Monday, October 22

Dancing with Dr Death - Virginia Kennedy with Dot Walker

In early 2005 the Australian media was filled with stories about an Indian-trained surgeon who had been linked with an increasing number of surgical infections, other complications, and deaths. Alongside the developing story of Dr Jayant Patel (who, it transpired, had already been restricted from performing some surgeries in Oregon and forced to surrender his medical license in New York) emerged the story of a whistle-blowing nurse whose job was threatened when she went to her local MP after numerous attempts at local resolution of the problem. The media dubbed Dr Patel "Dr Death", and the case sparked national debate about immigration (skilled and unskilled) and the state of rural health care, as well as a Commission of Inquiry.
Although I had some familiarity with the case, I hadn't followed it closely enough to be conversant with the names of all the players. Dancing with Dr Death was recommended by a nursing friend, and I suspected that without the recommendation I wouldn't have read it. In fact it was only when I saw it in the library while looking for another, related book that I was prompted to check it out. I assumed it was written by the whistle blower, and when I realised this was written by another nurse I assumed I had the wrong book, but Toni Hoffman hasn't written one. Kennedy, writing under a pseudonym to protect her career as a "qualified registered nurse", was assisted by Walker, "an author and educational consultant."
As expected, the book, which is subtitled "The Inside Story of Doctor Jayant Patel and the Bundaberg Base Hospital: A personal account by a nurse who worked at his side", discusses particular details of some of the incidents, including cases where Dr Patel has subsequently been found guilty of malpractice and murder. However the focus of the book is on the hospital itself - for the author Patel, with whom she had a friendly if guarded relationship, was a symptom of a far bigger problem, one which has not been appropriately addressed.
Originally from Tasmania - apparently a Mecca of Australian nursing - Kennedy was unhappy with the hospital layout, lack of equipment, poor staffing, actively unsupportive management and out-dated practices from the beginning. Kennedy's story is filled with example of "unprofessional attitude and lack of support or understanding from hospital administration." Some of her grievances are about genuinely unsafe practices, dangerously poor staffing levels, systemic complacency, and a management ethos that valued money about staff and patient well-being. Having heard from a nursing friend in Queensland about the apathy and general unhelpfulness of the organisation, I was interested to see that Kennedy also found the Queensland Nurses' Union to be of little or no assistance.
It is unfortunate that the impact of this is diminished by the sheer number of Kennedy's complaints - the first, which extends for the better part of two and a half pages, is an overly detailed account of her trip to get her uniforms; she is as outraged by the colour of them (burgundy and white, which she "was immediately repulsed by") as by anything else in the text.
There is an irritating lack of perspective ("What other career... would leave people so physically drained and mentally exhausted?"), the odd bizarre observation (following on from a discussion about complication rates of gallbladder surgery, she adds "even the more major surgery did not escape post-operative complications" - wouldn't you expect a higher rate of complication in more serious complications?), and had-I-but-known hyperbole: "I pictured in my mind the handshake and pats on the back between Peter Beattie and Dr PJ [sic] , and I wonder if the Premier wishes in hindsight he could have foreseen what the future held for the BBH" and "Yet unknown to me at this time, and probably more impacting, he obviously had other serious concerns. These without a doubt would have played heavily on his mind, governing his ability to know right from wrong. Little did I know what was about to unfold." This use of "impacting" occurs five or six times throughout the book.
Kennedy (a pseudonym) appears to have liked and respected Patel, and believes that his major problem was that he "over-rated his ability." Although the selling point of the book is the Patel connection, and from the lack of tight editing I strongly suspect it was commissioned and rushed out to catch the wave of public opinion, the author's main thrust is a diatribe against a system that she thoroughly hated. There's a lot in here that's worthwhile and important. It's just unfortunate that the message is obstructed by the overblown writing and diluted by irrelevancy. - Alex

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