Professor Ian Haines is a medical oncologist who is unafraid to wear his heart on his sleeve if it helps his patients feel supported through their cancer treatment
When Professor Ian Haines cried on ABC current affairs show Four Corners on 26 August, it took him by surprise.1
“It caught me off guard”, Professor Haines, a medical oncologist at Cabrini Private Hospital in Melbourne, tells the MJA. “I’m not often brought to tears, but it doesn’t worry me that I was upset.
“Patients share so much with me. It’s such a privileged job I have. I get to know them so intimately and there’s a bond that forms. I love that about my job.”
The immediate trigger for Professor Haines’s tears was recalling the moment when he had to tell the teenage son of one of his patients that his mother’s cancer was incurable.
“That was a key point in his life. He’ll never forget that moment”, Professor Haines had told Four Corners, through his tears.
Looking back on it now, Professor Haines acknowledges that there was more behind his emotion than young Nathan’s situation.
“I remember being about that age — 15 or 16 — when [a relative] was diagnosed with aggressive ovarian cancer in her late 30s”, he says.
“In those days (the early 1970s), there was no treatment beyond surgery. I watched her over many months when she was in absolute agony. My mother would stay up all night for months looking after her.
“That affected me, no question.”
Professor Haines took that experience and turned it into a storied 30-year career in oncology, pain management and palliative care.
After graduating from the University of Melbourne in 1978, he completed a medical oncology fellowship at Alfred Hospital in 1984. He then became the first Australian to be accepted into the clinical and research fellowship program at the prestigious Memorial Sloan-Kettering Cancer Centre in New York.
On his return to Australia in 1987, he set up the Melbourne Oncological Group, established and ran undergraduate teaching courses in palliative care at both the University of Melbourne and Monash University, and helped establish Cabrini’s own dedicated 24-hour domiciliary palliative care nursing service in 1999.
He ran a busy practice in Dandenong — “I like being able to give people in poorer areas the opportunity to access quality health care” — and worked long, gruelling hours week after week.
It all came to a shuddering halt on his 57th birthday, late in November 2011, when he suffered a cardiac arrest in the Cabrini car park. His life was saved by a passing orderly who performed CPR on him for 7 minutes.2
“You don’t drop dead for no reason”, Professor Haines says.
“My heart was normal, but I was trying to do too much. I had always thought that I could do twice as much as anyone else, but I was exhausted by the end of the week.
“I had to take it on board, honour the event. So I made changes to the way I practise. I gave up a lot of my work out at Dandenong, cut back on the number of patients I see each week.
“My heart attack was not as profound an experience for me as it was for my family. For me, I was asleep and then I woke up”, he says.
“I was incredibly lucky and I do have some survivor guilt about that. Knowing what my patients go through every day — what right do I have to be alive and well while they are going through so much?”
Professor Haines has two main aims in doing interviews like this one and the Four Corners story.
“I saw it as an opportunity to show patients that doctors do care”, he says. “And it is vitally important that people are given accurate information.
“Cancer is a disease of ageing. If we live long enough we’re all going to get either dementia or cancer and neither of them are good.
“We have a distorted view of cancer because when young people get it — people like Kylie Minogue, Belinda Emmett, Jane McGrath — there is a disproportionate amount of publicity”, he says. “But the message gets lost along the way and we don’t get accurate information.
“Everyone hopes they are the exception and hope is such an important thing, but we have to be responsible enough not to give false hope.”
The future of health care, Professor Haines says, is not in hospitals but in community care.
“We need to trust the public to help us work out the priorities”, he says. “The community is very intelligent when we give them the correct information.”
With the baby boomers inching towards old age, advance care plans and end-of-life conversations are becoming crucial, Professor Haines believes.
“The big debate in our lifetime, among those of us who watched our parents die without advance care plans is: ‘Where will we be as our lives end?’ I don’t know where I will be.
“We have to take part in this debate.”
Professor Haines may have cut down on the number of patients he sees but there is no diminution in his commitment.
“I don’t think I’m burned out”, he says. “I feel energised, full of satisfaction.”
His wife, Wendy, and his four grown children, keep him grounded.
“I’m full of passion and ideas and Wendy is the perfect balance to that. She keeps my feet on the ground.”
1. Four Corners 2013; Buying time. http://www.abc.net.au/4corners/stories/2013/08/26/3831617.htm
2. Seven News 2011; Oncologist Professor Ian Haines survives cardiac arrest. http://www.youtube.com/watch?v=HhwjNAbG0CY