Sick to Death: A Manipulative Surgeon and a Healthy System in Crisis-a Disaster Waiting to Happen

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A richly peopled but wordy account of a breakdown in the health system in Queensland, Australia, and of the cover-up that followed. Thomas, an award-winning investigative journalist for the Brisbane Sick to Death : A manipulative surgeon and a health system in crisis - a disaster waiting to happen.

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Hedley Thomas. They called him Dr Death. A year-old boy's leg had to be amputated as a result of his poor judgement. He botched a procedure on a young man, leaving him impotent and urinating through his rectum - and with a 30cm surgical clamp embedded in his abdomen. Undeterred by the atrocities he was causing, Dr Death continued to deceive the patients who trusted him to fix their pain.

At least 17 people in his care did not survive. She clambered up and bounced on the mattress. A trundle bed had been stored under the lower bed. Lorraine dragged it out on the Saturday afternoon and put it against the wall, forming an L-shape with the bunks. Lorraine frowned at the glass-topped table in the room.

It was an accident waiting to happen. She carried it into the main bedroom where she and Gerard would be sleeping. Next she hauled a low set of wooden bedside drawers from the main bedroom to the children's room. As Lorraine had feared, the unit was hot. Its bricks absorbed heat through the day. The windows missed the best of the sea breezes, and there were no ceiling fans.

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Lorraine put one of the electric fans she had brought from Brisbane on the bedside drawers. At least the children would be comfortable as they slept. Lorraine took one more precaution before satisfying herself that she had made the best of things. She spread quilts and blankets along the floor below the bunk beds. Michael, who would be in the bottom bunk, was a restless sleeper though neither he nor Elise had any history of falling out of bed.

Sick to Death: A Manipulative Surgeon and a Healthy System in Crisis_a Disaster Waiting to Happen

But, just in case, the quilts might soften an unlikely accidental fall. The family woke to a glorious Sunday morning and devoted it to the beach and the pool. Lorraine's worries eased. As the sun disappeared behind the Glasshouse Mountains, the family walked to Bulcock Beach for fish and chips at a sidewalk table. After they returned to the unit, Michael went to bed first. He was sleeping soundly by 9 pm when Lorraine checked on him. Elise, nestled beside her mother on the sofa, stayed contentedly reading her novel. From time to time she looked up at the TV.

An hour after Michael had turned in, Elise was ready for bed. She kissed her parents and smiled as Lorraine tucked her in for a second night in the top bunk. Lorraine, who had made a point of picking the children's clutter off the floor to prevent a stumble in the dark, did not notice something amiss as she turned out the lights.

The family had no experience with bunk beds. The safety rails that prevent a child rolling out were not there. As they were on holidays, Laura was allowed to stay up with her parents until the late movie ended. Shortly before midnight they all went to bed and, within minutes, everyone was sleeping. Gerard sat upright.

They had both heard it, a loud noise. A heavy thud. In the seconds that followed, moaning noises drifted from the bedroom and, instantly, Lorraine guessed what had happened: 'Oh my God, Gerard, I think Elise has fallen out of bed!

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She was on the quilt on the floor with her head towards the narrow shelf and doorless cupboard in the room. Lorraine frantically moved the small drawers with the fan on top so she and Gerard could both fit in the room more easily to tend their stricken child. Can you move your arms and legs? Elise could move her limbs, but Lorraine's relief was tempered by a new fear: Elise was in great pain. Gerard tried to contain his own anxiety in the gloomy bedroom as Elise lay on the floor with her Winnie the Pooh teddy bear, rubbing her head and whimpering softly. He took charge. He was the doctor. He might not have practised medicine for 18 years but he knew something about head injury.

I'll take her to our bed and have a look at her,' he said in as measured a tone as he could manage. Gerard checked her limbs, neck, chest and stomach for breaks or pain. He carried Elise to the main bedroom and brought the mattress from her top bunk. They lay her down on it on the floor in their room. She continued moaning in obvious pain.

Lorraine, shaking with worry and fear, wanted to rush Elise to hospital. She was becoming frantic. Gerard resisted. He doubted Elise had been unconscious after the fall. He persuaded Lorraine that they could safely watch her in the unit for the time being. Almost 3 am. He sighed with relief.

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He wouldn't wish the graveyard shift on his worst enemy. He knew exactly how long he had been going without a rest. Having come on duty at 8 am the previous day, he was at the hour mark of a hour shift. Doneman, a father of two young children, was exhausted. He would never touch alcohol while at work, but the effect of his fatigue equated to a blood alcohol reading of. Long-distance truck drivers could be forced off the road if found working dangerously long hours. Economic necessity and demanding bosses forced the drivers to stay awake with amphetamines as they hurtled down the country's highways.

Airline operators had much more to lose.

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The repercussions from carnage caused by a Mack truck colliding with a family car were nothing compared with those that might follow a Boeing ploughing into a mountain due to pilot fatigue. Australian pilots were permitted a maximum number of hours in the cockpit on long-haul flights after which strict regulations stipulated a lengthy rest in the bunks. Nurses, too, were banned from working excessive hours.

Yet doctors like Doneman in Queensland's public hospitals were given no choice. At this time of year, when many of the senior doctors were holidaying with their own families, those on the bottom rung were in greater demand than usual. The chronic shortage of doctors nationally was worse in Queensland, which had the lowest number of registered doctors per head of population of any state or territory.

There were about more doctors in Victoria, a state with a similar population but without the challenges unique to Queensland of decentralisation, poor working conditions and remote and Indigenous communities. Doneman had few complaints. He would do the hours, a rite of passage, and move up the ranks. He was not the most junior doctor in Queensland, but he was the least experienced doctor to be put in charge of the bed Caloundra Hospital overnight.

For the duration of this shift, he was the only doctor on duty. A quietly ambitious year-old, Doneman did not look like a newcomer to medicine.

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But he only began studying medicine in his late 20s. His confidence and age sometimes made his patients suspect, wrongly, that he was experienced. Just two years after receiving his Bachelor of Medicine and Bachelor of Surgery from the University of Queensland, he was making clinical decisions without having to defer to senior colleagues. Doneman had worked in hospitals known as God's waiting rooms because they catered to a large population of elderly retirees who had moved to the Sunshine Coast for its warm climate, beaches and lawn bowls.

As a junior house officer — almost the lowest-ranking doctor on the scale — he had treated worn-out knees supporting the overweight and the sedentary. He had treated gynaecological issues common to elderly women who had borne children. During rotations in paediatrics, orthopaedics, anaesthetics, obstetrics, gynaecology and emergency medicine, he had seen dozens of bright-eyed babies at the start of life and the old and frail who were soon to depart.

Maybe they sensed in his bedside manner a contagious energy and enthusiasm for medicine. After driving taxis to pay his way through medical school, Doneman had large bills and a meagre salary but he was doing what he loved.

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