountains. The family walked to Bullcock Beach for
Speaker 1: fish and chips at a sidewalk table. After they returned
Speaker 1: to the unit, Michael went to bed first. He was
Speaker 1: sleeping soundly by nine pm when Lorraine.
Speaker 2: Checked on him.
Speaker 1: Elise, nestled beside her mother on the sofa, stayed contentedly,
Speaker 1: reading her novel. From time to time, she looked up
Speaker 1: at the TV. An hour after Michael had turned in,
Speaker 1: Elise was ready for bed. She kissed her parents and
Speaker 1: smiled as Lorraine tucked her in for a second night
Speaker 1: in the top bunk. Lorraine, who had made a point
Speaker 1: of picking the children's clutter off the floor to prevent
Speaker 1: a stumble in the dark, did not notice something amiss
Speaker 1: as she turned out the lights. The family had no
Speaker 1: experience with bunk beds. The safety rails that prevent a
Speaker 1: child from rolling out were not there, as they were
Speaker 1: on holidays. Laura was allowed to stay up with her
Speaker 1: parents until the late movie ended. Shortly before midnight, they
Speaker 1: all went to bed, and within minutes everyone was sleeping.
Speaker 1: At one fifty am, the rain woke up. Suddenly, Jered
Speaker 1: sat upright. They had both heard it, a loud noise,
Speaker 1: a heavy thud. In the seconds that followed moaning noises
Speaker 1: drifted from the bedroom, and instantly the rain guessed what
Speaker 1: had happened. Oh my god, Jared, I think Alisea has
Speaker 1: fallen out of bed. They hurried to the bedroom, where
Speaker 1: Elise was lying curled up on her right side. She
Speaker 1: was on the quilt on the floor, with her head
Speaker 1: towards the narrow shelf and doorless cupboard in the room.
Speaker 1: The rain frantically moved the small drawers with the fan
Speaker 1: on top so Shit and Jared could both fit in
Speaker 1: the room more easily to tend their stricken child. Lorraine
Speaker 1: needed immediate affirmation that Elise had not broken any limbs.
Speaker 2: Elise, are you okay?
Speaker 3: Can you move your arms and legs?
Speaker 1: Elise could move her limbs, but Lorraine's relief was tempered
Speaker 1: by a new fear. Elise was in great pain. In
Speaker 1: the half light, she cried out.
Speaker 4: My head hurts.
Speaker 1: Jared tried to contain his own anxiety in the gloomy
Speaker 1: bedroom as Elise lay on the floor with her Winnie
Speaker 1: the Pooh Teddy bear rubbing her head and whimpering softly.
Speaker 1: He took charge. He was the doctor. He might not
Speaker 1: have practiced medicine for eighteen years but he knew something
Speaker 1: about head injury. He spoke in as measured a tone
Speaker 1: as he could manage.
Speaker 2: Try and keep calm. I'll take her to our bed
Speaker 2: and have a look at her.
Speaker 1: Jared checked Elise's limbs, neck, chest and stomach for breaks
Speaker 1: or pain. He carried her to the main bedroom and
Speaker 1: brought the mattress from her top bunk. They lay her
Speaker 1: down on it on the floor in their room. She
Speaker 1: continued moaning in obvious pain. She was touching the left
Speaker 1: side of her head.
Speaker 4: My head hurts a lot here.
Speaker 1: Lorraine, shaking with worry and fear, wanted to rush Elise
Speaker 1: to hospital. She was becoming frantic. Gered resisted. He doubted
Speaker 1: Elise had been unconscious after the fall. He persuaded Lorraine
Speaker 1: that they could safely watch her in the unit for
Speaker 1: the time being. Stop panicking, Everything will be okay, Alise
Speaker 1: piped up.
Speaker 4: Yes, mummy, don't panic for making me worry. I'm sorry,
Speaker 4: everything would be all right. No, it won't, mum, There's
Speaker 4: something really wrong.
Speaker 1: Chapter two, The Shift January two thousand and two. Andrew
Speaker 1: Donovan looked at the clock on the wall above one
Speaker 1: of the Cloundra Hospital ward beds. It was almost three am.
Speaker 1: He sighed with relief. He wouldn't wish the graveyard shift
Speaker 1: on his worst enemy. He knew exactly how long he
Speaker 1: had been going without arrest, having come on duty at
Speaker 1: eight am the previous day. Who was at the nineteen
Speaker 1: hour mark of a twenty four hour shift. Donovan, a
Speaker 1: father of two young children, was exhausted. He would never
Speaker 1: touch alcohol while it worked, but the effect of his
Speaker 1: fatigue equated to a blood alcohol reading of zero point
Speaker 1: zero five percent. Long distance truck drivers could be forced
Speaker 1: off the road if found working dangerously long hours. Economic
Speaker 1: necessity and demanding bosses forced the drivers to stay awake
Speaker 1: with amphetamines as they hurtled down the country's highways. Airline
Speaker 1: operators had much more to lose. The repercussions from carnage
Speaker 1: caused by a mack truck colliding with a family car
Speaker 1: when nothing compared with those that might follow a Boeing
Speaker 1: seven four seven plowing into a mountain due to pilot fatigue.
Speaker 1: Australian pilots were permitted a maximum number of hours in
Speaker 1: the cockpit on long haul flights, after which strict regulations
Speaker 1: stipulated a lengthy rest in the bunks nurses too, were
Speaker 1: banned from working excessive hours, yet doctors like Donoman in
Speaker 1: Queensland's public hospitals were given no choice. At this time
Speaker 1: of year, when many of the senior doctors were holidaying
Speaker 1: with their own families, those on the bottom rung were
Speaker 1: in greater demand than usual. The chronic shortage of doctors
Speaker 1: nationally was worse in Queensland, which had the lowest number
Speaker 1: of registered doctors per head of population of any state
Speaker 1: or territory. There were about two thousand, five hundred more
Speaker 1: doctors in Victoria, a state with a similar population but
Speaker 1: without the challenges unique to Queensland of decentralization, poor working conditions,
Speaker 1: and remote and indigenous communities. Andrew Donovan had few complaints.
Speaker 1: He would do the hours a rite of passage and
Speaker 1: move up the ranks. He was not the most junior
Speaker 1: doctor in Queensland, but he was the least experienced doctor
Speaker 1: to be put in charge of the eighty bed Caloundra
Speaker 1: Hospital overnight. For the duration of this shift, he was
Speaker 1: the only doctor on duty. A quietly ambitious thirty seven
Speaker 1: year old Donovan did not look like a newcomer to medicine,
Speaker 1: but he only began studying medicine in his late twenties.
Speaker 1: His confidence and age sometimes made his patients suspect wrongly
Speaker 1: that he was experienced. Just two years after receiving his
Speaker 1: Bachelor of Medicine and Bachelor of Surgery from the University
Speaker 1: of Queensland, he was making clinical decisions without having to
Speaker 1: defer to senior colleagues. Donovan had worked in hospitals known
Speaker 1: as God's Waiting Rooms because they catered to a large
Speaker 1: population of elderly retirees who had moved to the Sunshine
Speaker 1: Coast for its warm climate, beaches and lawn bowls. As
Speaker 1: a junior house officer, almost the lowest ranking doctor on
Speaker 1: the scale, he had treated worn out knees, supporting the
Speaker 1: overweight and the sedentary. He had treated gynecological issues common
Speaker 1: to elderly women who had born children. During rotations in pediatrics,
Speaker 1: orthopedics and esthetics, obstetric skynecology and emergency medicine. He had
Speaker 1: seen dozens of bright eyed babies at the start of
Speaker 1: life and the old and frail who was soon to depart.
Speaker 1: Maybe they sensed in his bedside manner a contagious energy
Speaker 1: and enthusiasm for medicine. After driving taxis to pay his
Speaker 1: way through medical school. He had large bills and a
Speaker 1: meager salary, but he was doing what he loved. His
Speaker 1: colleagues had noted the positive feedback from his patients. Somewhere
Speaker 1: within the Queensland Health bureaucracy, a secret document headed review
Speaker 1: of emergency services Sunshine Coast Health Service District flagged potential
Speaker 1: dangers at Caloundra Hospital. The review had been compiled by
Speaker 1: a small team of experts who had been investigating the resources,
Speaker 1: safety and performance of emergency departments along the coastal Strip.
Speaker 1: It was conducted on a confidential basis. Its author, doctor
Speaker 1: William Rodgers, found that the Caloundra Emergency department needed a
Speaker 1: minimum of four principal house officers. A principal house officer
Speaker 1: is a doctor in a third year of practical experience postgraduate. Further,
Speaker 1: their responsibility should not be stretched to looking after inpatients
Speaker 1: as well as those coming into the emergency department during
Speaker 1: normal working hours. Doctor Donovan, who knew nothing of the
Speaker 1: three month old report and its unheeded recommendations, was two
Speaker 1: years away from being made a principal house officer. When
Speaker 1: he began his faithful shift in early January, he had
Speaker 1: responsibility for the entire hospital. The nurses in the emergency department,
Speaker 1: Beverly Duncan and Diane Forbes, who had come on duty
Speaker 1: at ten forty five pm, were taking a break after
Speaker 1: a busy few hours. The patients were presenting with relatively
Speaker 1: minor ailments, and certainly none with emergencies. Most simply sought
Speaker 1: free treatment. Uniquely, with beds in short supply and resources
Speaker 1: strictly limited, the hospital also had a bizarre practice. It
Speaker 1: did not admit children. Chapter three We Need Help January
Speaker 1: two thousand and two. Elise was talking a little as
Speaker 1: Lorraine held an ice pack to her head. Around three am.
Speaker 1: She became agitated, flailing her arms and crying out with
Speaker 1: the pain. Laura and Michael, who had woken in the
Speaker 1: frantic commotion after the fall, looked on helplessly. Elise vomited.
Speaker 1: It was the last sign Jared needed. He knew then
Speaker 1: that she had to go to hospital urgently and would
Speaker 1: probably need a CTE or computerized tomography scan with detailed
Speaker 1: two dimensional computer enhanced X ray images. A ct scan
Speaker 1: could highlight any abnormalities such as bleeding in Elisa's brain
Speaker 1: or a fracture in her skull. He was about to
Speaker 1: tell the Rain of his decision. She beat him to
Speaker 1: it as a least moaned and complained about the yucky
Speaker 1: taste of vomit in her mouth.
Speaker 4: Right, we're going to the hospital now.
Speaker 1: Lorrain was emphatic as she cleaned Elisa's face and clothes
Speaker 1: and quickly got changed. Jered's appearance of calm had dissolved.
Speaker 1: Now he too was shaking. The fear was sensed by
Speaker 1: Laura and Michael, who huddled together on the trundle bed.
Speaker 1: They were frightened for release and worried about being in
Speaker 1: the unfamiliar unit alone. Jane cradled Elise in the back
Speaker 1: seat of the car as her head rested on a
Speaker 1: pillow that had been snatched up on the way out,
Speaker 1: Jared drove to the nearby Clownd Republic Hospital in West Terrace,
Speaker 1: but later would not even remember the route he took.
Speaker 1: He jabbed the illuminated night bell outside the emergency department
Speaker 1: until Beverly Duncan answered through the intercom and then opened
Speaker 1: the door. Jered quickly explained what had happened. A fall,
Speaker 1: a head striking a hard floor, ongoing pain, headache, vomiting.
Speaker 1: They were directed to a room in the emergency department,
Speaker 1: where Elise lay very quiet on the bed during a
Speaker 1: brief examination by Duncan, a United Kingdom trained nurse, who
Speaker 1: scrawled details on a clipboard and peered at the frightened
Speaker 1: child's pupils while shining a torch. Elisa's pulse rate measured
Speaker 1: fifty four a low reading. An oxymeter on her finger
Speaker 1: measured her oxygen saturation levels. As Duncan made small talk
Speaker 1: with Jared, he explained that he was a nonpracticing doctor,
Speaker 1: one of the sixty thousand staff of Queensland Health.
Speaker 2: They were colleagues.
Speaker 1: Duncan noted a child who was quietly spoken and unhappy.
Speaker 4: Where does it hurt? I'm aching all over, but many
Speaker 4: I've got a headache.
Speaker 1: Duncan found the aching all over answer strange. There was
Speaker 1: no obvious deformity to any limbs, no swelling, and no
Speaker 1: specific pain suggestive of a fracture. Lorraine was asked to
Speaker 1: leave the room to fill in forms at the front counter.
Speaker 2: I can hardly write as I'm shaking so.
Speaker 1: Much, Duncan, it seemed to Lorraine ignored her and walked away,
Speaker 1: leaving the distraught mother wondering what she had done to
Speaker 1: receive a cold reception. At three twenty five am with
Speaker 1: an injured child, Lorraine returned to the assessment room to
Speaker 1: remark to Jered the lack of empathy. She weighed their options.
Speaker 1: They were in an open, functioning emergency department staffed by
Speaker 1: health professionals. Complaining might be counterproductive. It could lead to
Speaker 1: a lease being ignored. The alternative of leaving to find
Speaker 1: other medical help seemed impossible, so they waited. Doctor Andrew
Speaker 1: Donovan was at a bench writing up his notes for
Speaker 1: another patient, a man in a wheelchair, When Duncan explained
Speaker 1: the basics a ten year old girl on holidays a
Speaker 1: fall from a top bunk, generalized aches and pains, vomiting,
Speaker 1: no loss of consciousness. In the central area of the
Speaker 1: emergency department, Nurse Duncan, doctor Donovan, and Nurse Diane Forbes
Speaker 1: discussed Elsa's vital signs. The chit chat seemed interminable to Lorraine,
Speaker 1: who was near breaking point. Sensing no urgency among the staff,
Speaker 1: she pleaded with Jared, who still felt guilty for keeping
Speaker 1: Elise in the Monterey unit for the first hour. She
Speaker 1: wanted Jared to beg for action. Jared directed a question
Speaker 1: to the nurse Forbes, who was sitting back at the
Speaker 1: nursing station.
Speaker 2: How long will the doctor be Please? Is anyone going
Speaker 2: to come and see my daughter? We are very worried.
Speaker 2: My wife is very concerned. Can you come now, at
Speaker 2: least for her sake?
Speaker 1: Nurse Forbes had heard the questions a thousand times before.
Speaker 1: Everyone wanted to be seen yesterday. It was as if
Speaker 1: nobody else mattered or even existed. The patients, emotional and
Speaker 1: sometimes abusive, had no idea how busy the staff were,
Speaker 1: and knew nothing about the pressures of competing priorities like paperwork. No,
Speaker 1: there was no point in arguing. Forbes nodded towards the
Speaker 1: bench where doctor Donovan was writing notes.
Speaker 4: He's just that will be with you. Shortly as the.
Speaker 1: Doctor walked into the assessment room, time was running out.
Speaker 2: For Elise.
Speaker 1: A drop or two of blood had already seeped into
Speaker 1: her left ear.
Speaker 2: The fall from the bunk.
Speaker 1: Had fractured Elisa's skull and damaged the middle meningeal artery
Speaker 1: in her brain. Without surgery to drain the blood, which
Speaker 1: might have been obvious during a thorough examination, the growing
Speaker 1: clot would force the soft tissue in Elisa's brain against
Speaker 1: the immovable bones in her skull. If left untreated, her
Speaker 1: brain could herniate, causing catastrophic injury. Chapter four, The Nursing Life.
Speaker 1: Tony Hoffmann went to the thesaurus just to be sure. Maverick.
Speaker 1: She liked the word, but as with many nicknames, it
Speaker 1: could be misconstrued. What else might it mean? Independent, nonconformist individual. Yes,
Speaker 1: Hoffman had to agree that she was something of a maverick.
Speaker 1: The nickname had been given to her in circumstances that
Speaker 1: were moderately controversial. As the senior nurse in charge of
Speaker 1: Bunderberg based hospitals combined intensive care and coronary care units.
Speaker 1: Since her arrival in two thousand, Hoffman made a strong
Speaker 1: case over unsafe hours being worked by her staff. Most
Speaker 1: of the fifteen nurses in the intensive care unit were exhausted.
Speaker 1: The fatigue, which stemmed from their early morning starts and
Speaker 1: late finishes, was affecting clinical care. A tired nurse could
Speaker 1: be dangerous, particularly in the ICU or intensive care unit,
Speaker 1: where the critically ill patients had the most tenuous hold
Speaker 1: on life. The nurses were not meant to leave the
Speaker 1: bedsides of patients being helped to breathe by ventilating equipment.
Speaker 1: It only took a short lapse in concentration or momentary
Speaker 1: inattention for a fatal mistake to be made. Without farsaw rancor,
Speaker 1: Hoffman had argued a case for more nurses and safer hours.
Speaker 1: Glennis Goodman, the director of nursing at the hospital, took
Speaker 1: Hoffman's submission to the next level. Eventually, the logic and
Speaker 1: common sense of the argument were accepted, more nurses were employed,
Speaker 1: the dangerous shifts were abolished. The patients in the ICU
Speaker 1: did not know that a fundamental change to the nursing
Speaker 1: roster gave them better odds of survival, but the staff knew.
Speaker 1: Hoffman won immediate and long lasting respect from the other
Speaker 1: nurses for her willingness to back them as as well
Speaker 1: as the patients. Tony Hoffman was a rarity, a middle
Speaker 1: manager prepared to raise her head above the parapet and
Speaker 1: speak out against convention and systems that had been imposed
Speaker 1: by her superiors and grudgingly accepted.
Speaker 2: By the staff.
Speaker 1: But in Queensland Health, an organization run down by political
Speaker 1: interference and financial neglect, Hoffman's style of robust, outspokenness was
Speaker 1: rarely rewarded. The mavericks who agitated for something outside the
Speaker 1: square were usually the first to be muzzled. Rebel, loner, misfit.
Speaker 1: Although it pained Hoffman to admit it, she probably was
Speaker 1: a loner, maybe even a misfit. She did not have
Speaker 1: a boyfriend, yet all her best friends were married. They
Speaker 1: spent every spare moment with their children, talking about their children,
Speaker 1: or planning events around their children. Her younger sister, Marie,
Speaker 1: was run off her feet with her two kids. At
Speaker 1: times when the demands of parenthood seemed limitless, Hoffman felt
Speaker 1: fortunate to have avoided those responsibilities. When the challenges in
Speaker 1: the ICU were unrelenting and the deadlines for her university
Speaker 1: assignments seemed impossible, she consoled herself that her life's journey
Speaker 1: was as it should be. At least she had her freedom.
Speaker 1: At least she had the time after work to devote
Speaker 1: to study, even if there were occasional bouts of loneliness. Still,
Speaker 1: pragmatism could not change the fact that Hoffman loved children
Speaker 1: and regretted not having her own. Although several of her
Speaker 1: long term boyfriends would have made her happy as partners
Speaker 1: for life, Hoffman had always hesitated when things became serious.
Speaker 1: Marriage frightened her it seemed like the end of the world.
Speaker 1: As a girl growing up in Ingleburn, southwest of Sydney,
Speaker 1: she had missed her father Warwick during his long road
Speaker 1: trips pulling freight in the truck owned by the family
Speaker 1: business W and M. Hoffman Transport. She was fifteen when
Speaker 1: her father decided to try his hand at growing potatoes, pumpkins,
Speaker 1: tomatoes and cabbages. Hoffman briefly resented him for taking the
Speaker 1: family from the outskirts of Sydney to a little community
Speaker 1: halfway between Brisbane and to Woomba, where almost everyone had
Speaker 1: unusual European surnames and spoke with a strange accent. On
Speaker 1: her first day at Lockyer Valley State high one of
Speaker 1: the students assumed she was a child of itinerant fruit pickers.
Speaker 1: Will you be staying just a little while, he asked
Speaker 1: the newcomer, I hope so. Tony sniffed, and the class bood.
Speaker 1: Her first instinct had always been to speak her moutherd rebel,
Speaker 1: renegade dissident. Over time, the open spaces, summer days spent
Speaker 1: swimming in the local water holes and camping with her
Speaker 1: new boyfriend made her grateful for the move away from Sydney.
Speaker 1: At the end of year twelve, she chose nursing. It
Speaker 1: offered accommodation, study and a salary. Having been accepted by
Speaker 1: the three major public hospitals in Brisbane, she opted for
Speaker 1: the Princess Alexandra Hospital. Hoffman hated nursing as a young woman.
Speaker 1: She missed her animals, her younger brothers Andrew and Matthew,
Speaker 1: and her baby's sister Marie. In the first six months,
Speaker 1: she thought she had experienced the worst things a nurse
Speaker 1: might be expected to do, everything from changing the dressings
Speaker 1: on severed limbs to helping pack a deep abdominal wound
Speaker 1: in which the intestines could be seen glistening. She received
Speaker 1: another surprise when one of the nurse educators stood up
Speaker 1: up and asked the class how do you wipe a
Speaker 1: patient's bottom. At the time, Hoffman knew little about what
Speaker 1: she was letting herself in for. After three years of
Speaker 1: work and study, she traveled overseas for three months and
Speaker 1: then returned to nurse in Tasmania. By nineteen eighty one,
Speaker 1: she had gone back to the United Kingdom to do
Speaker 1: Midwiffrey at Taunton in Somerset. While she was there, Hoffman
Speaker 1: was woken by the telephone at five seventeen am one day.
Speaker 1: She snuggled deeper under the copboards, hoping the telephone was
Speaker 1: ringing for one of the other nurses who shared the
Speaker 1: hospital's accommodation. A short while later, someone was turning the
Speaker 1: handle on her door. You need to ring home, the
Speaker 1: supervisor told her in a grave tone. Tony's mother, Mari,
Speaker 1: answered the telephone at the family.
Speaker 5: Farm andrew Stead.
Speaker 6: He had a motorbuk accident.
Speaker 1: Tony's younger brother had been visiting wineries near Stanthorpe with
Speaker 1: friends when he struck a powerpole while rounding a corner.
Speaker 1: He had suffered a major chest wound and died at
Speaker 1: the scene. Partly as a result of the accident, Hoffman
Speaker 1: realized that she wanted to specialize in intensive care. Although
Speaker 1: the patients wheeled into the ICU were often near death,
Speaker 1: they had at least been stabilized, unlike in the emergency department,
Speaker 1: where the doctors and nurses struggled with drugs and electric
Speaker 1: paddles to maintain life. The prognosis of patients in the
Speaker 1: ICU could be more accurately predicted. There was relative calm
Speaker 1: in the ICU, which was necessarily staffed by the best
Speaker 1: doctors and visited regularly by specialists. Hoffman took great satisfaction
Speaker 1: in standing beside patients as they stared death in the face,
Speaker 1: then seeing them return to their families. She obtained her
Speaker 1: first qualification in intensive care at King's College Hospital in
Speaker 1: London and went on to work in the intensive care
Speaker 1: wards at the Harley Street Clinic in London. Later she
Speaker 1: was to work at Tasmania's Lonceston General Hospital. Wanderlust took
Speaker 1: her to read in Saudi Arabia, where she was a
Speaker 1: senior nurse for six years. The children in the pediatric
Speaker 1: wards quickened the ticking of her biological clock. She was
Speaker 1: thirty and in a secret relationship with a Saudi man.
Speaker 1: If ever, she was going to surprise her family and
Speaker 1: friends by marrying.
Speaker 2: It was then.
Speaker 1: When Hoffman returned alone again from Saudi Arabia after the
Speaker 1: First Gulf War. She settled in Caloundra, a relaxed beachside
Speaker 1: town on the Sunshine Coast. She threw herself into her
Speaker 1: studies by correspondents, working towards gaining qualifications as a Bachelor
Speaker 1: of Nursing from Monash University. By the middle of two thousand,
Speaker 1: when she pipped one other singer nurse on the short
Speaker 1: list to win the job as nurse manager of the
Speaker 1: ICU at Bunderberg Base Hospital, Hoffman had found a substitute
Speaker 1: for children and married life. Happily, Hoffman had moved north
Speaker 1: to the sugartown of Bunderberg. It was home now. She
Speaker 1: spent most nights and weekends in her rented cottage in
Speaker 1: Grimsted Street, surrounded by textbooks, and determined to graduate from
Speaker 1: Monash University with the Masters in Bioethics, She decided that
Speaker 1: her thesis would examine how health professionals involved in treating
Speaker 1: critically ill patients were subjective in determining quality of life.
Speaker 1: In Hoffman's experience as a nurse, perceptions about quality of
Speaker 1: life too often depended on the individual values of the carers,
Speaker 1: the doctors and the nurses instead of the patient. She
Speaker 1: believed that a young and fit doctor who ran marathons
Speaker 1: would be less likely to appreciate how an elderly cripple
Speaker 1: might have an acceptable quality of life merely watching grandchildren
Speaker 1: run around the yard. Tony Hoffman decided that decisions about
Speaker 1: quality of life were best left to the patients and
Speaker 1: their next of kin. She enjoyed excellent working relationships with
Speaker 1: the doctors, but she hated it when they justified poor
Speaker 1: care leading to death as a path to a better outcome.
Speaker 1: How would they know, she asked. As far as Hoffman
Speaker 1: was concerned, every life was precious, no matter how poorly
Speaker 1: compromised the patient's health. She believed that the best possible
Speaker 1: care should be provided until the patient drew a final breath.
Speaker 1: The hospital on Bourbon Street beside the Burnette River had
Speaker 1: seen backward when she first arrived, and in many ways
Speaker 1: it was. The medical staff was largely made up of
Speaker 1: overseas trained doctors, some of whom could barely be understood
Speaker 1: because of their broad accents or their inadequate command of English.
Speaker 1: The district manager, Peter Leck, had no clinical qualifications, but
Speaker 1: he knew the key to success for him was staying
Speaker 1: within budget. The strict financial parameters were well understood by
Speaker 1: administrators who were remote from the patients. The easiest way
Speaker 1: to deal with a problem was to dismiss it with
Speaker 1: the excuse that there was no money to fix it.
Speaker 1: Lek's job was not necessarily a job for life. A
Speaker 1: budgetary blowout or a failure to get on top of
Speaker 1: these surgery waiting lists could mean the sack. On the
Speaker 1: other hand, the doctors and nurses were united in the
Speaker 1: belief that public hospitals were for the sick and injured.
Speaker 1: The unforgiving economic rationalism of Premier Peter Beat's Labour government
Speaker 1: Health Minister Wendy Edmond and her top bureaucrats in Queensland
Speaker 1: Health Headquarters in Brisbane was distressing. Staff who for years
Speaker 1: had been dedicated to the public system were giving up,
Speaker 1: preferring to work in the better funded private sector. As
Speaker 1: more and more demoralized clinicians quit, those left behind were
Speaker 1: increasingly pressured by administrators. The hospitals were infused with business strategies,
Speaker 1: where once the medical superintendent concentrated on patient outcomes, the
Speaker 1: new priority was cutting costs and increasing potential revenues. Nowhere
Speaker 1: was this more obvious than at Bunderberg Base Hospital. In
Speaker 1: the months leading up to the arrival of doctor j
Speaker 1: NT Patel. The administrators were measuring performance not by lives saved,
Speaker 1: but by dollars saved. The hospital had become a lean,
Speaker 1: mean business.
Speaker 2: Chapter five grimm.
Speaker 1: In January two thousand and two, before doctor Charles Nankeovell
Speaker 1: walked away for the last time from the Bunderberg Hospital
Speaker 1: on Boorbon Street, he hoped that the crisis in healthcare
Speaker 1: he was witnessing and repeatedly warning his managers about might
Speaker 1: still be corrected if the administrators who controlled budgets and
Speaker 1: human resources truly valued their highly skilled and passionate director
Speaker 1: of surgery. Now was the time to show it to him.
Speaker 1: He hoped someone from head office would ring and say,
Speaker 1: we hear your leaving. We're sad about that. Would you
Speaker 1: like to talk to us? Nobody called. Nankeavell had been
Speaker 1: pushed to the brink of a physical and nervous breakdown.
Speaker 1: Despite the excessive hours he had been working, the patients
Speaker 1: were suffering. They were waiting too long for surgery. Nankavell
Speaker 1: was regularly spending fourteen hours a day at the hospital,
Speaker 1: then being woken at home and asked to come in
Speaker 1: for a critical case or unexpected emergency. The weekends offered
Speaker 1: no relief. Nankeavell had to work most Saturdays and Sundays
Speaker 1: as one of two hospital surgeons serving a growing and
Speaker 1: aging population of almost eighty thousand people, most of whom
Speaker 1: were not privately insured. Nankavell needed urgent backup. He had
Speaker 1: pleaded his case with everyone from his district manager Peter Leck,
Speaker 1: to the head of Queensland Health, doctor Rob Stable. Nankeavell
Speaker 1: wrote to Doctor Stable in a confidential MIMO in late
Speaker 1: two thousand and won.
Speaker 3: I had my resignation letter ready one year ago. As
Speaker 3: it turned out, the same day I signed my resignation,
Speaker 3: Dr Anderson was stood down so was not handed in.
Speaker 3: I stayed on in Bunderberg an extra twelve months to
Speaker 3: try to help the patients here and with hope that
Speaker 3: things might improve. I suffered enormous physical and mental exhaustion
Speaker 3: and was operating on patients when I was totally unfit.
Speaker 3: I will not allow any other person to go through this.
Speaker 3: This very ugly episode is well known throughout Queensland and
Speaker 3: it's a big turn off for surgeons thinking of coming
Speaker 3: to Bunderberg. Our clinicians meetings with Queensland Health have identified
Speaker 3: the problems with the Department of Surgery as the number
Speaker 3: one problem affecting the Bunderberg Base Hospital. For several years,
Speaker 3: there's been no effective response to our concerns this is
Speaker 3: flabbergast of the staff. We seem to have no effective
Speaker 3: communication with Queensland Health. Clearly identified issues are not addressed
Speaker 3: and we don't seem to get appropriate feedback on why not.
Speaker 1: Nankevell warned of numerous examples of unnecessarily delayed diagnoses of cancer,
Speaker 1: massively overbooked clinics, an emergency department in a shambles, and
Speaker 1: an inability to meet guidelines for the surgical waiting lists,
Speaker 1: but his MIMO was to no avail. Instead, his letters
Speaker 1: and telephone calls branded Nankevell as a complaining clinician. There
Speaker 1: was no extra funding because nobody was prepared to insist
Speaker 1: that extra funds be provided. Nankeavell was livid. Whenever the
Speaker 1: quality assurance data arrived from the statisticians in the administration.
Speaker 1: They would dwell on statistics showing, for example, that his
Speaker 1: patients stayed an average of four point three days, when
Speaker 1: in Brisbane the average was slightly less. Constant pressure was
Speaker 1: exerted to move the patients through faster. Time is money,
Speaker 1: but Nanko Bell's priority was to make his patients better.
Speaker 1: If that meant a longer stay, so be it. He
Speaker 1: should not have been surprised by his failure to achieve change.
Speaker 1: The culture of Queensland Health was being distorted by a
Speaker 1: management model that described the patients as clients. It was
Speaker 1: a culture which nurtured the creation of committees. Rarely was
Speaker 1: anything resolved. Decisive action on even minor matters was frowned upon.
Speaker 1: Clinicians were expected to prepare a submission or a business case.
Speaker 1: The pointlessness of it all infuriated Nanka Bell. After careful consideration,
Speaker 1: he eventually decided not to follow through with a plan
Speaker 1: to tell all to the local newspaper, the Bunderberg Newsmail.
Speaker 3: If I tell the truth to the media, I get sacked.
Speaker 3: But if people in administration spin doctor the media, they
Speaker 3: get promoted.
Speaker 1: Kevell had examined Queensland Health's Code of Conduct. In one part,
Speaker 1: it states.
Speaker 7: All employees are reminded that irresponsible discussion of any matters
Speaker 7: regarding the health service, facilities, staff, and most importantly, patients
Speaker 7: is regarded as an offense.
Speaker 1: Nankevell regarded that statement as a gag. He dubbed the
Speaker 1: Code of conduct the Code of Silence. Doctor John Youngman,
Speaker 1: the second most senior administrator in the Queensland Health Organization,
Speaker 1: responded to Nankeavell's and Bunderberg's crisis with a brief letter
Speaker 1: which made scant mention of the unsafe working practices that
Speaker 1: Nankeovell suspected would kill either him or a patient. When
Speaker 1: he received doctor Youngman's letter, doctor Nankevell decided the hospital
Speaker 1: was a lost cause.
Speaker 3: That's it. I'm finished, I'm out of here.
Speaker 1: His immediate predecessor, doctor Peter Anderson, had suffered a worse
Speaker 1: fate for being outspoken about life threatening problems. Anderson and
Speaker 1: the director of medical services, vascular surgeon doctor Brian Thiel,
Speaker 1: had built up a strong surgery department. Thel hadn almost
Speaker 1: magical touch. Even after major operations. His patients were always
Speaker 1: in relatively great shape when taken from a theater to
Speaker 1: the ICU. Tony Hoffman marveled at their robust condition, but
Speaker 1: the constant struggle against an administration they regarded as closed
Speaker 1: and secretive eventually wore both specialists down. They abandoned the hospital.
Speaker 1: When Anderson went public in the Bunderberg News Mail to
Speaker 1: warn of the dangers posed by exhausted surgeons, he was
Speaker 1: subjected to a scathing attack by Health Minister Wendy Edmund
Speaker 1: in state parliament.
Speaker 8: I can understand doctor Anderson's need to constantly criticize the
Speaker 8: Bunderberg Hospital administration since they are the ones who exp
Speaker 8: bosed his double dipping into service to the public patients
Speaker 8: whom he was employed to care for.
Speaker 1: It was a typical Queensland Health ploy discredit the whistleblower
Speaker 1: by raising untested claims, then create a diversion from the
Speaker 1: fundamental problems plaguing the system, and make sure other staff
Speaker 1: who might have been thinking of going public no they
Speaker 1: will face public censure. After the departures of doctor Anderson
Speaker 1: and doctor Nankervell, a new Director of Surgery came to
Speaker 1: the job, doctor Sam Baker. He too tried to ensure
Speaker 1: management understood how dangerous the hospital had become because of
Speaker 1: its focus on the bottom line instead of outcomes for patients.
Speaker 1: In an internal assessment memo, Dr Baker was very candid.
Speaker 5: There is little direction for management with regards to strategic direction.
Speaker 5: They refused to clearly define the hospital's operational role and
Speaker 5: delivery of services and the critical massive medical staff required
Speaker 5: to meet this role. They appear more interested in making
Speaker 5: targets than delivery of quality healthcare.
Speaker 1: Doctor Chris Jelloff an anesthetist at the hospital, was deeply
Speaker 1: concerned for the well being of the staff and the patients.
Speaker 1: He had seen Nankervell deteriorate to the point where he
Speaker 1: looked like a beaten man, broken by the punishing hours
Speaker 1: he had to work. Doctor Jelloff was also in a
Speaker 1: bad way due to the demands. He was sure that
Speaker 1: his own decision making processes were impaired. He could not
Speaker 1: sleep despite being exhausted. His appetite had waned, but the
Speaker 1: hospital's waiting lists for surgery were lengthening and management had
Speaker 1: little interest in excuses. Doctor Jelloff decided over Easter two
Speaker 1: thousand and two that his fatigue and the lack of
Speaker 1: staff made it unsafe to continue operating and anesthetizing. He
Speaker 1: canceled any surgery that could safely wait for a couple
Speaker 1: of days. He was told to come to Peter Lex office.
Speaker 1: Peter Leck, who had the anesthetus' personal file on his desk,
Speaker 1: began the conversation with an unusual.
Speaker 5: Question, Chris, just by the way, remind me of your
Speaker 5: visa status as.
Speaker 1: A United Kingdom trained doctor. Doctor Jeloff's visa to live
Speaker 1: in Australia was tied to his contract as an overseas
Speaker 1: trained doctor, Queensland Health had special leverage over the imports.
Speaker 1: They were also cheaper to employ. Jeloff felt threatened by
Speaker 1: the district manager. He was certain Lek had asked the
Speaker 1: odd question at the start of a meeting about the
Speaker 1: cancelations of surgery to warn Jelof that his livelihood and
Speaker 1: aspirations to live in Australia were now on the line.
Speaker 1: Under different circumstances, Jeloff might have felt bound to go
Speaker 1: back to theater notwithstanding his exhaustion, But as he had
Speaker 1: recently married his Australian girlfriend, a fact Lek was not
Speaker 1: aware of. Doctor Jeloff no longer relied on Queensland Health
Speaker 1: as a visa sponsor. He left the meeting and he
Speaker 1: told doctor Baker about how Lek had tried to intimidate him.
Speaker 5: Jesus Christ, that's a bit rough.
Speaker 1: Baker was surprised. Jelloff could not stomach it for much longer.
Speaker 1: He quit in late two thousand and two after repeated
Speaker 1: but unheeded pleas to management for help. Dr Baker too
Speaker 1: decided the hospital was unsalvageable. He moved on in November
Speaker 1: two thousand and two. On thirteen February two thousand and three,
Speaker 1: some six weeks before doctor Jay Patel would arrive from
Speaker 1: the United States to fill the newly vacated Director of
Speaker 1: Surgery position at Bunderberg Base Hospital, seven specialist surgeons on
Speaker 1: the local Medical Advisory Committee wrote a MIMO.
Speaker 2: The MIMO was condemnatory.
Speaker 7: It raised the dictatorial, unresponsive, myopic, and inflexible approach of
Speaker 7: management who have little regard or respect for specialists, their
Speaker 7: needs or aspirations.
Speaker 1: Chapter six, My Brilliant Career, Portland, Oregon, United States, January
Speaker 1: two thousand and two. As thick snow blanketed the wide
Speaker 1: lawn fronting his two story house in Beaverton, a suburb
Speaker 1: of professionals and middle class millionaires on the edge of Portland,
Speaker 1: doctor jarnt Nukandre Patel, aged fifty one and newly unemployed,
Speaker 1: reflected on his troubled past. It never snowed in Jamnagar.
Speaker 1: When the heavens above the dusty, overcrowded city in the
Speaker 1: far west of India's Gooja Province brought the seasonal monsoon rains,
Speaker 1: impoverished farmers celebrated their good fortune. There would be another
Speaker 1: harvest food for the family and the prospect of money
Speaker 1: from the maize to buy essentials for the next crop.
Speaker 1: Too much rain and there would be floods, death and
Speaker 1: destruction on a massive scale. Hundreds, sometimes thousands of lives
Speaker 1: would be swept away with the flimsy homes and ragged
Speaker 1: belongings of the province's poorest wretches. Their misery would feature
Speaker 1: prominently in the local media for a few days. Loved
Speaker 1: ones would mourn. There would be renewed calls from ambitious
Speaker 1: legislators and community leaders for an inquiry into lacks building standards.
Speaker 1: Somebody might flag a new approach to shanty housing to
Speaker 1: keep the most disadvantaged out of harm's way, but ultimately
Speaker 1: nothing would change. It just made everyone feel a little
Speaker 1: better in the teeth of tragedy before moving on. This
Speaker 1: was their fate. Not only did Jamnagar never see snow,
Speaker 1: its doctors, some of the most privileged and respected citizens
Speaker 1: in the province, were never subject to the same accountability
Speaker 1: as the Hoi peloi. Doctor Patel sometimes wondered whether he
Speaker 1: would not have been better off had he stayed in
Speaker 1: his homeland. His superior family name, caste, academic excellence and
Speaker 1: status as a specialist surgeon meant something among his own people. There,
Speaker 1: colleagues at the MP Shah Medical College and Guru Govin
Speaker 1: Singh Hospital had never dared question his judgment or aptitude
Speaker 1: with a scalpel. The patients did not complain. Deaths and
Speaker 1: injuries were an inevitable consequence for the patients of every
Speaker 1: hard working surgeon. What part of this unquestionable logic did
Speaker 1: the American regulators of medicine and surgery not understand? The
Speaker 1: latest gratuitous insult had cut doctor Patel deeply. He knew
Speaker 1: it must have been a source of gossip among his
Speaker 1: friends and colleagues in the medical community. At least the
Speaker 1: Little Bme Report, published twice a year by the Oregon
Speaker 1: Board of Medical Examiners for the benefit or in doctor
Speaker 1: Patel's case, public shaming of registered and paid up practitioners,
Speaker 1: would not be read in Jamnagar, where he was still
Speaker 1: hailed as a genius.
Speaker 9: Statement of purpose. The Board of Medical Examiner's Report is
Speaker 9: published to help promote medical excellence by providing current information
Speaker 9: about laws and issues affecting medical licensure and practice in Oregon.
Speaker 1: Doctor Philip F. Parsley had written the lead article.
Speaker 9: Headlined responsibility rests with surgeon.
Speaker 2: It sounded ominous.
Speaker 9: In medicine, the physician is captain of the ship, and
Speaker 9: the Board of Medical Examiners takes a strong position that
Speaker 9: doctors are responsible for the patients under their care, whether
Speaker 9: that care is rendered directly or delegated to others.
Speaker 2: There was another heading, board Actions.
Speaker 1: The first column contained six names. There he was the
Speaker 1: third name down. Nobody could have missed the dishonorable mention
Speaker 1: of Jamdagar's finest in the Professional Journal of the Medical
Speaker 1: Regulatory Body of.
Speaker 9: Oregon, Patel Gyant m Mdeine one, Portland, Oregon.
Speaker 1: The entry disclosed an active order of vilifying and unambiguous
Speaker 1: text made by the Board of Medical Examiners in the
Speaker 1: late two thousand forbidding doctor Patel from performing a wide
Speaker 1: range of surgery. It could have been much worse, though,
Speaker 1: A dreadful toll of death and permanent life shortening injuries
Speaker 1: suffered by patients of Patel in the years since he
Speaker 1: began practicing in Portland in nineteen eighty nine when unreported
Speaker 1: by the newsletter, but the carnage had been noted in small,
Speaker 1: disparate parts elsewhere. There were the findings of a confidential
Speaker 1: internal audit of the outcomes from surgery of seventy nine
Speaker 1: of doctor Petel's patients. There were the subsequent investigative files
Speaker 1: of the Board of Medical Examiners. There were the legal
Speaker 1: depositions of the walking wounded, whose financial settlements gave doctor
Speaker 1: Pateel the dubious distinction of being the most successfully sued
Speaker 1: physician of his employer, the huge Kaiser Permanente Healthcare Group.
Speaker 1: And there were his colleagues who had expressed alarm at
Speaker 1: the lethal repercussions of his work. Impossibly complex procedures that
Speaker 1: should never have been attempted had led to patients like
Speaker 1: Marie Messcha, a retired restaurant owner with pancreatic cancer, dying unnecessarily.
Speaker 1: Patel had cut a critical vein and artery while trying
Speaker 1: to reach her tumor, causing massive blood loss. Messecha needed
Speaker 1: transfusions of more than three times her body's volume of
Speaker 1: blood as other doctors tried desperately to save her life.
Speaker 1: Her blood, the post mortem report said, was pulling off
Speaker 1: the bed and onto the floor before she died that afternoon. Later,
Speaker 1: when her daughter, Sandra Ickott, asked Kaiser Permanente staff about
Speaker 1: Patel's competence. She was reassured that he was an outstanding
Speaker 1: specialist doctor. Patel knew his surgical career in the United
Speaker 1: States was finished when the BME report published a clue
Speaker 1: to the truth about his surgery. In the months that followed,
Speaker 1: he came under mounting pressure to resign from Kaiser Permanente
Speaker 1: to avoid further humiliation and dismissal Jamnagar's most arrogant medical export,
Speaker 1: resolved to take his talents to a fresh pool of
Speaker 1: admiring peers wherever they might be. He regarded himself as
Speaker 1: a stellar surgeon who had been grievously wronged. Before the
Speaker 1: snow melted outside his Beaverton mansion, he began using the
Speaker 1: Internet to look for opportunities abroad. The huge international demand
Speaker 1: for experienced doctors had spawned dozens of recruitment companies with
Speaker 1: sophisticated web based forums, search fields, and even online application forms.
Speaker 1: It costs Petel nothing to start sowing the seeds for
Speaker 1: a new start in a country which knew nothing of
Speaker 1: his background. Patel read again the testimonials of some of
Speaker 1: his former colleagues mentors like Kaiser Permanente, chief of Surgery
Speaker 1: then retired Edward A.
Speaker 2: Aarronilo.
Speaker 6: I feel that wherever he works, or whomever he works for,
Speaker 6: will be the beneficiary of his excellent skills and knowledge,
Speaker 6: and will be all the better for it. He will
Speaker 6: be an asset to any group, hospital or organization.
Speaker 1: Patel particularly like that last line. He could not have
Speaker 1: put it more succinctly himself. Sick to Death is written
Speaker 1: and presented by me Hedley Thomas, the Australian's national Chief correspondent.
Speaker 1: Claire Harvey is The Australian's editorial director. Audio editing, production
Speaker 1: and music have been done by Jasper Leik, with assistance
Speaker 1: from Leah Sammage and Neil Sutherland. Our producer is Christen Amias.
Speaker 1: Production management by Stephanie Coombs, artwork by Sean Callenan. Thanks
Speaker 1: to Ryan Osland, Matthew Connan, Karina Berger, Ellie Dudley, David Murray,
Speaker 1: Dominique McDermott, Zach Sculander and all our family, friends and
Speaker 1: colleagues who helped in this series and contributed voice acting
Speaker 1: and special thanks to Tony Hoffman.
Speaker 2: And Rob Messenger.
Speaker 1: Subscribers to The Australian Here New episodes of Sick to
Speaker 1: Death first at Sick to deathpodcast dot com and on
Speaker 1: Apple Podcasts. You can get exclusive access to photographs, videos, timelines,
Speaker 1: and more at the website