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The Darwin Hospital miracle

TRANSCRIPT
JASON McCARTNEY, FORMER AFL PLAYER: I've travelled to Bali over the last 10 years and it just seemed like another Saturday night, the crowd was filling up and, you know, there was just a lot of young people just having a good time. Over at Paddy's Bar, probably been there 15-20 minutes with team-mate Michael Martin. We weren't even there long enough – I think only got one drink – and, ah, nothing untoward about the night. By the time we got to get the second drink, that all changed pretty quickly with just a massive explosion and I just remember a fireball sort of fizzing towards me, not knowing what had happened and being knocked to the ground.

STUART ANSTEE, BALI VICTIM: That's when all hell was let loose. I was able to get my way up and out of the club. Followed a girl out onto the street, sat down on the corner of the footpath and pretty much just laid back and I'm not sure if I lost consciousness at that point. But I was able to get up from there and met two Australians who helped me get to the first medical clinic.

JASON McCARTNEY: I just remember being out the front then and not even knowing about the Sari Club because there was too much smoke around where I was and I was on my own and Mick appeared and he wasn't too badly injured and he could see I was and he got me out of there pretty quickly.

STUART ANSTEE: I was in and out of consciousness that whole way from getting out of the club to getting to the military hospital. One thing I do remember is blood spurting out of my neck, out of the corner of my eye, just in my peripheral vision, so obviously I was a bit concerned about that but being in a state of shock and semi-consciousness I didn't really register what was going on or how bad a condition I was in.

JANA WENDT: Stuart Anstee and Jason McCartney were just two of the victims of the Bali bombings a year ago. In those first few minutes after the blasts they knew they were badly injured but didn't know what to expect from the Balinese medical system.

STUART ANSTEE: I was taken to a fairly small clinic, which was the first hospital I went to. I didn't really see a lot because my eyes were full of dust and grit and sealed up. I just remember taking in a lot of the sounds obviously I couldn't see a lot. Just hearing things was my main input. Some pretty horrible sounds from people asking for help, asking why they weren't getting help and that sort of thing.

JOHN HOGG, SURGEON: What we did we did on the wards without any anaesthetic, we had no instruments whatsoever. In that second ward I went to, I urgently needed a scalpel, they could not find me a scalpel.

JANA WENDT: Wollongong surgeon Dr John Hogg was holidaying in Bali last year when the bombings occurred. Like many, he rushed to the main hospital.

JOHN HOGG: I was then able to get a scalpel blade, and then I was able to do the procedure using a scalpel blade. We didn't have a handle for the scalpel. There was no water available. In the ward there was one small sink and you could just get a trickle of water out of the tap. There were no proper dressings. It became more and more difficult because as the day progressed the hospital became absolutely filled with throngs of people. Honestly, I don't know whether I saw 110, 120, 130 people. My main recall is that I don't think any of them complained as such. They were unbelievably brave, total heroes. So these people having these procedures without any anaesthetic and again not complaining, in pain not complaining, they were just extraordinary.

JANA WENDT: Back in Sydney the seriousness of the situation was being assessed. Although first reports were sketchy it soon became obvious that emergency help would be needed.

STEPHEN ASPINALL, WING COMMANDER, RAAF: I was able to get into the operations room just on 5am as the information started coming in that there had been a disaster, the nature of which was still largely unknown as were the casualties. There was a lot of fog and confusion at that stage about how devastating the disaster had really been.

JOHN HOGG: We really made a decision, all of us, that the priority was to get people back to Australia. So an overall strategy emerged, not particularly voiced by any individual but we, I think, all started to realise that repatriation was the thing that had to be done.

STEPHEN ASPINALL: My first call was to our airlift group here at Richmond to put them on alert that we were going to be responding to an emergency, nature still undefined and the response largely also undefined. We started calling in crews to man the C130s and also the medical teams to provide the support for the nature of the injuries we were expecting.

LAC MICHAEL GUNN, RAAF MEDICAL ASSISTANT: I received a phone call approximately 6:50 that morning requesting my attendance to get ready for an air medical rescue evacuation. So I arrived at the hospital and started to get ready for the AME, getting all of our equipment ready, etc.

FLT LT LIBBY SWINDEN McCONVILL, RAAF NURSE: We have a standard kit that we need to take and we got that ready. We threw everything on a pallet, seat belts on and took off and then we configured in flight en route to Darwin.

FLT LT AARON BAKER, RAAF PILOT: On the way up we listened to news reports and sort of built a picture of what had happened. So I think by the time we got to Bali we had a reasonable idea of what to expect.

JANA WENDT: With the build up to the wet season under way, it was a typical steamy, sleepy Sunday in Darwin. It was also a quiet morning at the Royal Darwin Hospital till a patient with a strange story walked into the Emergency Department.

RICK ELLIOT, BALI VICTIM: I was in Kuta last night and I'd just come from Paddy's nightclub and I was just heading back to the hotel and popped into the Sari Club. I'd only been there a couple of minutes and went around to the back of the club just to put my video away, under the bar. All of a sudden just a loud explosion and the ceiling collapsed in on me and everything went dark and then I just sort of – just a bit shocked and just sort of lifted the ceiling away from me and crawled out from under that and it was just dark and dusty.

JANA WENDT: Rick Elliot was lucky to walk away from the blast. He'd only been in Bali nine hours but now he didn't want to stay.

RICK ELLIOT: I tried to get to the hospital. I went to a couple of hospitals on a motorbike, which was scary in itself, and it was just chaotic at the hospital, there was a lot of injured people. I thought “Oh well, the first thing was just to get the first plane out”. So I just went back to the hotel and got my things packed and caught a taxi as fast as I could to the airport, and lucky there was a couple of seats left to Darwin. Rick went straight to the hospital in Darwin to have his wounds dressed. It was a 7:45 Sunday morning.

LEN NORTAS, MEDICAL SUPERINTENDENT: Well, the interesting part is that I received a call about an hour after he'd arrived, and the Emergency Department staff, nursing and medical, had actually realised very quickly that this young man had a story of fairly significant proportions. He spoke chillingly of carnage, of death, of horrific circumstances that had occurred involving Australians in Bali. And the staff were very quick to actually notify senior administration, and actually, in actual fact, help prepare for what could, or might be a sequel to this story.

JANA WENDT: So he was pivotal to how the hospital responded?

LEN NORTAS: Absolutely, absolutely. So the decision to actually treat this young man's intelligence as vital and as significant, was made very, very early, and thankfully it was exactly the right decision.

GARY LUM, ROYAL DARWIN HOSPITAL: At the time I was the acting General Manager for the hospital and at the same time I was also looking after the Pathology Department, so blood transfusion and those sorts of things. Some of my colleagues were meeting with senior politicians and working out exactly what was going to happen from that perspective, and when we got the word that patients would be coming to us, that's when we knew it was really on.

DAVID READ, SURGEON & ARMY RESERVE: I got a call from two sectors really, both civilian and military, civilian as my role as a consultant surgeon in Darwin, military as an army reservist, and both – both sectors were working on the same plan that it would be necessary to send a couple of specialists on the first Hercules to Bali.

JANA WENDT: The operation was beginning to gather momentum. But those on the first flight into Denpasar still didn't know what to expect.

DAVID READ: We were met at the airport by a consular official who told us – briefed us to what the situation was. And he'd arranged transport for us, and a driver to Sangla Hospital, which is about 30 to 40 minutes away from the airport. At this stage we split the teams – seven of us went off to Sangla Hospital, and four, five, six of us stayed with the aircraft at the airport.

MICHAEL GUNN: First of all there was an immense amount of people surrounding the hospital just staring in, probably just two- to three-layered thick on the outside just staring in. So we had to push through those people with stretchers and so on that we were carrying in and then eventually got into the hospital and just as many people on the inside.

DAVID READ: One of my biggest memories is walking into the ward where all the Westerners were, they'd all been well corralled into one area for us, and ah, it was dead silent. Everybody, when they saw us walk in, looked up at us with pleading eyes, you know, “Take me home, take me home” sort of thing. And, you know, the average percentage of burns for these people was around about 20 per cent or so. That really, really hurts. I cannot understand and comprehend how they were all silent and not complaining.

STEPHEN CRIMSON, RAAF NURSE: It's quite eerie, the patients were very stoic, they all knew that they were in trouble but nobody tried to come out and grab your attention over the next person, they were very brave, that's what really hit me. The silence. The silence and letting us get there and do our jobs and having some faith in us to get them out of there, it helped a lot.

DAVID READ: This situation it was – it was unworkable. There were media crews, onlookers, just every man and their dog was there. Nobody was in acute danger of dying there and then, so the decision was to scoop and run, is the technical term, to take these people via a fleet of ambulances, back to the – back to the airport.

PETER KENNEDY, RAAF LOADMASTER: To me it reminded me of a scene out of MASH. All the patients were in this, like a shed, sort of set up a triage area, the medical teams had set that up. A lot of people laying around on stretchers, IV bags and fairly chaotic sort of scenes. At that stage the medical teams are trying to stabilize all the patients for air travel. We tried to assist the medical teams by any assistance that we could possible render by either holding IV bags and then when the medical team would sort of stabilise that patient and move on to the next, we'd sort of get into someone's ear and just a little comment like, “Everything's going to be fine. We are going to take you back to Australia. It's going to be a better place. You are going to be back with your families,” all that sort of stuff. To us probably a very little thing to say and it probably didn't mean much at the time but it was just our way of letting them know that they were going back to a better place, safety wise.

LIBBY SWINDON-McCONVILL: We performed some surgery on the ground. Surgeons and doctors and nurses and medics helped them perform what is known as an escharotomy, where they incise the skin so they don't loose the limbs because of the swelling so we were doing those sorts of things and giving them fluids and pain relief, that was the main management.

DAVID READ: We did a number of procedures designed to relieve pressure on these limbs, to increase the blood flow to them, to prevent such complications in the future as gangrene, um, and give them the best chance of survival in the future. There's a limit you can do, um, in a fire station with a hand-held torch and a scalpel, so it was just the really the simple basic sort of stuff.

PETER KENNEDY: I didn't even know who Jason McCartney was. I'm a rugby league supporter, not an Aussie Rules fan and he was a pretty big guy and I just sort of mentioned as I picked him up on a stretcher I just sort of mentioned, “Gees, you're sort of a heavy sorta bloke, mate. Do you play football?”. And he sort of mentioned yeah, he did and we sort of had a bit of joke with him obviously he'd had a big off season, you know, been over in Bali having a good time, all that sort of stuff and he come out with the comment that, “Yeah, that would be just my luck”, he said “now you blokes are just going to drop me”. So we made a bit of a joke sort of, put him back down and walked away, then came back and said, “No, it's alright, mate, we are going to take you on board and everything's going to be fine".

JASON McCARTNEY: Yeah look, we were stacked, we were three high and look I – being on a stretcher, that's one of the amazing things, I didn't really know, and you didn't sit up and look around, you only knew what was next to you or in the near vicinity, you didn't know what else was around because you were – you didn't move too much when you are burnt like that either so I knew we were stacked three-high but I didn't just have any understanding of just how many people actually were on the plane at any one time.

STUART ANSTEE: It was just very cold, obviously no climate control on the Hercules. A lot of chaos, the doctors were running around pretty flat out trying to keep everyone stable. I think one lady died on that flight. It was just very cramped, very chaotic, a lot going on.

AARON BAKER: I think they were glad to be heading home. I guess it has been almost 24 hours since the explosion occurred and they were probably wondering, you know, when it was they were going to get home. So to have Australians arrive and say, "We're taking you home now", I think they were pretty pleased with that. That was the thing I tried to reassure was that we're here and we're taking you home and we'll be home soon.

MICHAEL GUNN: There was 22 people on the flight, on the return flight and each one of them has got certain needs for sure. You've got to attend to not only their dressings and so on but you've got to obviously look after their communication. They're in a foreign environment so not only us as medical staff but the ground crews, etcetera, that were also on the flight were constantly talking to these people because they need reassurance that everything is OK and we're heading to a better place and they're going to be looked after effectively. So constantly being talked to, constantly being addressed, making sure they're feeling OK.

AARON BAKER: I'd flown a couple of medical evacuations before but it's only ever one or two patients, definitely nothing on this scale, ah, and I don't think anyone around these days would have seen anything on this scale. On the way back we lost a patient about halfway home. It was nothing the medical team could do, just too badly injured. Just the unfortunate thing that comes out of these situations.

JANA WENDT: It was now 1:30am, over 24 hours since the bombings. The first C130 Hercules with 15 critically injured patients had landed in Darwin. At the airport, emergency medical teams swung into action.

DR BRIAN SPAIN, ROYAL DARWIN HOSPITAL: There were a group of us who work in intensive care as well as anaesthesia, and I organised some of the retrieval doctors. So they were all people who were used to dealing with critically ill patients in a field situation, so that we went out to the airport with some intensive care nurses and emergency department nurses and we were able to – we had equipment there so that we could take over from the military people. We knew some of them were on the brink of life and death as they were being transported, and that we needed to have highly trained people there to continue the management that the Australian Defence Force had started on the way to the hospital and follow those people through.

JANA WENDT: Suddenly all attention was on a regional facility in the NT. The Royal Darwin Hospital was built in the late '70s as a response to Cyclone Tracy but the Bali crisis would be as testing for this hospital and its staff as anything that nature could throw up.

LEN NORTAS: I guess I felt that some hadn't realised just how great that task would probably be, and because of the youth of a number of our staff, this was going to be a very defining moment. But I – as I walked around and actually saw the way in which these people were preparing, it was almost like preparing for a battle, in fact it was exactly the same as preparing for a battle.

JANA WENDT: After the break, how the doctors, nurses and staff of Darwin hospital fought that battle.

[Commercial break.]

DAVID READ: At that stage I became a little less useful as a surgeon. We, to be honest, had run out, started to run out of a lot of material anyway, we were getting low on fluids and low on antibiotics and low on pain relief. There was one, one person whose arm had deteriorated on flight that required an operation in-flight, and that really, we really did that with minimal anaesthetic and holding the fellow down. That's you know, it had to be done. Yes, I was very pleased to see two things. First of all, what I was told later, was every single ambulance in the Northern Territory. Clearly this was not the time to be bitten by a snake down at Tennant Creek or something. And Brian Spain, the director of anaesthesia here, and that was, made it a lot easier, because Brian and I work together in the civilian, the civilian sector here in the hospital. I told Brian what I knew of each individual patient, what I thought needed to be done in the future, and he relayed that directly by mobile phone to um, to Didier Palmer, the director of accident and emergency here at the Royal Darwin Hospital.

DR DIDIER PALMER, DIRECTOR EMERGENCY DEPARTMENT: Well we set up the department according to our plan, which was to set it up into three areas. Within the first half-hour we developed three resuscitation areas. The departmental plan was that someone greets people at the door and works out where they are going to go – and that person must know the total resourcing of the hospital – so that was director of the department, myself and a senior nurse, and then in each resuscitation area there was a consultant an emergency physician plus about eight to 12 doctors plus eight to 15 nurses in each of the three areas.

MARGE ST LEON, NURSE IN CHARGE: There was a feeling of anticipation, there was a feeling of excitement, I guess, because that's what we are trained for. It's like when a soldier goes into battle or anything you are trained for that kind of thing and you're ready for it. But I guess being ready for it doesn't – you might be physically ready for it – but emotionally that was going to take its toll on the staff later.

JANA WENDT: But dealing with the here and now became the priority for the hospital staff as the first wave of patients arrived in ambulances. One year on Didier Palmer recalls what happened as those first patients arrived at what is now the old emergency department.

DR DIDIER PALMER: All the patients came along here and I greeted most of the patients across there with one of the senior nurses, and then brought them just inside the doors of the emergency department and triaged them.

JANA WENDT: So initially this was full of people being assessed?

DR DIDER PALMER: No, we moved them in very quickly. We got them off the ambulance, got as much info as we could, bought them inside and then stacked the ambulances here to give ourselves space. You've gotta stagger things, but even so when we look back at our statistics we were receiving one patient every two minutes, 30 secs, roughly, and so everything was happening very, very quickly.

JANA WENDT: And you had to keep track of what was happening inside and where there was room to move individual patients?

DR DIDIER PALMER: Exactly. And one patient every 2.5 minutes – that's one ambulance – cause these where critically ill patients, only one patient could go in an ambulance. And this is what they saw – essentially to my left here is the first resus. room. And this small area to my right is what we ran our entire emergency department from.

DR GARY LUM: I think that it, uh, when you saw the first patients coming through, because they were largely the ah, the most-affected patients, the more severely burnt patients – and to see large numbers of those sorts of patients you can look at them and think, “What's happened here?”. I don't think anybody can be completely ready but we're professional people. It's not as if living in the Northern Territory we don't see burns patients, trauma patients, patients who are severely injured. Just the sheer number and knowing what they'd gone through, you did step back and you were thinking, "Gee, what's really gone on here?".

DR MALCOLM JOHNSTON-LEEK, SPECIALIST PHYSICIAN: Well our role was essentially, first of all, to carry out immediate resuscitation, which we did in the emergency department. Those patients that required immediate life or limb-saving surgery had their procedures done here. The more severely burnt patients as well were stabilised, had their initial dressings done because when they arrived it had been 24 hours by the time they actually got here from the time of the blast, so that is one of the most critical times in the management of any severe burn patient.

DR DALE FISHER, PHYSICIAN, RDH: I've never seen 60 people come through like that and that's when it really starts to effect you, is when they are still wearing torn clothes with blood on it, and you know you might see that in one person but I haven't seen that in 50 people before, and when you're talking to someone, I remember one German girl that I was suggesting to her that we were evacuating everyone out of Darwin, where would she like to go? Cause she wasn't even from Australia and she said it didn't matter. And I said, "You don't know anyone, no family, no friends in Australia?". No, it doesn't matter where she goes. "Who were you travelling with?".
"Well I was travelling with a friend but I've lost her."

DR MALCOLM JOHNSTON-LEEK: Some of them came with, their dressings were actually just towels that had been washed in Balinese water, because the Indonesians ran out of burns dressings. So there was always the ongoing problem of infection. The Indonesians ran out of IV fluids very quickly, just the sheer number of people that they had to treat. So we had to again resuscitate the patients. It's at the time when the swelling is quite dramatic, a lot of the facial burns patients had to be intubated because of the swelling of the airways. Had ongoing pain problems, which we addressed as well, and then it was a matter of co-ordinating which patients then went where throughout Australia through the initiation of the burns management plans.

ROMA SMYTHE, NURSE, RDH: I think one of the people who came through was missing a leg and arm, and they were basically patched in A and E and were waiting for theatre time, and I had never seen anything like that. And the staff we had allocated certainly hadn't, and it was quite traumatic. And we had quite – we had two patients who came up like that who we had to do what we could until they went to theatre. Yeah, it was something that I'd never seen and I don't want to see it again.

DR DIDER PALMER: It wasn't only burns injuries, although everyone was burnt. These were blast injuries, so explosion injuries. All the burns were complicated by that because there was debris embedded in the skin, but also blow out injuries - for example, exploded lungs. Everyone had exploded tympanic membranes, burst bowel, amputation injuries and also partial surgery from Bali where the doctors and nurses there had done really very remarkable things. So we were picking up people a little bit along the line.

JASON McCARTNEY: Straight away in my memory into the emergency room and just a nurse came in and then within less than a minute I remember there was six or seven people looking over me – nurses, doctors – and it was just about to take off the dressings I had and inspect, there were some notes that had been bought back, what had been done in Bali but to reassess and re-apply cream and re-do the bandages make sure you are in a stable condition and get the next person in, because although there was a lot of work to do there was a lot of other people to get through, so it was about doing the best they could to, I suppose, getting you to stage adequate level and then get the next people in, but constantly very closely monitored.

LEN NOTARAS: The atmosphere was not as you might expect it. It was not as you'd expect it in an emergency department as seen on television, or even in emergency departments that I've worked. There was no hysteria, there was no loudness, there was no urgency in terms of people calling out and demanding things to be done. There was a collective, reserved intent on getting the job done, and you could actually feel it in the room, you could feel the staff getting on with their job, actually doing things.

DR DIDIER PALMER: So this was our main resuscitation room. It's empty now but if you can imagine six beds in here. One bed there; one there; one there; one just behind you, and one behind that curtain. At one point I walked into this room and there were six patients being resuscitated, each with a team of four, five, six people around them, ah, absolutely silent. I walked in – lines going in, test tubes going in – everyone was silent, everyone just working together for one common goal. Even the patients were silent, uncomplaining, just happy to be here in many ways.

JANA WENDT: It really was a remarkable scene in the whole experience.

DR DIDIER PALMER: Yes. It was something that will certainly stay with me.

JANA WENDT: The emergency flights keep coming. four flights over 12 hours ferrying 62 patients in all. Doctors, nurses and staff worked to the point of exhaustion.

DAVID READ: I was pretty knackered by that stage, I'd been awake for about 30, 30-plus hours. There were four theatres going at that stage and they were adequately staffed, so I went to bed for three hours. And when they started fatiguing, some of them had been up operating since 6:00 in the morning, I came back about 17:00 hours and operated for another eight hours until midnight, by that stage I was a totally spent force and it was time to go to bed.

JASON McCARTNEY: Speaking with my wife she often talks about the fact that nurses and doctors, some had been working 35-36 hours non-stop – and look it's just amazing. I think everyone who was involved it was just such heroic efforts– to be inundated like that and just go to work and do an amazing job like they did and sustain it for that period of time is just beyond belief sometimes.

JANA WENDT: Staff here didn't have much time to reflect on what they'd achieved. Some 38 hours after the first bomb victims had arrived, many were ready to be flown out to specialist facilities around Australia. A small regional hospital had performed a medical miracle.

DR DALE FISHER: By about 5pm we'd realised that we couldn't keep doing this for more than another day or so, and what's more, the patients were likely to deteriorate, as you do soon after burns. So once the decision was made to evacuate people back to their home towns we – yeah that logistic exercise had to be done which was assessing who was fit for transportation, who's not fit, and make sure they are going back to the place that they should.

MARGE ST LEON: I remember walking in the back area and seeing all these army stretchers – line upon line with young people on them – and that helped because some of them had got rid of that awful glazed look and some of them actually had a smile on their face because they were going back to their, you know, reciprocal States. And that helped us, as nurses, to see that, you know, they are moving on and that for an ED nurse I guess is closure.

WENDY BIGGS, NURSE, RDH: Yeah, the next morning, coming back at 7am in the morning, when I'd left at 9:30 that night, came back, and the last lot were being evacuated to Melbourne, and that was about the last eight or so were going there. And an hour after that I had an empty ward. A ward that looked like a disaster zone because there was equipment everywhere and stock and all sorts of things everywhere, but it was quiet, there was no patients, there was nobody left.

JANA WENDT: But not every patient went home. Stuart Anstee stayed at Royal Darwin Hospital for another month. He recently returned to meet the doctors and nurses who'd helped him recover. For the first time since his operation, Stuart meets the surgeon who performed it over a year ago. An undetected piece of shrapnel had entered his neck and severed a major artery, vein and nerve. It was a life-threatening injury that was quickly discovered by the staff at Darwin.

STUART ANSTEE: So do you remember the operation, do you, fairly well?

DR VARNY PRASAD, SURGEON: Yeah.

DR DAVID GAWLER: Oh yes.

STUART ANSTEE: It was fairly long, six hours? Because I really didn't talk to you much about it after.

DR VARNY PRASAD: I think we started about 10 and by the time we finished it was 6:30 or something.

STUART ANSTEE: Really, that long?

DR DAVID GAWLER: Are you sort of coping with life? You feel you're the same person or a different person?

STUART ANSTEE: Pretty much is same, I think, pretty much back to normal. Yeah, both my mates who were over there, had a chat to them and it's all pretty good. Back to a different job so yeah, it's going well. So the actual operation, did you have to take some artery out of the leg or were you able to stitch...

DR DAVID GAWLER: No, what we did, there were two vessels that were damaged. The common carotid artery and we were able to remove about a centimetre of that and then join the ends together and then we spent quite a long time looking for a piece of shrapnel that was very elusive.

STUART ANSTEE: Didn't end up finding it.

DR DAVID GAWLER: Well, we had a good idea where it was and we were worried we'd make a hole in your gullet if we removed that.

STUART ANSTEE: Obviously I was lucky to have Dr Gawler and Dr Prasad up here, probably two of the best surgeons in their field. They were able to do that work to a high standard and there's no post-op infection or anything like that. So it all went very well and I was lucky to have those two doctors on staff as well as the rest of the Darwin people. So yeah, they did a great job.

JANA WENDT: Stuart still has the shrapnel embedded in his neck, but he's now looking to the positives in his life.

STUART ANSTEE: Yeah, I lost one friend up in Bali and two of the girls that we'd met a couple of nights previously were killed. So that was unfortunate but the friendship that I've had with the surviving mate has obviously grown stronger. It's hard to put into words. Obviously there's still a bit of a numbness about it. Going back to the trial, going back to Bali, watching the anniversary progress and come forward. It's all input and helps to add closure to the whole process, I think. Yeah, it's obviously a major event of my life but being able to come through that and move on with me life has obviously made we stronger. So I suppose you get positives and obviously the negatives out of it.

DR DIDIER PALMER: This was a change for Australia, you know, our world had changed, our hospital had changed, everything has changed. So all of those things played a role and we only really realised that in the few days or week or two after the last of the patients had left, when a sort of contemplative calm came over the hospital where people suddenly realised they were sad, they were bereaved, that they had lost something, they might have gained things too, but they'd also lost something. It was very much a bereavement.

LEN NORTAS: If ever there was an Australian spirit captured for a period of time, that, I think, was the period of time where we lost a degree of innocence but we captured that spirit. And I guess many of our staff, while they'll remember the horrors of those hours, those days, will also remember that spirit and the professionalism of the staff, the heroism of the victims.

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