This is Gail

by O'Brien, Gail

  None of this ever got in the way of their duties as parents. Dad rarely missed school events or Saturday sports. He coached rugby teams, was the master of ceremonies for school functions and even let Mum coax him into dancing as one of the Village People in a parents and friends’ revue she choreographed at my school.

  He’d often be home by 7.30pm so we could eat as a family. He received countless offers to speak at international conferences but did not travel more than three times each year to avoid spending too much time away. Mum would usually accompany him on these trips but occasionally Adam, James or I would be lucky enough to go. When it was my turn and we went to Boston I stayed in the giant hotel bed in the mornings, ordering room service and watching movies while he delivered his lectures, then in the afternoons we explored the city together, walking through Harvard University, browsing bookstores and taking photos of rows of tulips.

  Since Westbourne Street, Drummoyne, we moved house no less than six times — three times in the same suburb before moving across the Gladesville Bridge to Hunters Hill. Thanks to some opportunistic purchases of rundown houses, Chris and Gail had accidentally become home renovators before it was fashionable.

  Dad could be cheeky and irreverent, which sometimes prompted an attempted scolding from my mother. But she could hardly keep a straight face and Adam, James and I knew that she was as entertained as we were. Once, at a suburban restaurant where Dad’s guitar teacher Peter Pik regularly performed, Pete, who specialises in finger-picking guitar, was playing beautifully and setting the mood. Dad called out, ‘Why don’t you sing, you bastard?’ (an inside joke referring to a disastrous gig that Pete once played which he wanted to forget). ‘Christie!’ Mum hissed. During a family holiday to Tasmania and a visit to Port Arthur, Dad was impatient for Mum to emerge from a building in the former penal colony so we could all leave. He picked up a handful of pebbles and sprayed them over the corrugated iron roof, cupped his hands into a megaphone and trumpeted, ‘Gail O’Brien, come out with your hands up.’ She appeared a few minutes later with a thunderous expression.

  As my brothers and I grew, so too did Dad’s reputation and practice. He had become known throughout the region as a leading surgeon and cancer specialist. Mum, still operating as practice manager, regularly worked in the rooms to lend support to the secretaries.

  In the late 1990s a Channel 9 television crew started work on a new reality television series, RPA, featuring staff and patients of Royal Prince Alfred Hospital. We all got a buzz out of seeing Dad on TV occasionally but he was soon being featured on the show so regularly that colleagues jibed it should be called ‘The Chris O’Brien Show’. So well known did he become that in 2000 the program’s producers asked him to accept a Logie award for most popular reality program. Dressing for the red carpet, Gail asked Chris’s advice. ‘Which colour blouse goes better with this jacket?’ When she arrived at the awards night, she found herself next to a woman who was wearing the same jacket, only with no blouse at all and just one button done up at the navel.

  People in the street started recognising Dad from TV; they would approach him and shake his hand. At the hairdresser one day Gail spotted a picture of him in a women’s magazine above the caption ‘Dr Gorgeous’. Apparently my dad was ‘Dr Gorgeous’ to many women. ‘That’s your dad?’ a school peer exclaimed to me. ‘Oh my God, my mum and I love him. He’s so nice.’ Then after a pause she added, ‘His arms are a bit hairy, though.’ He was public property all right. But far from being an intrusion, my brothers and I found all this quite natural. I grew up thinking that it was normal for one’s father to be a surgeon everyone seemed to know.

  Although I didn’t understand the source of my dad’s mass appeal at first, it became clearer to me over the years. His tender and humane treatment of patients seemed to be what people commented on most. They loved his bedside manner and the way he talked to people. Chris advised his trainees, ‘Treat every patient as you would treat a member of your own family,’ and this attitude was obvious in every episode of RPA. He sat on patients’ bedsides and reached across tables to hold their hands. He consoled a teary wife, saying, ‘Don’t go out and buy black clothes,’ and joked that a colleague should not say ‘oops’ in front of the cameras because it made him look bad. I heard stories of how he treated people when the camera wasn’t there. One gentleman, a public patient, became emotional as he asked how much Chris’s surgical expertise would cost. ‘There’s more to life than money,’ Chris said as he put his arm around the man to console him. Chris’s newfound minor celebrity made the practice even busier. One patient arrived with a wry referral from a GP who said that particular patient had seen Chris on television and wanted to be treated by him. ‘So I have searched him all over and found a small lump on his head. Would you please remove it.’

  The TV show was a bit of fun and provided some light relief, but Gail had a sense that Chris’s celebrity was more significant than he knew. She observed in the practice, as it pulsed with patients, that many people there felt as if they knew her husband like he was their brother or son. But of course, much more than being a TV star, Chris was a surgeon whose focus was on contributing to improve the outcomes of cancer patients as well as building Australia’s reputation for treatment and research in head and neck cancers.

  In 2002 Chris told Gail about his plans to create an organisational entity to concentrate more fully on head and neck cancers. It would be called the Sydney Head and Neck Cancer Institute (SHNCI). Since working as a trainee surgeon at the University of Alabama, Chris had become an advocate for comprehensive cancer centres as the best hospital model to foster innovation, produce ground-breaking discoveries and deliver world’s best practice in cancer treatment. Dozens of these types of centres existed in the United States, but no facility in Australia could meet all of the criteria. The comprehensive cancer centre model is characterised by offering patients the complete range of treatment from surgery to chemotherapy to radiation therapy, within a scientific environment that produces research, new therapies and gives patients opportunities to participate in clinical trials. The ‘bench to bedside’ idea of comprehensive cancer care means there is a rapid translation of research findings to improved care.

  The SHNCI would be the first incarnation of Chris’s dream to create a team that adopted a comprehensive approach to cancer research and care. It would bring together surgeons, radiation and medical oncologists, dental specialists, speech therapists, specialist nurses and dieticians, research scientists and data managers in a multidisciplinary setting. The institute would fund a research program that maintained a database and introduced trials to patients, and international experts would come to Sydney to undertake research and teach.

  Chris had a way of tapping people on the shoulder and pulling them into his causes. At the institute’s inaugural meeting almost every person on the committee had survived head and neck cancer. The faces sitting around the table at Doyles on the Beach restaurant in Watsons Bay bore evidence of Chris’s surgical skill — faded scars indicating incisions, flaps or skin grafts. The Sydney seafood magnate Peter Doyle himself was there, along with a dozen or so other former patients. Every one of those people would become powerful supporters of Chris’s advocacy for improving cancer care. Today, nearly fifteen years later, the loyalty of a number of them endures. Bill Conley, a partner at a major law firm, and Bob McMillan, a businessman in the printing industry, went on to become founding directors of the Chris O’Brien Lifehouse. Nat Zanardo, who until recently owned Canterbury BMW, persists in fundraising for SHNCI.

  Gail’s role as manager of Chris’s practice expanded to the SHNCI’s administration and financials. The important first task for the committee was to raise funds, and Gail stepped in to lead this. A black-tie launch for the institute was planned at Sydney’s Regent Hotel (later renamed the Four Seasons). Without any real experience in fundraising, Gail set her mind to securing some big auction items. She wanted a string of pearls, relevant to head and neck surgery because
it could hide a thyroidectomy scar, the most common operation that Chris did. She contacted two big pearl dealers but nobody returned her calls, despite her persistence.

  By chance Gail was introduced to Bronwyn Carabez who was not a large dealer but had her own small jewellery store specialising in pearls. Bronwyn said she would love to help and arranged for the auction item and anything else the event needed, cementing Gail’s faith that great generosity could be found.

  As the night of the gala ball approached, Gail felt increasingly nervous. Six hundred people were coming, including the NSW health minister Craig Knowles, lord mayor of Sydney Frank Sartor, the governor of NSW Professor Marie Bashir and her husband, Sir Nicholas Shehadie. Channel 9 journalist and TV presenter Helen Dalley had agreed to be master of ceremonies.

  The hotel gave Chris and Gail a room to get ready and on the night, they stood side by side at the bathroom mirror before greeting their guests. They looked at each other with a mixture of relief and disbelief. ‘We did it!’ Chris said. A girl from Cronulla and a boy from Regents Park were making their own reality, and their partnership was bearing fruit beyond anything they had ever imagined. The event was a great success in every way and raised over $100,000. Since then, the SHNCI has supported dozens of international fellows, from backgrounds ranging from ENT (Ear, Nose and Throat) to general plastic and maxillofacial surgery, to participate in periods of training in head and neck oncology. The institute has also contributed to research that discovered a causative link between the human papillomavirus and some head and neck cancers, especially tonsil cancer.

  As well as director of the SHNCI, Chris was director of cancer services for the Sydney South West Area Health Service and clinical professor of surgery at the University of Sydney. He had founded the Australian and New Zealand Head and Neck Society, of which he became president in 2004. He trained young surgeons and teams. He lectured widely overseas, and continued writing book chapters and scientific papers, totalling more than a hundred. His private practice, by then established for more than fifteen years, was becoming overburdened as people travelled from around the city, country and Asia–Pacific region for his care. Patients were double- and triple-booked as colleagues bypassed secretaries. Chris would not say no to someone who needed to see him, and always made room for urgent cases.

  When Gail provided support in the practice, the packed waiting room made her feel claustrophobic. Secretaries cowered behind their computers as throngs of patients grumbled about waiting times and expired parking meters. Chris had a way of defusing any discontent, dutifully tending to each individual and giving him or her his undivided attention. If he was late into the rooms from rounds or a meeting, he would stride in, calling, ‘Don’t worry, folks, doctor’s here!’ and elicit a smile from even the crankiest patient. On the busiest days Gail would feel so overwhelmed that she felt like she couldn’t breathe. When she would leave for home in the afternoon, relieved to push through the door, she would think of Chris there in the eye of it all, slowly trudging his way through each task and patient.

  Then came a new opportunity — the role of director of the Sydney Cancer Centre. It was an administrative role that would see him leading Royal Prince Alfred Hospital’s cancer treatment services and it would allow him to expand his vision of research-based cancer care in the context of multidisciplinary teams. Led by a fundraising body established by Frank Sartor and chaired by Lucy Turnbull, a prominent businesswoman who succeeded Sartor as Sydney’s lord mayor, the centre was planning a ‘Raise the Roof’ appeal to expand their premises. But the aspirations for the centre quickly grew to an entirely new building. A purpose-built centre would be the Sydney Cancer Centre’s opportunity to create something that was truly comprehensive, akin to the centres of excellence in the United States.

  Chris and Gail invited the New South Wales premier Morris Iemma and his wife, Santina, to dinner. Gail was happy to see that the ravenous premier wolfed down the meal she had cooked. After dinner Chris pushed his plan, resulting in a grant of one million dollars to establish the business model. Chris was intent on trying a new model of cancer care in a privately run not-forprofit institution that was egalitarian in its admission of patients yet not controlled by the New South Wales health bureaucracy.

  Gail and Chris had discussed the opportunity of Sydney Cancer Centre director as a two-days-a-week role, moving him away from work as a consulting surgeon. In fact, the result was that he had two full-time jobs. Furthermore, their fundraising efforts had grown from the SHNCI to the wider needs of the Sydney Cancer Centre. One late weeknight evening, as Chris and Gail sat in the study together auditing financials and reviewing plans for another function, Gail felt as if her rib cage was squeezing closed. ‘I’ve got a pain in my chest,’ she said to Chris.

  ‘I used to get that. But you work through it,’ he replied.

  It was not the answer she wanted. Gail thought the practice was spinning out of control and that as manager she must be doing something wrong. But an expensive consultant gave her a business appraisal and offered no practical solutions, except perhaps to find more hours in the day.

  Chris’s load was monumental. ‘Christie, we have to take some things off the list,’ Gail would say. They would sit down together and list every commitment but they couldn’t seem to find anything that could be crossed off. Nothing could come off the list, they said again and again. Then the decision was taken out of their hands.

  Dear Mum,

  I asked your close friend Di Ross for her recollections of you and our family throughout these years. After all, our families have been close since you and Di met when Adam and her oldest son, Fergus, started kindergarten together. Her response? ‘Interminable violin lessons.’ The patience you had to sit by Adam and me as we scratched our ways through the Busy Busy Stop Stops of ‘Twinkle Twinkle Little Star’. I continued playing for fifteen years, Ad moved from violin to trombone and then trumpet. James started piano lessons — interminable is the right word!

  Mum, it’s clear that throughout these years your life had become completely entwined with Dad’s. When I asked you about your decision to leave work and support his practice, you could not recall any conversation about it, as though your common desires to build a life together and raise a family gave rise to a mutual and effectively unspoken understanding of how that would work. I am eternally grateful for the home life that this created. But I suppose, three decades later, it would place you in a somewhat precarious position. We were completely reliant on Dad and his ability to work for security.

  I wonder, what advice would you give to your younger self?

  With a heart full of love and gratitude, Juliette

  * * *

  My dear Juliette,

  The baby grand piano that sits in our living room at home bears the scars of many years of angst and resistance to practising — adds to the patina. If you look closely, you will actually find James’s teeth marks on the lid from when, at the age of eight, he dropped his head out of frustration and landed his teeth in the wood! I was fascinated to learn that the Suzuki Method (which you children followed for violin and piano) places the mother in a central role for the child’s learning. She must attend the child’s lessons and supervise practice — she almost learns the instrument herself. That’s certainly how it worked for me.

  This of course assumes that the mother has the time to play this role. I did have this time, because I had stopped working as a physiotherapist. I wanted to stay at home and look after my children. I loved being a mother.

  Ultimately this was my choice but sometimes our choices place us in insecure positions later on. With what was to come, I was thankful that I had never relinquished my professional registration as a physio and always kept up with continuing education. I have no regrets, Juliette. But my advice to my younger self now would be to keep her hand in what she was trained to do. Don’t give it all up thinking she’ll never need it again, no matter how strong the marriage is. She needs to empower herself by kno
wing she could cope independently if the need should arise.

  Lots of love, Mum

  PART TWO

  In Sickness and in Health

  Countdown

  One evening in late November 2006, as Chris and Gail lay in bed, their bodies yielding to the exhaustion of the day, the week, the year, Gail looked at Chris’s silhouette in the darkness. She knew that things were not quite right with her husband.

  Outside their window, the beautiful Lane Cove River drifted gently by our Hunters Hill home. On this night, Adam, now twenty-five years old, was not at home, but his bedroom was filled with his possessions ready for his return: a weight-lifting set and bench, a ‘door gym’, posters of wrestlers and photos of family on the walls. He was living in Goulburn, completing his final months of training at the NSW Police Force Academy and would drive back to Sydney every few weekends and holidays. James had just turned seventeen and was now boarding at St Ignatius’ College, Riverview, and preparing to enter his HSC year, in which drama and music would be his focus. I was twenty-two and had almost finished a communications degree. I was grateful to Mum and Dad for letting my boyfriend, Gareth, live with us. I felt a deep contentment when my brothers were home as well, as though the house sighed with fullness and love when we were all under the one roof.

  People would come and go in a whirlwind of activity; at the time, we also had close friends from Lausanne, Switzerland, staying with us: Luc Bron and his wife, Michèle, and their baby daughter, Hélène. Luc had worked with Dad during his Ear, Nose and Throat (ENT) residency and later as a clinical fellow. He was like a member of the family.