Sick to Death — Episode 6: The Bloodletting

Podcast: Sick to Death
Host: Hedley Thomas (The Australian)
Date: January 1, 2026

Episode Overview

Episode 6 of "Sick to Death" plunges listeners into the dramatic escalation of the Dr. Jayant Patel scandal at Bundaberg Hospital during late 2004 and early 2005. The episode, titled "The Bloodletting," chronicles both the mounting evidence against Patel and the desperate efforts by nurse Toni Hoffman, medical staff, and bereaved families to prompt accountability and intervention. It unpacks major surgeries gone catastrophically wrong, the administrative inertia and complicity that enabled Patel’s continued practice, and the personal toll on those who witnessed, reported, and suffered from medical malpractice.

Key Points & Insights

1. Toni Hoffman's Crisis Point (00:04–06:05)

• Escalating Concern and Frustration: Toni Hoffman, an ICU nurse, reaches her breaking point after months of inaction regarding concerns about Dr. Patel.

  • Managers suggest mediation, psychological counseling, and “personality conflict” resolutions instead of addressing clinical issues.
  • Dr. Darren Keating’s admiration for Patel verges on “sycophancy,” ignoring frontline staff warnings.

• Hoffman's Ultimatum:

  • Hoffman directly confronts management, declaring,

    “Dr. Patel’s patients are dying because of his care.” — Toni Hoffman (02:52)

  • Presents evidence of unprecedented complications and directly ties deaths, including Mr. Brammach’s, to Patel’s interference and negligence (03:51–04:10).
  • Threatens to take matters outside unless an “independent audit” is conducted (04:56).

• Climate of Fear:

  • Staff believe Patel is “untouchable” due to executive backing, with widespread reluctance to formally complain for fear of retaliation (05:08–06:05).

2. The Failure to Intervene and Escalating Harm (06:05–12:51)

• Administrative Inertia:

  • Despite repeated warnings and internal interviews confirming Patel’s dishonesty and incompetence, he is deemed “too valuable.”
  • Dr. Behrens, Dr. Risson, and others voice direct concerns, but no restrictions are placed on Patel.

• Pattern of Cover-ups:

  • Patel manipulates surgical audit processes, even attempting to “redefine” complications to minimize reported harm.

  • “What we call wound dehiscence and what we class wound dehiscence.” — Dr. Patel (07:39)

• A Vascular Surgery Horror:

  • Dr. Jason Jenkins, a Brisbane vascular surgeon, discovers gross negligence in patient Marilyn Daisy, including retained sutures, unaddressed gangrene, and lack of essential treatment options.

    “These sutures were heavily buried within the tissue and very difficult and painful to remove. I find it mind boggling...” — Dr. Jason Jenkins (10:46)

• Direct Threats Met with Indifference:

  • Jenkins threatens Patel with reporting to the Medical Board, but Patel is unmoved. The hospital fails to investigate gravely concerning cases.

3. Fatal Outcomes: The Story of Jerry Kemps (15:21–32:32)

• A Catastrophic Surgery:

  • Jerry Kemps, a robust, previously healthy man, is diverted from a palliative pathway to an unnecessary esophagectomy by Patel, despite clear evidence it is inappropriate.
  • Patel’s disregard for ICU capacity leads him to pressure for withdrawal of life support from another patient for a surgical bed.

    “That brain dead patient should have been switched off last night at 8pm.” — Dr. Patel (21:04)

• Operative Disaster:

  • The operation is marked by dangerous mismanagement and inattention to massive bleeding.

    “That’s what drains are for, Damien.” — Dr. Patel (27:09)

  • Over 30 units of blood are transfused as nurses and anesthetists are aghast.

• Family Misled:

  • Even as Kemps is dying, Patel minimizes the crisis and assures family it was “a great success.”

    “He told her it was a great success. We have got it all. There’s a little bit of bleeding there, but that’s nothing.” — Dr. Patel (27:33)

• Nursing Outcry and Administrative Apathy:

  • Nurses and doctors are traumatized by the death, and attempts to trigger a proper coronial investigation are thwarted; Patel discourages reporting to the coroner (32:27).

4. Paralysis and Complicity Among Hospital Leadership (32:33–54:14)

• Ongoing Preventable Suffering:

  • Other patients, such as teenage trauma survivor Shannon Mobbs, experience devastating, avoidable harm due to Patel’s unwillingness to transfer to tertiary care; his surgical “repairs” result in loss of limb and life-threatening sepsis (36:59–41:45).

• Mounting Staff Rebellion:

  • Nurses and surgical theatre staff unite in unprecedented complaints, finally showing strong unity and emotion to management (43:39).

  • “My concerns are with the surgeon that performed his initial three operations ... I would like his treatment at the hospital investigated...” — Linda Mulligan reading memo (41:45)

• Management Response: Reward, Not Removal:

  • Despite mounting internal and external alarms, Dr. Keating and Peter Leck continue to champion, praise, and even recommend a lucrative new contract for Patel.

    “Nil significant areas for improvement in Patel’s performance and he rated the surgeon’s performance as excellent.” — Dr. Darren Keating (49:56)

  • The hospital’s obsession with surgical throughput and waiting lists continually trumps patient safety.

5. The Clinical Audit and Ongoing Danger (54:14–63:40)

• Investigation Finally Begins:

  • Dr. Jerry Fitzgerald, Chief Health Officer, is commissioned to perform a clinical audit, but is initially hamstrung by hospital management framing the issue as a personality conflict.

  • “This is not an investigation of Dr Patel. This is us gathering information to find out whether or not it is important to have an investigation into Dr Patel.” — Toni Hoffman (54:38)

• Patel's Denial and Deflection:

  • Displays arrogance and frames critics as lazy or emotional; “nurses have been complaining about doctors for centuries...” (55:36).
  • Offers to cease procedures only if others insist:

    “Well, if you don’t want to do these procedures anymore, we won’t do them here.” — Dr. Jayant Patel (55:47)

• Final Acts of Subterfuge to Save Patients:

  • Staff resort to hiding vulnerable patients from Patel to save their lives, as seen in the case of Joan Cameron.

  • “He told Patel, look, the carotid doesn’t need fixing. His priorities are his heart, his anaemia, his everything else.” — Dr. Jerry Fitzgerald explaining Dr. Miak’s intervention (61:28)

  • Toni Hoffman and others contemplate the lengths required to stop Patel’s harm—now convinced only full exposure will suffice.

Notable Quotes & Memorable Moments

| Timestamp | Speaker | Quote/Description | |-----------|-------------------------|--------------------------------------------------------| | 02:31 | Dr. Darren Keating | “When you get to be as great as this man, you can do what you want.” | | 02:52 | Toni Hoffman | “Dr. Patel’s patients are dying because of his care.” | | 10:46 | Dr. Jason Jenkins | “I find it mind boggling that someone could leave sutures in for this long. It shows a complete lack of understanding...” | | 21:04 | Dr. Jayant Patel | “That brain dead patient should have been switched off last night at 8pm.” | | 27:09 | Dr. Jayant Patel | “That’s what drains are for, Damien.” | | 30:07 | Dr. Jayant Patel | “This man’s going to die. He’s going to die on the table. I can’t do anything. Get the family. Get the family.” | | 32:27 | Dr. Jayant Patel | “We know the cause of death. It was due to a bleed in the aorta.” | | 43:39 | Linda Mulligan | “Different degrees of emotion to the point of one stating that the whole issue is keeping them from sleeping.” | | 49:56 | Dr. Darren Keating | “Dr. Patel is a very committed and enthusiastic clinician who has continued to be a very effective member of staff and director of surgery.” | | 55:36 | Dr. Jayant Patel | “Nurses have been complaining about doctors for centuries. Some of them are lazy. They don’t want to work hard.” | | 56:27 | Toni Hoffman | “We don't like this guy, but that's not the issue. The issue is he's doing these things here and it's harming people.” |

Timestamps for Major Segments

• 00:04–06:05: Toni Hoffman's escalating alarm; management’s lack of action; direct confrontations
• 06:05–12:51: The ignored warnings; audit manipulation; Dr. Jenkins’ revelations
• 15:21–32:32: The death of Jerry Kemps; gross mismanagement in high-risk surgeries
• 32:33–41:45: The case of Shannon Mobbs; compounding horror and ongoing administrative neglect
• 41:45–45:00: Staff rebellion and unprecedented nurse complaints
• 45:00–54:14: Management’s priorities—protecting throughput and Patel’s contract
• 54:14–63:40: The clinical audit and ongoing subterfuge; attempts to shield patients from Patel

Tone and Narrative Style

Hedley Thomas maintains a factual, methodically investigative tone, weaving firsthand accounts, quotes, and reconstructed dialogue to dramatize events while preserving credibility. The overall atmosphere is tense, at times shocking, underscoring systemic failure with both empathy for whistleblowers and horror at institutional rot.

Final Thoughts

Episode 6 is a powerful, harrowing account of whistleblowing in a broken system—an exposé not just of one doctor’s malpractice but of the bureaucracy and culture that allowed it to flourish. It documents the collective trauma, the tipping points for brave individuals who risked everything to protect patients, and the extraordinary inertia of leaders more preoccupied with reputation and statistics than lives. This episode is essential listening for anyone grappling with medical accountability, whistleblower protection, or institutional governance.