Associate Professor Andrew Dent, AM

Emergency Medicine Australasia (2008) 20, 444–446

doi: 10.1111/j.1742-6723.2008.01125.x

OBITUARY

Associate Professor Andrew Dent, AM

Andrew Dent, the former director of the St. Vincent’s Hospital, Melbourne ED, died on 10 June 2008 at the age of 53 years. His life and career spanned many experiences in different countries, and he encountered a great number of people who came to respect, admire and love him. Andrew died as he lived his life, totally selfless, dedicated to his work and completely supported by his family. He was a great man who helped shape emergency medicine (EM) and medical education both in Australia and beyond through clinical example, research and inspirational advocacy. A Melbourne graduate; Andrew began his career as a general surgeon in the UK where he undertook his specialist training. From there, he spent 2 years living and working at the Shisong Catholic Mission Hospital

in the Cameroon, West Africa. After spending some time at home in Melbourne and developing a new career pathway in EM at the Austin Hospital, Andrew took his young family to East New Britain Province in Papua New Guinea (PNG), where he worked at the St. Mary’s Catholic Mission Hospital in Vunapope. His skills as both an emergency physician and surgeon were essential when the Rabaul volcano erupted in 1994, sending the region into chaos and subsequently rendering the hospital and local areas uninhabitable. Andrew commenced at St. Vincent’s Hospital in 1995 where he quickly took up a leadership role as the director of the ED. With strengths in medical education, academic research and great personal charisma and integrity, Andrew established a cohesive and highly functional department during his 12 years of leadership. He was forced to step down from this role in June 2007 with the sudden and devastating diagnosis of colon cancer. True to his great strength of will and character, Andrew continued to teach and work at St. Vincent’s throughout his illness and treatment, and often during times of immense pain and frailty. He managed to maintain his presence at St. Vincent’s until a new ED director had commenced, not long before his death. Andrew achieved a great number of awards and qualifications, although these were largely unheralded during his life, mainly through his own preference. Apart from his Fellowships in Surgery and Emergency Medicine, Andrew was also a Fellow of the Australasian College of Tropical Medicine and completed a Masters in Public Health in the International Health stream in 2002. He was an enthusiastic researcher who published and presented papers exploring the themes of international medicine, medical education and the many issues facing vulnerable people who attend the ED. Although he published papers early in his career based on his experience in Africa and PNG, Andrew was in his most prolific research period around the time of his diagnosis. His research on the educational needs of junior doctors as well as specialist emergency physicians has been of great import in shaping curriculum and educational

© 2008 The Author Journal compilation © 2008 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine

Obituary

opportunities for these groups. Similarly, his research on drug and alcohol issues, frequent ED attenders and homeless patients in the ED has kept alive the psychosocial aspects of EM and challenged conventional thinking about the role of ED in engaging with these issues. Andrew was awarded the Australasian College for Emergency Medicine teaching excellence award in 2004, and made a member of the Order of the International Federation of Emergency Medicine at the International EM Conference in San Francisco, USA in April this year. Most recently, the day before he died, Andrew was made a member of the Order of Australia for service to EM as an academic, researcher and educator. Andrew has been a driving force in the development of EM both at St. Vincent’s and the wider medical community. Within his own ED, Andrew oversaw numerous physical expansions and improvements, pioneered the ‘EMU – emergency medical unit’ in response to increasing demand and access block in the early 2000s, introduced novel paperless IT systems for medical and administrative documentation and trained, recruited and professionally developed a cohort of dedicated and loyal emergency physicians and trainees. Andrew enshrined the role of EM research by creating and staffing the Emergency Practice Innovation Centre, which has consistently produced research of high clinical and academic import, and attracted stand-alone project funding since its inception. He was an open-minded recruiter of staff, with a special interest in people who had experienced life and work in developing countries, and those who were from other nations, exemplified by his nurturing of EM trainees from Iran. Because of his unequivocal focus on patients and their well-being, Andrew broke down hierarchies within his workplace, such that any member of staff had equal and valid contributions to make, and all felt valued and flourished as team members. Andrew was a true visionary with a powerful social conscience, and he moulded the St. Vincent’s ED so that it epitomized the values it espoused: justice, unity, excellence, human dignity and compassion. While leading in EM, Andrew maintained a wider focus on medical education and the needs of doctors at all levels of training and experience. He was the Director of Intern Training at St. Vincent’s and, as a result, became a mentor for junior doctors in the hospital. More formally, Andrew was a member of the Postgraduate Medical Council of Victoria, where his contribution to the education of junior medical staff was greatly valued, and helped develop the undergraduate EM curriculum and assessment for the University of Melbourne. He regularly gave up his weekends to travel to rural Victoria for

the training of general practitioners, and was an admired facilitator and great leader within the Early Management of Severe Trauma courses. Andrew pioneered simulation as an educational tool, using his staff for role play, well before technology helped develop this practice. Since the arrival of high-fidelity simulation, Andrew was integral in using it for training of medical staff at all levels, especially within EM, and was a foundation for the development of the Education Centre at St. Vincent’s. One of his greatest and lasting legacies has been the development of the Advanced and Complex Medical Emergencies course for the professional development of Fellows of the Australasian College for Emergency Medicine, and the comprehensive learning needs analysis that shaped it. Andrew was the inspiration and driving force for this novel and exciting course, developed with enormous commitment and skill for the benefit of his EM colleagues throughout Australasia. Andrew’s vision of care and compassion was not confined to St. Vincent’s nor Victoria, but rather encompassed the world and in particular the Pacific region. He maintained his links with PNG and gave a medical and social conscience to a multinational oil company as its medical director. Through his advocacy and because of the enormous esteem in which he was held, Andrew established preventative health programmes in HIV/ AIDS and malaria reaching small communities throughout the Southern Highlands and Gulf Provinces in PNG, in addition to the resourcing, training, staffing and support provided to community health clinics in those regions. His support for this service included personal 24-h on-call availability. Andrew’s desire was to build capacity in PNG, and so his emphasis was on training and mentoring local medical and nursing staff. He assisted in the development of the specialist EM training programme at the University of Port Moresby, and examined the first PNG emergency physician under this programme. Andrew delivered several Early Management of Severe Trauma courses in PNG and facilitated and hosted clinical placements for doctors and nurses from the Pacific region at St. Vincent’s Hospital. Importantly, he fostered enthusiasm among his St. Vincent’s colleagues, and empowered them to share his Pacific involvement and expand their networks in the region. Andrew travelled to PNG regularly and had a great love for the country and people, which was reciprocated by the many people he met and inspired. The year after his diagnosis was used to enshrine Andrew’s lasting legacy for the benefit of building support and medical capacity in the Pacific region with the establishment of the St. Vincent’s Pacific Health Fund.

© 2008 The Author Journal compilation © 2008 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine

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G Phillips

It is difficult to paint a picture of Andrew without resorting to a long list of his achievements and activities. These things, however, do give us a glimpse of his amazing capacity and enthusiasm for work, his vision and priorities, and finally a small window into the personal qualities that made him so admired and loved. Fundamentally, Andrew was a good and gentle soul, who truly and unambiguously subordinated his own needs to those of others. This made him a man of great integrity, who believed in values of compassion and justice, and lived, worked and breathed these values. All his colleagues and those who encountered him recognized and admired this quality and those lucky enough to get to know Andrew developed a deep respect, love and loyalty for him. He could be frustrating at times, modelling a work ethic that others could not follow, but his leadership was enabling and inspiring. People worked hard for Andrew not out of a sense of obligation or duty, but rather because he inspired them to a new height and believed that they had the capacity to get there.

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The theme of selfless service pervaded Andrew’s funeral, where hundreds of people representing family, medical, corporate and social services attended. The dignity and respect with which so many people stood to honour Andrew was a powerful testimony to his life. His untimely death at the peak of his career is a great tragedy and, for his wife, two sons and those very close to him, utterly devastating. It is nearly impossible to find meaning and hope within such a great loss, except to say that the living example of Andrew Dent gives us a vision of what a person can be and do, and inspires us to follow his example. Vale Andrew Dent. Requiescat in Pace. Georgina Phillips Emergency Physician St. Vincent’s Hospital, Melbourne, Victoria, Australia

© 2008 The Author Journal compilation © 2008 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine