Uncovering the toxic culture of surgeons | Four Corners Documentary

Key Concepts

• Medical misogyny
• Surgeon's ego and "god complex"
• Patient care and empathy
• Surgical complications and follow-up care
• Hospital culture and accountability
• Workplace harassment and sexism
• Gender equity in neurosurgery
• Medical negligence and legal recourse
• Impact of surgeon's behavior on hospital staff
• Mental health and suicide

Annie Sar Good's Case

• Annie Sar Good had back problems for years and was referred to Greg Malum for a spinal fusion operation at Epworth Private Hospital.
• Annie's husband perceived Greg Malum as arrogant and flirtatious.
• Annie underwent an operation where a movable disc was placed into her spine, but soon after, the prosthesis dislodged and moved into her abdomen, pushing on her internal organs.
• Annie required emergency surgery. She says that Greg Malum accidentally cut an artery during the first operation.
• She suffered sympathetic nerve damage, leading to circulatory issues in her feet.
• She received a modest settlement from the medical device company.
• Annie experienced post-traumatic stress disorder.

Greg Malum's Legal History

• Greg Malum had been named in 10 legal writs, a high number compared to his peers. Most surgeons might have one or two in a 30-year career.
• Being sued multiple times suggests potential issues with communication, respect, and professionalism.
• Despite this history, Four Corners clarifies that they are not suggesting Greg Malum has been a negligent surgeon.

Rick Leguin's Case

• Rick Leguin, a physicist and senior controls engineer, had a compressed spinal cord from a fall decades ago.
• In 2016, he was referred to Greg Malum for a laminectomy.
• Rick walked into the hospital but woke up paralyzed after the surgery.
• He claims Greg Malum informed him of his paralysis with a lack of empathy and provided minimal follow-up care.
• Rick felt abandoned and considered ending his life.
• He attempted to sue Greg Malum, but his lawyers advised him to abandon the legal proceedings due to a low chance of winning because the statute of limitations had almost expired.

Nub Magak's Case

• Nub Magak was injured in a car accident in 2008, leading to a mass of fluid on her spine.
• She was referred to Greg Malum for surgery.
• Despite being told there was only a 2% chance that something could go wrong, Nub woke up permanently paralyzed.
• She reports that Greg Malum did not visit her after the operation to explain what happened.
• Nub's family, upset by the lack of communication, were threatened with police intervention when they suggested going to Greg Malum's rooms.
• Nub sued Greg Malum, and the case was settled out of court.

Royal Australasian College of Surgeons' Guidelines

• The college has strict guidelines for fellows, including communication with patients, empathy, and compassion when delivering bad news.
• Failure to provide adequate follow-up or explanation after a complication is considered unacceptable.
• The college's framework emphasizes the importance of showing empathy and compassion, especially when breaking bad news or discussing poor outcomes.
• The college guidelines state that surgeons should not repeatedly display a negative attitude towards junior medical staff, nurses, and other health care professionals.

Epworth Hospital and its Culture

• Epworth Healthcare CEO Andrew Strip issued a statement condemning Greg Malum's behavior in the corflute video.
• Greg Malum resigned from Epworth before an external investigation into his behavior was completed.
• This was the second time Greg Malum had left a hospital under difficult circumstances, previously resigning from the Alfred Public Hospital after a written warning about not turning up when on call.
• Former Epworth staff described a culture where surgeons are seen as "untouchable," and complaints are often dismissed or minimized.
• Egotistical behavior by surgeons was a common concern raised by staff.
• Some female staff felt uncomfortable with Greg Malum's behavior, describing it as crass, inappropriate, and overly familiar.
• One radiographer made a complaint to HR about Greg Malum's behavior after an incident in the theater.

Gender Equity in Neurosurgery

• Neurosurgery in Australia is a male-dominated field, with women representing only 16% of practicing neurosurgeons. At Epworth, there are 25 neurosurgeons and not one of them is a woman.
• Dr. Kate Drummond, president of the Neurosurgical Society of Australasia, advocates for "socially engineering" women into neurosurgery to address gender inequity.
• Dr. Drummond believes that any woman who meets the standard should be appointed for training in advance of men until gender equity is achieved.

Laura Hefernan's Death

• Laura Hefernan, a nurse at Epworth, began dating Greg Malum in January 2014.
• Nurses had said Greg Malum was "persistent" and that he "was pursuing her and going after her."
• The relationship ended when Laura discovered Greg Malum was cheating on her.
• Laura sent a distressed email to her girlfriends, describing Greg Malum as a liar and expressing feelings of shame and humiliation.
• She wrote that Greg's ex-wife "knew that we were both being totally duped."
• Laura wrote that Greg's ex-wife "thinks he has narcissistic personality disorder."
• A doctor offered to accompany Laura to complain about Greg Malum's behavior, but Laura declined, saying he was "too powerful."
• Laura committed suicide in September 2014.
• Laura wrote a suicide note to her parents, expressing her heartbreak and feelings of being used and humiliated.
• Greg Malum attended Laura's memorial service against the family's wishes but did not offer condolences.
• He never contacted the Hefernan family after Laura's death and did not respond to police inquiries.
• Laura's death had a profound impact on the nurses at Epworth, with some refusing to work with Greg Malum afterward.
• One nurse who spoke up for Laura left Epworth shortly after, feeling that more intervention was needed to address Laura's declining mental health.
• Laura's mother, Christine Hefernan, believes that Greg Malum "wasted her life."

Greg Malum's Response

• Greg Malum did not respond to Four Corner's detailed questions.
• In a preliminary phone call, he claimed the corflute video was a joke and that his fondness for mobster movies had been misinterpreted.
• He pointed to his long and successful career at Epworth.

Waring Private Hospital

• Greg Malum is now operating at Melbourne's Waring Private Hospital, which claims to have zero tolerance for inappropriate behavior.
• Ramsay Healthcare, Waring's owner, stated that Greg Malum has temporary credentialing and his application for full credentialing is progressing.

Synthesis/Conclusion

The Four Corners investigation reveals a pattern of behavior by neurosurgeon Greg Malum characterized by a lack of empathy, poor communication with patients, and alleged sexist behavior towards colleagues. Cases of surgical complications followed by inadequate follow-up care have left patients feeling abandoned and traumatized. The program also sheds light on a hospital culture at Epworth where surgeons were perceived as untouchable, and complaints were often dismissed. The tragic suicide of nurse Laura Hefernan, following a relationship with Greg Malum, underscores the potential consequences of unchecked power dynamics and the importance of workplace accountability. Despite his history, Greg Malum continues to practice at Waring Private Hospital, raising questions about the effectiveness of credentialing processes and the commitment to zero tolerance for inappropriate behavior. The report emphasizes the need for systemic change to promote gender equity, improve patient care, and foster a culture of respect and accountability within the medical profession.