By Bernie Brian
Doctor Phillip Nitschke, formerly a resident medical officer (RMO) at Royal Darwin Hospital, probably wishes he could forget the last 12 months of his life. During that time he lost his job twice, his professional ability was questioned and he is now being forced to go to Adelaide to continue the obstetrics training that he began late last year.
Nitschke's bad year began on March 24, 1993. On that day, hospital administrators organised a briefing session for medical and nursing staff on "Management of Trauma Casualties: External Radiation Contamination". The next day a nuclear submarine, USS Houston, was arriving in Darwin Harbour, and the sessions were part of the hospital's responsibilities under the Counter-Disaster Plan.
Nitschke was angered by the ridiculously short warning of the submarine's visit. He told Green Left Weekly, "Under the disaster plan it is the hospital's responsibility to distribute potassium iodate tablets to police stations around the city. To do this, the hospital would have needed six weeks' notice". (Potassium iodate is a blocking agent that prevents radioactive iodine being absorbed by the thyroid.)
Nitschke probably had more understanding than most staff at RDH of the procedures in the event of a nuclear accident. In 1990 the hospital sent him on a two-week training course on the procedures for a patient admitted with exposure to radiation.
After returning from this course, Nitschke offered to rewrite the hospital's nuclear protocol, which he considered "a joke". He says it consisted of two pages of nonsensical information with no advice or guidance on what to do in the event of contamination. At the bottom of the document were four numbers; three of these had been disconnected and one did not answer. However, the offer to rewrite the protocol was either ignored or actively obstructed.
Aware of how unprepared RDH was if an accident were to take place on the Houston, Nitschke and some of his colleagues in the Medical Association for the Prevention of War (MAPW) issued a press release. This criticised the short warning of the ship's visit and supported the right of the community to know when it is subject to danger.
While participating in a protest at Darwin wharf over the submarine visit, Nitschke was paged by the hospital administration and asked to attend a meeting with the general manager, David Douglas, later that afternoon. At that meeting, Nitschke was accused of a "gross violation of the Public Service Act" and told his job was on the line. He was given seven days to answer the charges.
Hospital authorities were particularly incensed that an ABC report had said that Nitschke was speaking on behalf of the hospital, not the MAPW. But even after the ABC admitted its error, the dispute dragged on for many weeks. The issue attracted considerable press coverage, and public opinion was in Nitschke's favour. His fellow doctors were so angered by his treatment that they called on the chief medical officer to resign.
The hospital administration and the Department of Health finally arranged a meeting on April 16 with the Resident Medical Officers Association. A statement was released vindicating Nitschke, apologising to him and recognising his expertise in the field of radiation protection. It acknowledged that RDH was "ill prepared" for an accident on a nuclear-powered warship.
The statement also called on the relevant authorities to give at least two weeks' notice of visits by nuclear-powered vessels.
In July, Nitschke made a submission to the Senate Standing Committee on Disaster Management. Despite submissions to the committee being under parliamentary privilege, the contents of Nitschke's submission became the subject of a press release issued from NT health minister Mike Reed's office on July 20.
Calling Nitschke's "attacks" on RDH "typically inaccurate and sensational", Reed suggested that the hospital would "be able to scrape by without him" if Nitschke didn't "like the situation". The matter of Nitschke's submission to the inquiry becoming public knowledge is now being investigated by the Senate Privileges Committee.
In August, Nitschke received a letter informing him that his contract would not be renewed in 1994. What was particularly puzzling to Nitschke was that he had applied to work in accident emergency, an area always short of staff. Nitschke, who had five years experience in the field, claims that while being interviewed for the position he was led to believe that he mighty also be in the running for a senior position. At this time Nitschke also began six months' training in obstetrics.
Nitschke began campaigning vigorously in November to secure a contract for 1994. His case received considerable press coverage. The hospital responded by holding an internal inquiry which upheld the hospital's actions and criticised Nitschke's contribution to RDH. The RMOs of RDH voted unanimously to strike if an independent inquiry was not held.
Nitschke's case also attracted the support of the Australian Medical Association. In October it passed a resolution upholding the "right of doctors to speak out". With strike action looming, the AMA agreed to sponsor an independent inquiry, chaired by Dr Peter Arnold. After finalising his report, however, Arnold refused to release it, fearing it to be defamatory.
A copy of the report was leaked to the NT News. It was critical of the role of RDH general manager David Douglas and called on him to make a public apology to Nitschke. A negative feature of the report was that it called for Nitschke's instant dismissal if he made any further public comments. Soon after, RDH made it public that a job would now be available for Nitschke.
Just when Nitschke felt that his employment was once again secure, a number of complaints appeared from the staff of the obstetrics ward. One of these came from the sister of the ward and concerned Nitschke saying "fuck the patients". He admits having said this after having had a particularly bad day.
The other complaint was only revealed to him by an NT News journalist. He was accused of improper behaviour and dress, being offensive to pregnant women, having body odour, dirty fingernails and malodorous sneakers. Nitschke continued to receive support from his MAPW colleagues and various other sources, including a branch of the Country-Liberal Party. A member of this branch told Nitschke that there were other letters circulating accusing him of such heinous crimes as being gay.
An inquiry into these complaints found that there was no basis for the allegations. However, the inquiry recommended, in Nitschke's own word, that he be "dumped" from obstetrics. Half way through his obstetrics training and still with no new contract for 1994, Nitschke found himself once again looking down the barrel of unemployment.
Today, Nitschke is reluctant to see himself as some sort of hero fighting the bureaucracy. He recognises that a considerable section of the public share his concerns over the dangers posed by visiting nuclear-powered warships. He is quick to point out that the threat of losing a job does not pose the same risk to a highly trained professional compared to the majority of the work force. He is full of praise for the support given to him by his colleagues in the MAPW.
The postscript to this story is not all that encouraging. On March 1, the nuclear-powered submarine, USS Helena entered Darwin Harbour. Once again the public was given 24 hours' notice. The main purpose of the short notice, according to unnamed authorities quoted in the NT News, was to avoid "organised protests". Nevertheless a small, spirited group, including Nitschke, did gather on Darwin wharf to protest against the visit.
According to Nitschke, the new RDH nuclear protocol was prepared only 24 hours before the visit of the Helena. When asked why the hospital had not received greater warning of the ship's arrival, chief medical officer Alan Walker said he had known about it, but forgot to tell medical staff.
Nitschke told Green Left Weekly that morale among the doctors at RDH is low. Since he left the hospital, seven other doctors have left, and there is a critical shortage of medical staff.
Nitschke also fears that the hospital administration is seeking to employ doctors who may be more cooperative with management and thus weaken the Resident Medical Officers Association. One recent appointment has strong connections with the Queensland National Party.
MAPW
The Medical Association for the Prevention of War was established in Australia in 1982 and in the Northern Territory in 1983. According to an NT MAPW spokesperson, Dr Peter Tait, the organisation has about 250 members nationally. At its national conference in 1993, members debated proposals to expand the concerns of the organisation to include social justice and environmental questions. Proposals to change its name to reflect this were not accepted, but a name change may still come up for discussion at its next national conference in Adelaide later this year.