Damned if I Do

by Philip Nitschke

  Meanwhile, I was increasingly finding my feet at Royal Darwin Hospital. An incident that sticks in my mind is meeting the notorious murderer Daniel Heiss. In 1991 Daniel, and another man, Peter Kamm, were sentenced to life in prison for the 1989 murder of Dean Robinson, which took place south of Darwin when Daniel was only twenty-three. The murder was considered particularly gruesome because the shallow grave the men dug was not deep enough for Robinson’s head, which was left exposed, only to be set alight and then covered with an anthill.1

  I first became aware of Daniel Heiss when I arrived one day to commence a 6 a.m. shift in casualty and saw a rope made of knotted sheets hanging from a smashed tenth-floor window. Curiously, the rope ended at around the first floor, and I wondered what was going on. I would later learn that Daniel had used the sheets to make what would be the first of two escapes during his twenty-three-year incar­cera­tion. The audacity of the hospital escape effort caught my ­attention and I was very interested when I finally met Daniel, some two years later.

  Daniel had come into hospital for investigation following a stomach complaint, and was handcuffed to a trolley in the examination room. I was undertaking my anaesthetic term and was sent to review him for surgery. We had a chat as I tried to take blood, which was next to impossible, since he was handcuffed to the trolley by both ankles and wrists, something I’d never seen before: total overkill. After what amounted to a stand-off, I finally convinced the prison guards to grudgingly release one of his arms. I liked Daniel—who was polite and had a good sense of humour, but sadly resigned to his plight—and I felt for him in his humiliation.

  Daniel would make a second escape in 1995, and evaded police capture for twelve days, by living rough in Darwin’s rural area. In typical Territory style, he came to be seen as having something of a Ned Kelly persona, with people even leaving food out for him. Given that more than two ­hundred police were involved in the search, this public support for Daniel says something about the resentment Territorians commonly show towards authority. I would later join the com­munity support committee that was lobbying for Daniel’s release on parole after seven failed applications and I often visited him in jail. Daniel’s co-accused, Peter Kamm, was granted parole in April 2010. In my mind, locking a person up for life is a form of torture and serves no purpose. I was disgusted when the Country Liberal Party used Daniel’s image for a law-and-order election campaign titled ‘Life Means Life’, as Daniel had done his time. He finally got parole in June 2011 and I was very pleased to have been involved in a small way. One of Daniel’s paintings now hangs in my office and I see him when I’m in Darwin.

  In the year I met Daniel, I was also appointed as the ­hospital’s medical photographer, with the job of making a photographic record of wounds and injuries and documenting many of the medical cases that came through the ­hospital. Photographing the rare croc attacks, box-jellyfish stings and other medical phenomena, much of it in the mortuary, took up half my time; the rest was spent as a doctor in accident and emergency. Then things came unstuck. Because of my background in physics, I was also the hospital’s radiation protection officer. When I arrived at work one day, I was stunned to see a notice instructing all medical staff to report for training sessions on what to do in the event of a nuclear accident and emergency. The notice went on to explain that this was necessary because the US nuclear submarine USS Houston was arriving in Darwin Harbour the following week. Despite being radiation protection officer, I’d heard nothing of any radiation-exposure training ­session, and the idea that staff could be brought up to speed on this crucial matter within twenty-four hours was ludicrous. I was critical of the nuclear industry, and a Darwin visit by an American nuclear warship looked like just another item on that ­country’s long litany of sins.

  I made a public statement as a spokesman for the newly formed Darwin branch of the ‘Medical Association for the Prevention of War’ and my complaints went out the same ­evening on ABC radio’s PM program. Then hell broke loose. I was accused of breaching the Public Service Act, and the Department of Health issued a statement contradicting what I’d said about the hospital’s preparedness for nuclear emergencies. Although the USS Houston came and went, it was to be three weeks of bitter dispute before the Northern Territory Department of Health finally apologised to me. It was seen as a great victory, and we all thought that would be the end of it.

  A few weeks later, I took the opportunity to give evidence to a Senate committee that was looking at Territorian views on disaster planning and I spoke about the hospital’s unsatisfactory arrangements. The next day, my old adversary from rangering days, Mike Reed, now the Territory Health Minister, issued an ominous press release finishing with the line: ‘If Dr Nitschke doesn’t like the situation, I have no doubt the Royal Darwin Hospital will be able to scrape by without him.’ A few days later, I got a letter from the hospital, telling me that my services as a doctor would not be required when my contract finished in two months.

  This was unprecedented. Royal Darwin’s doctors’ ­contracts were always renewed, and doctors were always in short supply. There followed months of wrangling, with a threatened strike by junior doctors, inquiries into the incident from the Department of Health and the AMA, with findings suppressed for fear of libel, and finally an investigation by the Senate Privileges Committee into whether I had been discriminated against in my employment on the basis of evidence I had given under privilege. In its final report, the Senate Committee stopped short of finding this, but asserted that a remedy should follow due to ‘those who have punished Dr Nitschke for what should have been his right as a citizen’.

  An AMA report on the difficulties at Royal Darwin was carried out by Dr Peter Arnold of the New South Wales branch of the AMA and produced a mixed set of conclusions. There were apparently things in his report that were favourable, but also some criticism. The phrase ‘enemy of the people’—the title of an Ibsen play— was used, with the implication that I fell into that category. I say ‘apparently’, because the AMA refused to release the report, claiming it mentioned people by name and was potentially libellous. The content of the Arnold report was only revealed when it was eventually tabled in the Northern Territory Legislative Assembly by the then Labor opposition leader Maggie Hickey.

  It was time to up the ante and demonstrate against this conspiracy between the AMA, the hospital and the public ­service. A small group of doctors made a banner that said ‘free speech?’ in letters more than a metre tall. As hospital photographer, I had keys to the roof and it was decided to unfurl the banner from there on a Sunday night. The hospital was eleven storeys high and a Darwin landmark; first thing on Monday morning, the banner would be seen for miles around.

  I gave the keys to the others and they put the banner in place. After everyone had come back down from the roof, the lock on the door was superglued to prevent the ­security staff removing the banner as soon as it was noticed. The next morning it was seen and talked about and photographed, and stayed there until eleven o’clock, when security finally drilled out the locks and got onto the roof to remove it. But it had served its purpose. Time magazine published a photograph of the ‘free speech?’ banner and an article that described the underlying issues and the sense of injustice that had provoked it.

  What a shitstorm erupted. Suspicion fell on me, because of my battle with the Health Department and my ­possession of the roof keys. I pleaded ignorance, and had a good alibi. While it was never established who was involved, my keys were confiscated and that was the end of my privileges as hospital photographer. The claim was made that the disabling of the locks meant there was no access to the lift shaft and that if there’d been an emergency in the hospital, hundreds of lives could have been lost.

  All this took a toll on me and on my relationship with Tristan, who, not long after, packed up and moved back to Adelaide. This was not the end of our relationship but it was the end of us living together as a couple. As for me, w
ith Reed in charge of NT Health I could foresee another stalled career, just as in the Parks Service. It felt like sweet justice in 1997 when, as deputy chief minister, Reed—who always pushed an anti-gay agenda—was caught out buying pornographic videos, Highway Hunks and Hot Firemen, from a Sydney sex shop, only to claim they were for the purposes of ‘research’.2

  The hospital bureaucracy and I were never to reconcile, and I had no wish to go back. I decided instead to set up an after-hours general practice—Ausdoc Mobile. At first I had a partner, another doctor, Lynton Stevens, who’d also just left the hospital, but he returned to Adelaide. So I carried on alone setting up the business.

  In my new Holden Barina, I took to the streets of Darwin to provide after-hours medical care to anyone who wanted it. It was soon clear that the main consumers of the service would be the city’s drug users and sex workers. Territory law made it a crime to prescribe drugs for those addicted, and any medication using opiates had to be for a patient in pain. Drug users who were ‘hanging out’ when supplies were short or they were broke could not lawfully be helped, and would inject anything they could in desperation. I saw the ­provision of clean opiates to those addicted as a clear example of harm minimisation and often provided them with methadone syrup.

  I also wrote prescriptions for morphine tablets, which would help an addict get through withdrawal, as long as they were prepared to tell me that they were experiencing pain. I later found that some of my prescriptions were being shared, or sold on the black market, and I was told to come in for an interview with the Health Department, that I was prescribing too much morphine. Tristan, who knew more about the system than I did, told me I was getting not a briefing but a warning.

  The work took me all over Darwin and the nearby rural area, from family homes with sick kids, to some seedy and fairly dodgy places, like the area down by the wharves. Some of the people on the fishing boats were heavy drug users and I’d be down there on the boats at midnight with my bag. Although I was carrying drugs with me and was threatened a few times, I never came to physical harm. People sometimes got angry and wanted more than I was prepared to provide, but generally accepted my explanation. I did take precautions. As this was before the days of mobile phones, I relied on a running sheet showing where I was going to be at what time, and I made it clear to the people I was seeing my whereabouts were known. The closest I came to being hurt was when I went into a place in a very poor part of Darwin where there were a lot of drug users and, more dangerously, a lot of drug dealing. A fierce dog, a pit bull, sprang at me. Its chain brought it up just a few inches short of my throat, but its claws ripped my shirt to shreds. I still sweat when I think back about that.

  Under Marshall Perron, the Northern Territory government policy on drug use was utterly hypocritical. It ­basically claimed that there were no local Territory drug addicts, only drug-using visitors from out of state. This meant the Territory didn’t have to provide any residential rehabilitation services. In a bizarre policy dreamed up by then Territory Minister for Health, Fred Finch, the government’s solution was to put suspected drug users on buses to get them back to their interstate homes. Inevitably, this would have applied to many of my patients. Unbelievably, Finch tried to get this policy passed through the Northern Territory Legislative Assembly and Minister Finch tried to implement it. One of my patients became the first to receive his one-way ticket south but Greyhound refused to take him. I then contacted southern media and explained what was happening.

  ‘You’re joking,’ the reporter said.

  The report went out on AM. The story had overtones of what was done in the racist southern states of the US, and an embarrassed Territory government had to abandon the idea.

  To get around the restriction on my writing of opiate prescriptions, I set up a video-conference link with Lynton Stevens, who was now a doctor in Adelaide. That was 1995, long before today’s e-consultations. My sample patient explained to Lynton that he was addicted to narcotics. After listening to the story and asking some questions Lynton then faxed us a prescription, something he could legally do in South Australia. It was a stunt to draw attention to the absurdity of the Territory’s drug laws. By this time I’d become friendly with Fairfax’s Darwin correspondent Gay Alcorn, and a report drawing attention to these drug laws ran nationally in The Age and Sydney Morning Herald.

  I don’t know how long I could have gone on in that role as a Darwin after-hours GP. But it didn’t matter, as ­something would happen soon that would change my life forever.

  PART II

  NINE

  First in the world

  Bring the machine around on Sunday afternoon and I’ll die around two.

  Bob Dent, 1996

  Max Bell, a taxi driver in Broken Hill, was sixty-seven years old and had stomach cancer. About two months before the Rights of the Terminally Ill Act was due to be enacted, and I was still doing my mobile after-hours medical practice, he contacted me. He was in a very bad way; surgery on his stomach had left him with constant nausea, vomiting and an inability to eat solid food and he had heard about my support for the new euthanasia law in the north. He told me of his life during one memorable out-of-the-blue phone call. He asked if the Territory law might work for him and I said I thought it would; after all, he was terminally ill, with no hope of ­recovery. So, I flew down from Darwin to Broken Hill and met him. With Tristan now back in Adelaide I had been spending some time in Broken Hill, as she was doing ­regular locums there as a paediatrician and I really liked the place.

  When I met Max, I saw how very sick he was. We again discussed the possibility of him using the ROTI law. Now that he had a glimmer of hope, Max took matters into his own hands; he had his pet dog put down, put his house up for sale and drove his cab, under huge duress, to Darwin. Dying was his intention, but in fact he hadn’t quite given up all hope. He had an idea in the back of his mind that the tropical warmth, sunshine and beauty of the Top End might just heal him.

  Max was a feisty character. He’d been a pro-golfer, a boxer and a bodyguard and he’d packed his golf clubs and boxing gloves for the trip to Darwin. It irks me that you have no control over the way you are portrayed after death. The stage play Last Cab to Darwin, by Reg Cribb and Jeremy Sims, trashes Max’s life and reputation. Cribb said that his play was based on the real-life character of Max Bell, but he created a womanising drunk. In the play, I am depicted as a conniving, death-loving doctor. The awful times that Max and I shared didn’t deserve this treatment. But then, it’s common for dramatists such as Cribb and Sims to be more interested in the effects of their ‘art’ and their own careers than on any real attempt to understand the truth.1

  Anyway, the drive north really knocked Max around. He was desperately ill and on his arrival I had him admitted to Darwin Hospital, as I set about getting the necessary signatures of a palliative care specialist, a surgical specialist and a psychiatrist, as the law required. What they had to do was quite simple: a doctor had to certify that Max was dying, that his palliative care options had been explained to him and that he was of sound mind. They didn’t have to endorse euthanasia, they just had to certify that this poor bastard was dying, something you could tell at twenty paces. I rang every doctor I could think of but couldn’t find a single one in any of the above categories who was willing even to see him. To his credit, Marshall Perron visited Max in hospital, but no doctor would.

  The AMA’s campaign had put the fear of god into the medical fraternity, whose concern for their own legal safety seemed paramount. Chris Wake, its president, had ­successfully spread the rumour that doctors could be charged retrospectively if the ROTI Act were overturned. It was clear the issue itself had doctors running scared.

  After three weeks, and still very sick, Max had had enough of waiting. He signed himself out of hospital, clambered into his old Commodore taxi and, after staying a night at my place, set off on the 3000-kilometre journey, vomiting his way back
to Broken Hill. He was furious with me for not warning him about the pitfalls of his Darwin plan. His parting words were, ‘You didn’t do your homework, boy.’

  There was no way I could leave things that way. I went to Broken Hill a week later and, with some of his friends, helped Max get reasonably comfortable in his house, which we’d managed to get taken off the market. All his possessions had been sold though, so we had to get him a bed and some kitchen items, and looked after him. I had my swag and camped in his lounge room. Nurses from the hospital came and went.

  One day he said to me, ‘I want you to have the car.’

  He knew that I was using Tristan’s car, an old Sigma. I said I was fine, but he insisted. I told him he could put this in his will if he wanted to, but he had already filled in the transfer of ownership form. I took it to the Motor Registry and used the car—the Commodore taxi—for the next fifteen years. With its meter still installed in the dashboard, I would often feel Max with me as I drove.

  I stayed with Max until he was so weak he had to move into palliative care in Broken Hill Base Hospital. Delirious on morphine and with no control over the process, Max died over a period of three days, in just the way he’d dreaded.

  So from Max, there were multiple lessons learnt, about laws, the character of doctors, palliative care and politics. But another lesson was more positive. Earlier on, Murray McLaughlin, a journalist on the ABC’s Four Corners program, had asked me if I knew anyone intending to use the Territory Act. I put him in touch with Max, and Four Corners went to Katherine, to film Max as he arrived and on his drive north, and later in Darwin. The result was a powerful Four Corners program entitled ‘The Road to Nowhere’, which revealed Max’s terrible suffering and went to air just as he was making his return trip.2