Dr Chris O’Brien (1952-2009) – A Tribute
I did not know Professor Chris O’Brien well, but during the time I was a member of the Royal Prince Albert (RPA) hospital Ethics Committee, he with other professors would bring their applications for approval for new procedures and for any invasive protocols on their patients for approval. Most of these were highly complex and beyond my area of expertise, as they were for the legal representative, and we relied upon those professors who were regular members of the Ethics group to give advice.
I soon became aware that Chris O’Brien was an unusually caring and sympathetic surgeon seeking to heal people with neck and head cancers even though it might mean a risky procedure, or an attempt at something new. Later when I saw him in action as a star of the TV series “RPA”, it was like watching a friend whom I had learned to trust.
His Early Life. Christopher John O’Brien, was born in Regents Park, the son of Kevin, a clerk, and his wife Maureen Healey, a teacher. He went to Parramatta Marist Brothers then studied medicine at Sydney University. He married Gail Bamford, a physiotherapy graduate, in 1980, and they had three children, Adam, Juliette and James.
His Achievements. When Chris O’Brien graduated in medicine from the University of Sydney in 1976 he completed his residency and surgical training at Royal Prince Alfred Hospital. He decided to specialise in head and neck surgery and undertook clinical fellowships in that discipline in England and the USA. Head and neck surgery attracted him because serious cancers in that area need careful treatment for appearance and quality of life as well as removal. Returning to Australia in 1987 he joined the staff of RPA as a consultant head and neck surgeon. There he contributed to the expansion of the clinical service and also established a comprehensive head and neck database which is now the largest in Australasia and one of the largest in the world.
He also established a basic research program and an international fellowship program under the umbrella of the Sydney Head and Neck Cancer Institute that he founded in 2002.
Professor O’Brien had two postgraduate degrees from the University of Sydney – a Masters of Surgery for basic research in microvascular surgery and a Doctorate in Medicine for his work on the management of metastatic cancer in the neck.
He was the author of over one hundred scientific papers and 17 book chapters and he has been honoured with invitations to many countries and institutions as a visiting professor and guest lecturer, including numerous invitations to give prestigious named lectures including the Hayes Martin Lecture in Washington in 2004, the Eugene Myers International Lecture in Los Angeles 2005, the inaugural Jatin P Shah Lecture in Prague 2006 and the Semon Lecture in London 2006. He was also made an Honorary Fellow of the Royal College of Surgeons of England in recognition of his contribution to the training of young British surgeons.
In 1998 he founded the Australian and New Zealand Head and Neck Society and was president in 2004. He was also a member of the American Head and Neck Society and was the first non-American to be invited to join its Council. In 2003 Professor O’Brien became Director of the Sydney Cancer Centre, based at Royal Prince Alfred Hospital and the University of Sydney, while maintaining all of his clinical, teaching and research responsibilities. Over recent years he developed a proposal to transform the Sydney Cancer Centre into a comprehensive cancer centre and that project is moving forward with great momentum. He was a devoted husband and father with many interests including running, skiing, reading and playing guitar.
His Great Role Reversal. Unfortunately, in November 2006 he was diagnosed with a malignant brain tumour necessitating three operations, radiotherapy and months of chemotherapy. He also included a regime of natural medicine and meditation that he embraced enthusiastically.
He stepped down from all of his clinical and administrative positions at the time of his diagnosis in order to concentrate on his recovery and he continued to maintain an outlook of optimism and confidence, encouraging other cancer patients, their loved ones and clinicians treating cancer to have a similarly positive outlook.
He wrote a remarkable book (Never Say Die, by Dr Chris O’Brien, HarperCollins) that told of his attitude to suffering and approaching death. When Professor Chris O’Brien was told that he had a malignant brain tumour in November 2006, he refused to bow to his poor prognosis. No one who knew him was surprised. Over the years he had helped thousands of cancer sufferers fight off their own sense of powerlessness, loneliness and fear. He believed passionately in the power of being positive.
Becoming a cancer patient himself, the ultimate role reversal, was a huge challenge – and he never pretended it was easy. It was O’Brien’s choice to go for a third craniotomy, removing part of the skull and brain by his surgeon friend Dr Charlie Teo.
Colleagues and patients were stunned that O’Brien, of all people, should get cancer but the surgeon pointed out that 33,000 people in NSW are diagnosed with the disease every year. The fact that he had become one of them was not exceptional, he stressed.
O’Brien knew what he was facing. His type of cancer, a grade-four glioma, also known as a glioblastoma multiforme (GBM), is the most aggressive of the primary brain tumours, and the one with the poorest prognosis. “It has a very, very capricious reputation for being, you know, relentlessly lethal – not absolutely 100 per cent inevitable, but statistically, the odds are weighted strongly against me,” he said in 2007. “You don’t accept the statistics. You say, ‘Well, you know the statistics, but there is still hope.”
His Humour. Gail O’Brien was sitting by her husband’s side in hospital after his first craniotomy, when Frank Sartor, the then Minister assisting the health minister (cancer), telephoned, asking how the surgery had gone. Gail thought her husband was asleep. He wasn’t. He opened his eyes and said: “Tell Frank I’m going into politics. I’m perfect for it now I’ve got only half a brain.”
First thing each morning he would check his pulse, to make sure he was still alive. He would claim to be on a “modified vegetarian diet, comprising fresh fruit, vegetables … and meat’‘. It was typical of the surgeon’s sense of humour that after a while he started to joke that the goodwill messages were beginning to ease off and the bills were outnumbering them again.
Television Star. That spirit of his, as well as his decency and compassion, made him a well known figure on Channel Nine’s long-running hospital reality show, RPA - so much so that when the news got out about his cancer diagnosis, the network was flooded with emails and messages of support.
“How did I come to be involved in the TV show RPA? In the second year a couple of really interesting and nice patients were willing to participate and the producers of the show seemed to find their stories interesting and the type of surgery I do interesting also. After that they tended to chase me a little to encourage me to identify patients with interesting problems, or interesting personalities — “good talent”. As a consequence over the next 11 or 12 years I seem to have featured quite frequently on the show.”
Millions of Australians came to watch Chris O’Brien regularly and felt they really knew him as a warm, vigorous and charismatic surgeon.
His Dream. His big dream was to see a comprehensive cancer centre built in Sydney, modelled on those in the United States. O’Brien worked in a cancer centre in Alabama during the 1980s and, even after he became ill, continued to lobby for a similar set-up here, concentrating world-class research, diagnosis, clinical trials, cutting edge treatment and cancer support services under one roof instead of fragmenting them through numerous hospitals and facilities.
In April 2009 the Prime Minister, Kevin Rudd, committed $100 million to an integrated cancer treatment and research facility, Lifehouse, adjoining RPA. Federal funding of $100 million was announced for the Lifehouse centre in April, and construction is due to begin at the end of 2009. When completed in 2012, Lifehouse will be Australia’s largest cancer care centre and will form an enduring legacy to the man Mr Rudd has described as a “truly exceptional Australian”.
O’Brien’s work in the management of head and neck melanoma, salivary gland tumours, mouth cancer and metastatic cancer in the neck had brought him as much recognition overseas as it had here. In 2005, he was made a Member in the Order of Australia (A.M.) and two days before his death he learnt he was to be appointed an Officer in the Order (A.O.), the second highest honour able to be given in Australia.
His Faith. He told reporters just hours before his death that his work had prepared him for the disease and for death: “I think inevitably I’ll die of this and I’m not frightened of dying. I’m at peace with my situation, I’m not willing it to come quick but it will come soon enough.” Then he repeated several times, “Physically and spiritually I am travelling well.” Spiritually? He continued, “I was raised a Catholic and then got away from a personal sense of faith. When I was diagnosed, I was reading a book, and I came upon the word “grace”. I began to think about it. We all live by the grace of God. Through thinking about it I came back to a personal faith in God’s grace.”
His Funeral. Nearly 2000 people attended the State Funeral in St Mary’s Catholic Cathedral. The Governor General, the Prime Minister, the Premier, scores of Federal and State politicians, judges and lawyers, the medical and hospital fraternity, family members and close friends, and hundreds of television viewers took their place for the funeral of a boy who had grown up in Western Sydney.
Professor Chris O’Brien “fundamentally changed lives’’ and left a lasting national legacy in fighting cancer, Prime Minister Kevin Rudd told mourners at the renowned surgeon’s state funeral.
“Chris O’Brien reached out beyond himself and fundamentally changed lives. He did so with his hands, surgeon’s hands, hands of great skill and so he saved the lives of many. But more critically, he did so with his heart and in a profoundly human and profoundly spiritual way. He did not deny his suffering. He embraced it and then he deployed it. He sought to capture the nation’s imagination on how, as a nation, we could do better, much better in fighting a disease which afflicts tens of thousands of our fellow Australians every year. Here lies the man who touched the nation’s soul and we, the nation Australia, are richer for him having lived and having worked among us. Farewell my friend.’’
Chris O’Brien was a great man, but more important than that, he was a good man.
Rev The Hon. Dr Gordon Moyes, A.C., M.L.C.
Reference: Nikki Barrowclough, Professor refused to bow to his cancer, SMH, 06 June 2009.