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Katie I'm Katie Page, CEO of Harvey Norman. Since 2018, Harvey Norman has been a key partner in the Australians investigative podcasts such as Sick to Bronwyn, Shandy's Story, the Teacher's Pet and the Night Driver. Harvey Norman are proud sponsors of the Australians Podcast investigations and their award winning journalism. My name is Headley Thomas. Sick to Death is based on my book of the same name and it's the true story of Dr. Jayant Patel's lies and manipulation and the herculean effort it took to finally stop him. We've used voice actors throughout this series and on occasion the real people from this story have read their words for us. It is brought to you by me and the Australian. Chapter 60 ego analysis 13 to 20 June 2005 the journey from Brisbane to Jayant Patel's hometown took us through Mumbai, Ahmedabad and on a five hour bone rattling ride through Gujarat province to the town of Jamnagar, our friend and escort, Rahul Bedi decided he knew just where he would go if he were in Jayan Patel's shoes. We were crossing the southwest corner of a country where as many as 300 million people earned a dollar a day. In India, medical treatment is largely for the wealthy and doctors, and even those who should not have been trusted with a pocket knife, are revered. Unquestioningly, Rahul decided that if Patel felt threatened, he would return to Jamnagar, where he grew up and enjoyed an education and where his family retained strong caste ties. Patel could even start a clinic to complement the hospital where he first performed surgery. His troubles in the US and Australia would be of little consequence in India, according to my friend, because life is very cheap here, he explained. It's not such a big deal. We left Ahmedabad at dawn and were in Jamnagar by noon. India's poverty made it difficult to put the Patel scandal into perspective. My first world standards and values worked well in Australia. These same standards and values could not withstand the sight and smell of needy children in rags lying with their parents in the dust and rubbish beside the road as we sped past in an air conditioned four wheel drive emblazoned with the insignia of one of Gujarat's most luxurious hotels, the Taj. Our room rate of $170 a night plus taxes would have taken a low caste Gujarati labourer half a year of backbreaking toil to earn. At dusk in Jamnagar, the potholed road to the Guru Govind Singh Hospital heaved with a chaotic jumble of cars, trucks, motorcycles and cabs weaving noisy paths around street urchins and pedestrians alike. By nightfall, casualties from several accidents had been dropped at the hospital for patching up. Some, like the man we saw wheeled out of the surgery ward on a decrepit trolley at sundown would not survive. The equipment in the surgery ward looked decades old. If a hammer and anvil had been in one of the cupboards I would not have been surprised. There was no air conditioning to offer relief from the near 40 degrees Celsius summer heat wave. No electronic life saving devices monitored the vital signs of patients fallen on hard times. With five failing health the ward was quiet apart from the swishing of overhead fans. I spoke to Dr. Mansorali Mamdani during a tour. Dr. Patel was a resident here with me. We worked together in these wards. We did general surgery including neck, abdomen, hernia, breast lump and thyroid. Many times he operated and I assisted or he assisted me. An old hand painted sign above the dusty entrance to the adjoining MP Shah Medical College, the teaching showpiece for every privileged Gujarati wanting to study to be a doctor implores students to leave their arrogance behind. The sign says Be teachable. Always assume that there is vital information you still need to learn. Little had changed at the college whose graduates three decades ago still remembered their confident classmate Patel. His regular visits back to Jamnagar from the US and Australia were always warmly received. But now the most illustrious export of the city of 500,000 people had become the most disgraced. Dr. Mamdani walked me into the college's student branch to seek old files proving Patel's original enrolment and grant grades for those who knew him as a medical student and then a resident doctor in Jamnagar and who stayed in touch during his career as a surgeon in the U.S. there was a shared view. The doctors I spoke to agreed that Patel had abnormal self belief. He never accepted he was wrong. Dr. Mamdani described this personality trait as the key to understanding Patel's downfall. Patel, whose deception and pride meant nobody in Jamnagar knew of the bans and disciplinary action against him in the US was always dangerously confident in his own abilities. Dr. Mamdani told me he saw no need for consultation. Colleagues with alternative solutions to surgical or medical questions were deficient. He had a very different type of personality. He is arrogant. He thinks that whatever he says is the word of God. He doesn't like to hear anyone's challenge. He is very intelligent but he is autocratic. He feels he is the superior doctor and he knows everything and that there is no need for him to have any supervision. He would not like to consult he was final. He was never prepared to accept whatever he has done wrong. Suppose he was having a discussion about surgery and there were questions about his responses. His answer was always no. Whatever I say is true. Then he would refuse to discuss it. We saw this in a teaching program. Whatever answer he gave, he said was always right. That is the root cause. I think the autocratic personality will ruin your life. This trouble he is facing now will is the result. He could have found peace doing something else. But Jayant Patel would never believe that such things should happen to him. I am not against him. He has done nothing wrong to me. His wife Kishore and my wife are closely associated. We've had many family dinners. The medical negligence he can fight. This is a professional thing. And we say to him, we can help you. But as far as the other things are concerned with the fraud and misrepresentation. This is not something we can help with. He will have to face the consequences. As we chatted, a small group of medical students gathered around Mamdani, the associate professor of the college. For a decade. He patiently explained the reason for our presence. During a meeting with Dr. Subhash Patel in his nearby gastroenterology clinic. I understood the disappointment so keenly felt by Jayant's closest Jamnagar friends. They are not related, but Subhash and Patel were childhood playmates, college classmates and professional colleagues. In the years since Patel had emigrated to the United States, they remained friends. Subhash had fretted every day for weeks about whether to pick up the telephone to offer support. He always decided against it. Patel was not someone who could take the call in the spirit in which it was intended. Subhash decided that Patel would regard it as offensive or in bad taste. He has always been like that. He has never liked anything negative said about himself. He is very strong willed and ambitious. He has always been very sure about himself. All of us are very worried about him. But we do not want to hurt his feelings. He has been branded Dr. Death. His career is doomed. It is something very tragic for someone who has had such an illustrious medical career. Until Patel left the antiquated and cash starved Guru Govind Singh Hospital to make his fortune and improve his qualifications in the US he and Subhash had something else in common. They grew up together as the privileged progeny of well off families. In the campus cafe, the manager Vinu Bai recalled Patel as a son of royalty and indeed Jahan Patel's grandfather. A former Deputy Chief minister of Gujarat state during the pre independence era of fellow Gujarati Mahatma Gandhi was once treated like royalty. The prominent politician's son became a successful and influential oil mill businessman. Jayant's father trusted one doctor in Jamnagar to look after his health. The father of Dr. Subhash Patel. The bonds, loyalties and recognition of clan and caste are far reaching particularly among Patels in this trader's town with its strategic military interest near the Pakistan border. Whenever Patel visited Jamnagar, he would make a point of meeting Subhash who told me he came from Australia one time and said he was commissioned by the US Government and an institute in Australia to set up a surgical facility. He took it as a challenge. That's what he told me. I'm now learning of matters that I did not know about before. We knew nothing about his Oregon and New York history. He would come to visit me here and said nothing of his trouble. But on the Internet now there are 1500 references to him. We can only hope that some good comes of all this. If only that doctors will think twice before indulging in such things in future. Patel's old mentor and teacher, Dr. Rudresh Mehta, now retired led me to the roof garden above his flat. There was still no sign of the monsoon rains needed to rejuvenate the land and ensure a harvest to ward off famine. Metta looked crestfallen. He had regarded Patel as almost infallible a most brilliant product of the MP Shah Medical College to which Mehta had devoted most of his working life. Indeed, Metta had taken credit for Patel's apparent success. His wife was also fond of Patel's wife Kishore a junior gynecologist at a Jamnagar private hospital before the move to the United States. A fortnight before our visit, Patel had telephoned Meta. I said to him, what is all this? I asked him, where are you? I told him that people are looking for him. That's what the TV says. Mette listened incredulously as his former student made light of the problems. Patel insisted to his old teacher that he had done nothing wrong. It was a misunderstanding, he said. It's nothing that serious. He said a surgeon never operates to kill and cancer patients can die. He was upset in the beginning, but I found him very calm and composed. It was a serious talk. He said he was waiting for Australia's moments. For 50 years we've been giving excellent teachers to the US I feel very bad. What is the real story? Will we ever know? He could have talked to me earlier. Unless one recognizes his own mistakes, one never improves. Some of the other doctors we interviewed in Jamnagar suggested that Metta's overt favouritism of Patel as a student had unhealthily fed the understudies ego. Down a rubble and rubbish strewn alley close to the town hub, the Patel family's Mukund villa where he grew up stood desolate and uninviting. His mother was living with her daughter in a nearby town. Gujarat police inspector Sri Mohit doubted the issue would ever excite his jurisdiction's interest. He told me this is very big news in Australia where life has more value but it is of less interest here. It was a different story in Portland, Oregon, where my colleague Tuck Thompson competed with Australia's 60 Minutes US TV crews and journalists representing newspapers and radio outlets along the west coast. Tuck went to Patel's neighborhood with neat front gardens and double fronted two story houses evoking notions of prosperity and solid family values. Patel was holed up inside the house as Mexican helpers tended the garden. His wife Kishore played cat and mouse with the media crews on her drive to work. Tuck Thompson spoke to doctors and Patel's former patients who described a sociopathic personality and a monumental ego. You don't want a doctor with a God complex, said Lindy Davis, an Oregon medical technical assistant whose right arm was partially paralyzed when Patel severed three nerves in her neck while removing a lump. Lindy Davis was one of Patel's last surgical cases in Oregon in 2001, before the KaiserP Healthcare group finally forced him to quit. She had been referred by Patel's wife Kishoree. My hand and shoulder went instantly numb. He said not to worry about it. It was common. The medical oath says first do no harm. He has done harm and he should be held accountable for the that. I'm upset with the regulators. They protect the doctors and the organizations. There's a brotherhood of doctors who don't want to let anything out. They think they are gods. When Tuck Thompson contacted the American doctors who had lauded Patel in the references that helped him win the job in Bundaberg, none would defend their earlier favourable assessments. Tuck was scolded for having the temerity to bother them. Oregon Medical association chief executive Jim Cronenberg said that to be a good surgeon you need to understand how to navigate anatomy. You need good eye hand coordination and you need good surgical judgment when to operate and when not to and what to do and what not to do. This guy was lousy technically and had terrible surgical judgment. This is a remarkable case. In 30 years I've never seen anything like it. He doesn't understand consequences. He does what he does and he doesn't care. As top Queensland government lawyers in Brisbane held confidential talks with Patel's Australian barrister Tom Percy and newly hired solicitor Damian Scattini. The surgeon's Portland lawyer, Stephen Howes was also holding a closed door meeting in Oregon. Queensland's Premier Peter Beatty was embarking on a trade and investment mission to the United States and Italy and he had ordered his Director General Leo Kelleher and the State development minister Tony McGrady, who were in the US for a biotech conference and trade mission, to make a very public appearance in Oregon. McGrady told an airport press conference in Portland that every Queenslander thinks that Dr. Patel should return. Tuck Thompson described a dishevelled Leo Kelleher looking like he came down the luggage chute. But McGrady had designs on stardom. Descending the escalator to the baggage claim area, Thompson watched a passerby ask McGrady why he was so important. Why was the media around him? I'm a movie star, Tom Cruise, he quipped later in the Lawyer Stephen House's high rise law office on the 11th floor of the PAC West Centre. The talks went nowhere. Patel's lawyer regarded his visitors from Brisbane with disdain. When McGrady taped an interview with the ABC's State Line host Kieran McKechnie shortly after the hopeless meeting with Stephen Howes, the politician sounded pleased with himself. McGrady spoke of generating massive coverage of our trip. He emphasised the turnout at his morning media conference and and boasted that the coverage went across the us. It raised the question. Was his mission more to do with hogging the news or seeking the return of a surgeon? Given all of these media conferences that you and the Premier are doing, I mean, is this just a media stunt because you know that you have very little hope of extraditing Dr. Patel. Kieran McKechnie asked him now I get a little angry when people suggest that this is some sort of political stunt. I mean, that's the sort of nonsense you hear from the opposition all of the time. The reality is that we are determined, we are determined to do everything we can to get Dr. Patel to return to Queensland to face the inquiry. Meanwhile, Beattie had held another media conference, this time at Los Angeles airport just in case anyone missed the earlier coverage. What we're trying to do is create a set of circumstances where Mr. Patel can't practise medicine anywhere in the world unless he comes home to Queensland or to Brisbane to give evidence to the inquiry. Dr. Bruce Flegg, the Liberal Party's hard working politician with ambitions to succeed. Beattie condemned the travelling circus. The Beatty McGrady publicity stunt in America is bizarre. It's got to be one of the strangest activities in a criminal pursuit in Australian history. Thinking people understand that a criminal pursuit is a matter for legal authorities and not for politic. Looking for a media headline, Toni Morris took some of the credit for the international ruckus. One of the purposes of the Commission of Inquiry when it decided to release the interim report last Friday containing recommendations for Patel's prosecution, was to flush out Patel and his legal representatives. Scattini and Howe stayed in regular telephone and email contact, comparing notes from their respective meetings. In the two hours Scattini had spent in talks with Crown Law officials, it appeared possible under certain conditions that Patel would come back to Australia. Queensland's Attorney General, Rod Welford, said he is interested in returning to Australia to give some account of how he managed things in Bundaberg. But the terms were unacceptable. Patel asked for an indemnity from prosecution. Beattie was prepared to pay the economy fare, organise safe accommodation and even fund a portion of the legal expenses. But an indemnity was unthinkable. By the end of the week, Scattini, Howes and Patel were all agreed he would definitely not be returning voluntarily to Queensland. Not soon. Not under these circumstances. I was surprised that Scattini, a fierce critic of Queensland health who had made his name and money by suing doctors for negligence, wanted Patel as a client. If Scattini had been leading the legal fight on behalf of the patients for compensation and corrective surgery, nobody would have battered an eyelid. When the Patel furore erupted two months earlier, Scattini had been one of the first to express alarm and to encourage follow up articles he wrote to me. It beggars belief. I can think of another regional hospital with guest doctors that bear scrutiny as well. The dry humoured son of an agricultural scientist, Scattini had always struck me as honest and ethical. His reputation among his peers was excellent. He genuinely believed that Patel was being unfairly treated. But some of the staff in his own firm, Quinn and Scattini, were uncomfortable about the decision to act for the surgeon. Scattini stayed back at his desk one night to compose an appropriate explanation and then he sent around an internal memoir. Probably many of you have had friends or relatives ask you how we can represent such a person. The practice of law is not a popularity contest. Sometimes our clients will be unpopular. Sometimes, such as now, they will be actually hated by large numbers of people who like the rest of us only know what they have been told to believe. Stephen Howes in the United States, however, was well suited to one the of his toughest legal assignments on behalf of Patel. He had been making headlines in Oregon for years. I found a revealing profile from August 2003 in the Oregonian newspaper. It was headlined Champion of the Unpopular Causes. Stephen Howes. Reporter Robin Franz describes him as a short, unassuming, publicity shy criminal lawyer who pursues justice for the most publicity prone clients. Friends say he often takes cases where he sees the possibility of redemption, and he tells clients facing lengthy prison sentences that the best measure of a man is what he does after he stumbles. Those who know him well, attorneys, prosecutors, judges and private investigators say he's a complex man, highly principled, intelligent and driven by a ferocious energy that intimidates his adversaries in the courtroom. I think winning was everything he ever thought about, says Pat Mancuso, Howes high school football coach in Ohio. Despite his small size, Howes played quarterback and defensive back, and what he lacked in size he made up for with determination. He was a scrapper, a fighter, all go, go, go. With Howes in Oregon and Scattini in Brisbane, the Beatty government had met its match. Chapter 61 wound feuds 20 June 2005 Jodi Hillier could stand it no longer. Shantu Shah, one of Jayant Patel's acquaintances in Portland, had described cancer as a punishment of God for the past and present life deeds of a person. And According to Shah, Dr. Patel was a doctor life and a hero who helped cure thousands. On the TV news, Jodi Hillier had also heard one of Jayaan Patel's orange neighbours extolling the surgeon's friendly virtues. The sympathy infuriated Jody. She had felt a burning hatred. Her mother, Doris, who also had cancer, had suffered greatly as one of Patel's patients. They wanted to throttle him. For many of the traumatised patients and their relatives in Bundaberg, the start of public hearings in the sugar town meant the reopening of angry wounds. The story was still dominating the news agenda. The private investigator retained by reporter Paul Barry and 60 Minutes had earned his fee for some old fashioned covert surveillance. Several million Australians saw Patel looking harried and drawing deeply on a cigarette near his Portland mansion. On the top rating current affairs program the Private Investigator, a former FBI agent, tells Barry this is his third stop at the video store. The reporter strides to the front door of Patel's home and starts knocking. Dr. Patel, Dr. Patel, we know you're in there he says there was even talk of a dramatic movie. Lance Reynolds, the president of Atlantic Films and Television in New York, wanted a few key figures to consider an offer for film rights. The same day, the New York Times published a lengthy front page essay by correspondent Ray Bonner headlined Deaths and a Doctor's Past. Transfix Australians. Patel's celebrity lawyer, Stephen Howes, told the world's most influential we have very grave concerns about this drumbeat of incessant and prejudicial publicity that is saturating all of Queensland and indeed all all of Australia. Howes and his newfound legal colleague in Brisbane, Damien Scattini, were running hard on a line that the publicity meant Patel would never receive a fair trial. I was reminded of one of the most notorious accused killers in the United States, O.J. simpson, who was televised live to air in a freeway chase after the murder of his wife Nicole and a friend. In high profile cases involving multiple deaths, overwhelming publicity was inevitable. The more heinous or sensational, the louder the drumbeat. If society adopted House's philosophy, the most wicked alleged offenders would never be brought to trial, nor did it necessarily follow that Sensational publicity led to a guilty verdict. Simpson was acquitted despite overwhelming evidence, including that of DNA. When I trawled the Internet to try to understand more about Stephen Howes, I noted his earlier and seemingly contradictory comments to his own professional association, the Oregon State Bar. Howes told the Barr bulletin, published in May 2004, I've observed that crime news coverage is a huge phenomenon in this country. Despite that, Howe said that he had been pleasantly surprised by the relatively minimal impact media coverage seems to have on prospective jurors. The saturation of the media is not as great as we think. It's not as bad as we think in terms of tainting the process, which is good because it's very, very difficult to get a change of venue. When Terry o', Gorman, a Brisbane criminal lawyer and Queensland president of of the Council for Civil Liberties, said there was a high risk that Patel, if extradited, would not get a fair trial, the politician Peter Beattie denounced the theory as absolute rot. Peter Beattie said, it is just taking civil liberties to an absolute absurd position. At last, Beattie had found favour with Jodi Hillier, who commented, we have people saying that this man won't have a fair trial and that he can have all the media and patience for Defamat, for his new name that suits him so well. Dr. Death. What would he like us to call him? God? Does he expect us to thank him for the hell that he has put so many people through. How can this man get away with it? How on earth are people ever going to feel the same again about going to a public hospital? I hope to God that he is prosecuted for every single person that he touched with his hands of death. I hope that he suffers like all of his patients have and I hope to God that he will never be able to pick up his scalpel again, but if he ever does, he can use it on himself. Her mother told how she had been left for five days with a horrific flesh eating disease feasting out on my body. Doris Hillier blamed Patel for a botched operation and subsequent complications. She urged anyone upset at the treatment of Patel to travel to Bundaberg and, as she put it, sit in on one of our support group meetings and listen and see what this barbaric animal has done to us all. Detectives from the homicide squad who had kept a low profile in Brisbane while downloading transcripts and exhibits from the inquiry's website were seconded to Bundaberg to take statements and attend the inquiry's public hearings. In the lecture hall of a local education centre, two detectives went to Portland and New York to gather formal documentation about the disciplinary actions by the respective regulatory bodies. It was the same documentation that we had discovered on the websites. Police Commissioner Bob Atkinson had already parted company with Toni Morris on the extradition issue. Atkinson favoured a slow burn approach, a laborious investigation by a handful of experienced detectives, hundreds of interviews, a panel of medical experts, thorough reviews by the Director of Public Prosecutions and finally an approach to the Federal Justice Minister to trigger a formal extradition application and the arrest of Patel by US Federal marshals. There were risks in this strategy too, the most obvious being a move by Patel to India, which does not share an extradition treaty with Australia. Morris firmly believed there was more than enough evidence already for a prima facie case for fraud, manslaughter and grievous bodily harm. Patel should not have been practicing in Australia full stop. Any adverse outcomes arising from his deception were therefore criminal. The Morris view seemed plausible, particularly after a leading US criminal lawyer who specialised in extradition, Douglas McNab, contacted me to query why the Queensland police had not moved swiftly. McNabb said Patel should have been arrested immediately. I thought it unlikely that the American justice system would wage a battle to prevent Patel being extradited to Brisbane. He had been blamed by independent US medical investigators for the deaths of Americans before he came to Australia. We were not dealing with a blue eyed, all American hero with no blood on his hands. Patel was drenched in it. This podcast is made possible by subscribers to the Australian and our principal sponsor, Harvey Norman. Since late 2017, when I started pursuing Chris Dawson for the 1982 murder of his wife, Lynn, Harvey Norman has been a loyal backer. It began with the Teacher's Pet, and Harvey Norman and its CEO Katie Page's support has continued for over eight years. I'm proud to have had their backing on all of mine and the Australians investigative podcasts, the Night Driver, Shandy's Story, Shandy's Legacy, the Teacher's Trial, the Teacher's Accuser, Bronwyn, and most recently, the Sick to Death Podcast. For more information on this podcast, go to theaustralian.com. Chapter 62 sound bites 20 June to 1 July 2005 Gail Aylmer felt uncomfortable about being filmed in the cavernous inquiry venue, a short walk from the shopping malls. In Bundaberg's commercial Heart, she exercised her right to have the cameras turned off during her evidence. In a makeshift office strewn with TV cables, screens and film editing equipment, the journalists and their crews collectively groaned. They needed dramatic footage. It would be a lot harder to package a story bereft of pictures. As the first witness called onto the stage for the start of the hearings in Bundaberg, Gail painted a sorry portrait of Patel and his contact with the patients. She recounted the efforts to persuade Patel to wash his hands and wear gloves and his stubborn reluctance to observe basic hygiene. Now can you explain? Was this simply a matter of principle or was this something significant? Was Dr. Patel simply touching patients on the head? Oh no, he was touching their wounds, pulling off dressings to have a look to see how the wound is going, poking around the wound. He was actually really touching the wounds where I felt that there was a risk to the patient and to the next patient that he went to as well. It explained why many wounds had become infected and broken open. The evidence of nurses, patients and doctors over the days and weeks was tragically spellbinding. Aylmer was followed by other senior nurses, Lindsay Druce, Robyn Pollock and Jenny White. They all gave damning evidence. Dr. Darren Keating sat impassively for most of The Bundaberg sittings, 21 days in all, staring ahead at the stage as Patience glared at him. Was he taking in every word of testimony? Would he seek redemptions for his apparent failings as a manager? Amanda Watt, my friend and reporting colleague from the Courier mail, doubted that Dr. Keating had accepted responsibility. She suspected he was coming each day out of arrogance and the need to absorb as much detail as possible to better brief his lawyer, Jeff Deem. Keating was not going down without a fight and he won grudging respect for his stance. Jane Hodgkinson, Channel nine's senior reporter, boiled the complexities and tensions down to a succinct soundbite. This, she told me, is about heroes and villains. Sitting in the front row of the second tier of the lecture hall and hearing the testimony of nurses, doctors and patients, it was clear Tony Morris still enjoyed public approval as the head of the inquiry. People were speaking their mind about serious matters. In the past, they had felt compelled to bury the administrators and bureaucrats who had been accustomed to turning bad news into a series of bumps under the carpet. And overriding doctors and nurses on what was good for the patients were ducking for cover. Morris had also begun to herald bad news for the Beatty government. He was broadening the inquiry's focus from a dysfunctional hospital and a deadly surgeon to a sick system replete with COVID ups and negligence. Inevitably, this would cause heartache for labor politicians in electorates across the state. We were seeing the stirrings of a potential revolution in health and. And politics. On the other hand, reputations were being damaged. Some were to be damaged irreparably. One afternoon outside the lecture hall, I stopped briefly to talk to Patricia Feeney, the solicitor for Peter Lek. She looked distressed. She said, it's so unfair. Although at the time it was a closely guarded secret, Feeney had received further advice from Leck's psychiatrist about his worsening mental state. Dr. Jeremy Butler told her the principal factor in Peter Lek's declining condition was his unexpected appearance at the inquiry in Brisbane when he endured the withering examination by Toni Morris. Leck subsequently exhibited significant psychiatric symptoms indicating a fragile mental state. And Dr. Butler warned that if Leck appeared at the inquiry in Bundaberg, his condition would further deteriorate. Tony Hoffman, meanwhile, needed to finish her evidence. She knew that the lawyers for Peter Leck, Darren Keating and the Director of Nursing, Linda Mulligan, wanted to discredit much of what she had already told the inquiry. Hoffman feared that she would be singled out and have her motives questioned. Yet the doctors who had done little or nothing would emerge unscathed. Even the highly experienced and authoritative Dr. Peter Miack, the strongest critic of Patel throughout his reign, had not taken an opportunity to report his concerns to the Director General or the Medical Board or the Health Rights Commission or the Australian Medical association or the coroner. And he looked uncomfortable when Justin Harper, one of the Lawyers for the patients pointedly illustrated the many avenues MIAC had not taken. I'm not an ombudsman in the surgical ward. I don't de facto become a sort of policeman for the surgical unit. If I put to you an assertion that there is a culture within the hospital, that you keep the reports within the system and that you don't go outside the system, would that be a fair reflection of the culture of the Bundaberg Hospital and the associated medical profession surrounding it? I think that's probably accurate, yes. I mean, it's well known that if you go outside the system, you get into trouble. As a senior nurse, Deputy Commissioner Margaret Vida understood the culture and hierarchy in hospitals. Was it difficult for you to advance your concerns factually without the support of Dr. Martin Carter, given the culture in which doctors and nurses clinically operate? She asked Hoffman. I think one of the hardest things is in the unit. Dr. Carter would verbalise how terrible he thought Dr. Patel was. He was the doctor who, you know, coined the phrase Dr. Death. But when the chips were down, he wouldn't. He was not willing to make a complaint or come with me or support me. He would talk about it to all of us in the icu, about how terrible he was and openly, you know, say, you know, don't let him near me. Linda Mulligan's barrister, Phil Morrison qc, who was not in the least intimidated by Morris, launched himself at Hoffman. He accused the local hero of withholding information from Mulligan and of wanting to see her sacked. You were setting her up for a fall, weren't you? And you still are, aren't you? No. I had one intention. To fix the system. Not to fix the system. If we could fix the system, that would be wonderful. I had one intention and that was to stop Dr. Patel from operating on any more patients. That was my intention, to try and save just one life, just one more life. When Mulligan's barrister tried to interrupt, Hoffman was having none of it. She was shouting and tearful. No, I will finish now. And that is what my only intention was. This was never about them and us. This was never about Executive and myself. I thought Executive would be glad to try and save some of these patients lives and I thought Queensland Health would be supporting me in that. But instead that is not the case and it has become a them and us situation. Tony Morris had become fed up with what he saw as the bureaucracy's attempts to thwart his inquiry. He was convinced that the administrators were out of control. The evidence suggests a situation within Queensland Health, which is rapidly approaching what might be termed bureaucratic gridlock. There are so many bureaucrats writing memoranda to one another, reading memoranda from one another and attending meetings with one another, that nobody has any time left to actually get anything done. But on 29 June, Morris and the inquiry would self destruct. As the lawyer Robert Mulholland QC later argued to the Supreme Court. It happened during a penetrating cross examination of Peter Miac by Jeff, deemed Keating's resourceful and quietly effective. Lawyer Tony Morris, appearing unhappy at the tarnishing of one of his key witnesses, crossly asked Dean if Keating had instructed him to attack Peter Miack. And the inquiry commissioner said he wanted everyone at the bar table to understand that one of the issues that's clearly being raised is this shoot the messenger attitude. And if it comes to our attention that anyone from the Director General of Queensland Health down has given instructions for witness like Dr. Miak to be attacked, then that will be an appropriate foundation for us to make findings. At the end of the proceedings, an astonished Dean held his ground. How could he defend Keating without exploiting weaknesses? In MIAC's version of events at the hospital, Keating's solicitor in Brisbane, David Watt, sent an urgent letter to Queensland Health. Thus far, all of Dr. Keating's legal expenses, totalling about $5,000 a day, had been funded by the public purse. David Watt wanted to know if the public purse would also pick up the tab for extra costs in the event that Dr. Keating was advised by his lawyers to bring an application to have the proceedings of the Commission of Inquiry stayed due to the lack of natural justice. David Watt was effectively asking whether Queensland Health was prepared to fund a legal bid to terminate the inquiry. The confidential response from Queensland Health lawyers Kate Curnow and Peter Crofts heartened Dr. Keating. The taxpayers had funded the inquiry and the taxpayers would fund an attendance attempt to obliterate the inquiry. I had missed the exchange involving Dr. Miak, but I was similarly angry about a shoot the messenger attitude over a story I had published that day. The story gave a sneak preview of the just completed clinical review which found Patel culpable in up to 16 deaths. Eight of these were definite. A further eight were prompted, probable, though inconclusive, according to Dr. Peter Woodruff, as the review had not yet been handed to either Peter Beattie or Tony Morris. Both were miffed that I had got in first when Beattie flew into a rage. My major concern was to protect sources. As if there were not enough inquiries underway, beattie demanded another one. Queensland Health internal investigator Rebecca McMahon was ordered to try to identify the source. She worked hard, wasting valuable time, hers and others, to produce a strictly confidential 185 page inconclusive report. Doesn't Beattie understand what has been going on? I asked my wife Ruth, who had moved to Bundaberg with our children so we could stay together for the hearings. Ruth encouraged me to make the point in a column which was written in anger and criticised Beattie for losing the plot. The political hypocrisy was breathtaking when it suited the politicians. They leaked like sieves to promote themselves. But when well intentioned public servants leaked matters of great public interest, all hell broke loose. If it had not been for leaks by Tony Hoffman in Bundaberg, the Jayant Patel scandal would have been swept under the carpet. All the far reaching reforms and funds being promised to make hospitals safer would not be on the agenda. All the critical lessons would not be learned. Peter Beattie still didn't get it. He looked, I wrote, like a tin pot dictator fermenting the very culture that has helped reduce the disaster in his health system. I wished he had met Dr. Brian Teal, the clinical professor of surgery who had been Bundaberg's highly effective and respected director of medical services until the bureaucracy and the political games wore him out. I really do believe this was waiting to happen, said Dr. Teal, describing a system which, through steady decline and corporate bastardry, was no longer sensitive to patient needs. He had become disillusioned because he saw political sensitivities, not patience, being the priority for administrators. He railed against their overly zealous controls. Bureaucratic administrators do not like to hear bad news. They do not like to be exposed to criticism. Many present problems are symptomatic of a culture of avoiding or burying criticism. The government has the view that health cannot win you an election, but can lose you one. Against this background, it has not been keen to hear anything bad about health. It's a control freak mentality that permeates the system. There is a desire to control which to me is almost pathological. It discourages critical commentary and it leads to a system which walks around with its head down and and not a great deal of self respect. It gradually erodes the importance of the individual contribution within the amorphous system. Goodwill has disappeared from the system and unfortunately it is gone forever. Chapter 63 Kill it early July 2005 the rumours were right. On the 4th of July, a Monday, David Groth, the inquiry's official secretary, sat back in his chair. Holy snap, he said. The Letter from Peter Lech's solicitor, Patricia Feeney, fresh out of the facsimile machine, was brief and to the point. Feeney wrote, we confirm our instructions. Instructions to bring an application to the Supreme Court to have the chairperson, Mr. Morris QC, disqualified from further proceedings in the Bundaberg Hospital Commission of Inquiry on the basis that he has demonstrated apprehended bias against our client in respect of matters arising under the inquiry. At 10:02am the next day, Maurice started day 18 of public hearings in Bundaberg by disclosing the letter and the inquiry's fight for survival. I looked over to the tireless advocate for the patients, Beryl Crosby. She was slowly shaking her head in disbelief. As Morris asked Patricia Feeney for more information, Jeff Deem, the lawyer for Dr. Darren Keating, signalled his intention to join the challenge. The financial, political and emotional cost of the inquiry so far had been enormous. Morris was determined to finish the work and ensure his place in history. He blinked. He held out an olive branch. One solution would be, if there were a substantial case for bias or something of that nature, would be simply to say, well, we'll make no findings with respect to your client. Adverse findings. We might not say nice things about him. We won't make adverse findings. Would that address your client's concerns? For 40 minutes at the morning break, the patients, angry, bewildered and fearful, sought answers from their lawyer, Jerry Mullins. Tess Bramwich, who had been enduring almost every day of evidence with her daughter, asked, are they allowed to do that? And Beryl Crosby said, so it's a cop out. Ian Fleming volunteered that it was his own evidence the previous week, bulletproof and ironclad, as he called it, of his complaint to Keating about Patel, which had triggered the challenge. Where was the natural justice when we were suffering in that hospital? When they were slicing me open like an animal, where was my justice? It was us together that got something done. This is unbelievable. Doris Hillier was so angry, she looked ready to strike someone. How can they do what they're doing? Don't they give a damn about what we went through in the hospital? Fellow patient Lisa Hooper said, I think Toni Morris is the most understanding and compassionate man. I don't believe for one minute that he's biased. How can they say that about him? It's so unfair. Tony Hoffman called my mobile telephone from the hospital's intensive care unit to find out what was happening. The nurses were dealing with patient crises, but the news from the nearby inquiry room was already racing around the icu. There has been a bus accident an abdominal aortic aneurysm, a woman with a detached placenta, and now this, hoffman told me. Darren Keating, usually expressionless and unemotional, smiled broadly. Two days later, on 7 July, his legal documentation designed to sack Morris, was filed in the Supreme Court. He started to giggle as he made his way to the exit of the Bundaberg inquiry room. You look very happy, Dr. Keating, I said. He nodded in agreement. I haven't had much to be happy about until now. The witnesses, doctors, nurses, patients and their loved ones soldiered on valiantly to give evidence. In the days that followed, Morris rejected legal submissions to Down Tools, pending a resolution. It would take weeks or months, Morris reasoned, for the Supreme Court to hear the legal arguments and reach a view. The stakes were enormous. The inquiry had become a lightning rod for change in the health system. On the other hand, the most senior bureaucrats in Queensland Health, who were yet to give their evidence, wanted Morris to fail and collapse. They had given their blessing for Keating and Leck to rely on public funds to pay for the legal challenge. So too had the Crown Solicitor, Conrad Lowe, and his deputy, Robert Campbell. When Peter Beattie and the Attorney General in his government, Rod Welford, were briefed, the agreement to fund Leck and Keating in their Supreme Court challenge was reversed. Just 24 hours after Keating's solicitor, David Watt, had heard of the generosity of the Queensland Public Purse, he received a letter from an embarrassed doctor, Steve Buckland, I have been directed by the Premier to inform you that Queensland Health will not authorise the expenditure of public funds for the purpose of legal representation beyond that approved solely for your client's appearance at the Bundaberg Hospital Commission of Inquiry, Dr. Buckland wrote, Peter Beattie pledged his backing for the inquiry process, whatever happened. Over a drink with the patient's lawyer, Jerry Mullins, at Bagara beach near Bundaberg, Keating's lawyer, Jeff Deem, who was navigating a perilous legal course while managing to remain friends with everyone, said, you know there will only be one person to blame if the inquiry falls over Morris. You can't be accused of showing bias. If you remain silent on the evidence, he will be the only person who can be held responsible. Sick to Death is written and presented by me, Headley Thomas, the Australian's national Chief Correspondent. Claire Harvey is the Australian's editorial director. Audio editing, production and music have been done by Jasper with assistance from Leah Samaglou and Neil Sutherland. Our producer is Kristin Amias. Production management by Stephanie Coombs Artwork by Sean Callanan thanks to Ryan Osland, Matthew Condon, Corinna Berger, Ellie Dudley, David Murray, Dominique McDermott, Zach Schoolander and all our family, friends and colleagues. Colleagues who helped in this series and contributed voice acting and special thanks to Tony Hoffman and Rob Messenger. Subscribers to the Australian Hear new episodes of sick to death first@sicktodeathpodcast.com and on Apple Podcasts. You can get exclusive access to photographs, videos, timelines and more at the website. This podcast is made possible by subscribers to the Australian and our principal sponsor, Harvey Norman. Harvey Norman has provided unwavering support for my investigative podcast since 2018. For more information on this podcast and on our entire investigative catalog, go to theaustralian.com au.