Ian Haines died on November 23, 2011. It forced him to make some life changes, as he explains. Story by Nicko Place
It’s probably not surprising that Ian Haines has such a clear memory of the day he died. It wasn’t just that the fact of his death was a remarkable event in itself, but the actual experience of dying.
‘I remember a wall of white light,’ he tells GiantAmongMen, sitting in his kitchen on a sunny Thursday morning, sipping coffee. ‘The white wall was all around me, like how you’d imagine being entirely surrounded by a cloud. I remember thinking: “Geez, what’s this? I’ve never seen anything like this before.” Then it was as though all the life just drained out of me.
‘It was all very quick and it was slightly euphoric. It certainly wasn’t painful, and there was nothing scary.’
In the moments before he died, Professor Ian Haines was enjoying his 57th birthday. Well, he was about to. He was knocking off early from his job as one of Australia’s leading and busiest oncologists, at Melbourne’s Cabrini Private Hospital. Ian had made his way to his car at the unexpectedly human knock-off hour of 5.30 pm, intending to meet his family for a celebratory dinner.
‘I was parked near the ramp and as I drove up the ramp to leave the car park, there was a car in front of me, and two cars behind me,’ Ian recalls.
Then came the unexpected wall of white and then nothing at all until he woke, roughly 24 hours later, fighting to the surface from an induced coma to find himself in Cabrini’s Intensive Care Unit with tubes down his throat and ‘utter shock’ in his mind as a nurse explained he’d had a massive cardiac arrest. Technically, Ian had suffered a ‘spontaneous ventricular fibrillation’ and MRIs afterwards found that his heart and arteries were completely healthy, with no blockages. If he had stayed dead, a coroner would have returned the verdict: ‘Sudden death – cause unknown.’ Basically, his heart just stopped.
Those two cars behind him, and the random fact he hadn’t actually left the car park, are what gave Ian a second life. The drivers of both those cars, impatiently waiting for the silver Honda to find a gap in the traffic, then wondering why it hadn’t pulled out, then one of them getting out to check, then urgently dragging Ian’s dead body from behind the steering wheel to perform emergency CPR, were highly trained medical professionals. One called Cabrini’s ‘crash team’, a drop-everything crew for such emergencies, but they went to a different exit ramp on the other side of the hospital. The other driver, orderly Jonathan Cooper, got Ian’s heart started again, oxygen finally being pumped to the brain. Ian had been dead for an estimated seven minutes at that point. There were fears of brain damage which, happily, proved to be unfounded.
‘If I had been in a dark corner of the car park when it happened, nobody would have seen me and I’d be dead,’ Ian says now. ‘If I’d pulled out of the car park and driven 100 metres, I’d be dead. You do suffer kind of a survivor guilt. I think about all the cancer patients I have seen, who haven’t survived. I wonder why did I live? Why did I get this second chance?’
Ian was 57 when he died and jokes that he’s now five years old, about ready to start school. It was November 23, 2011 when his old life ended with that coronary. In its immediate aftermath, as well as a bunch of fractured ribs (a common result of correctly performed emergency heart massage), he was forced into a watershed confrontation regarding how he had been living and how his life should be.
‘I literally killed myself with overwork,’ he says now. ‘I had always pushed myself hard at work and felt invincible. You know, I thought I could do twice as much as anybody else, run twice as fast to achieve more as a doctor. And then I was dead at 57. You can only conclude that I worked myself to death. It’s quite humbling, actually, to think that I could have left my family like that.’
He’d started in 1987, attempting to set up a private practice oncology offering, which meant he wasn’t part of a large cancer team; he was it. If the patient needed anything, day or night, it was up to him to deliver that assistance. Because, as he puts it, ‘Whitlam gave me a free education and paid my rent while I studied’, he always felt a need to give something back, so on top of working at Cabrini, in one of the wealthiest areas of Melbourne, he also opened the only oncology offering in Dandenong, one of the poorest regions in the city, and Berwick. ‘I was the only oncologist in Dandenong for 25 years,’ he said. ‘It’s a huge population area.’
Then he started teaching at the Alfred Hospital, training young medical staff in the delicate art of palliative care. All while occasionally turning up in the media to stand up against doctors and researchers who accepted undeclared study trips and other offerings from major drug companies, which was not an unstressful battle given the potential self-interest and multinational heavyweight brands he was tackling.
‘A typical day for me might have been to be at Dandenong at 7 am, to see up to 20 patients. Then back to Cabrini in Malvern by 11 am, to do a ward round, and then consult in the day centre – maybe 15 patients. Then to head somewhere else in the afternoon, and be called back at night when a patient needed urgent support.
‘In my first 15 years, there was not a single day when I got from the front door of the hospital to my kitchen without getting paged to turn around,’ he said. ‘There was one night where I got paged four times. I got home, got paged, went back in. Headed home, got paged, had to return to Cabrini again. Got home, got paged. Got home, got paged a fourth time. It was the price of setting up oncology as a private practice.
‘But you couldn’t say no to anybody. People are in pain, they have cancer; they need your help. And anyway, nobody in a consultancy practice ever says no. If you say no to a referral from a doctor, that doctor will never refer to you again, and there are other oncologists desperate to take those referrals.’
Oncology, and medical practice, is a business, just like any other, with high competition between the practitioners. For 30 years, Professor Haines has been a strong and reliable brand, mixing elite cancer medical knowledge with a very human, therapeutic style, either curing cancer or working tirelessly to prepare the patient and their family for death in the most pain-free and caring way possible. His personal KPI is if a new patient was sitting, scared, stressed and anxious in their chair, to have them sitting back in the chair, relaxed, by the end of the consultation. He has always been about getting to really know patients, to connect with them and be compassionate. If he can’t save them, he is with them right up until the end.
And all while being such a Jedi at time management that he was proud he never missed one of his four kids’ school concerts, or a birthday party, or Christmas festivities or other important family moments. All while losing his parents, and a brother unexpectedly, and being the solid rock, the voice of reason, the go-to-guy for all the usual life issues of a large extended family. ‘I’m very good at compartmentalising,’ he said. ‘I could get an enormous amount done in a short time while in work mode, and then could switch into family mode.’
But underneath, it was taking a toll.
‘To be honest, and I’ve never spoken about this, but for the last few years before it happened, I had felt like I was on a treadmill and I didn’t know how to get off,’ he said. ‘I had started a group of oncologists to work together, in an attempt to have others who could cover me. I was starting to hope that perhaps my long-time consulting surgeons would decide to retire rather than me having to admit I couldn’t take more patients. Once people get a sense that you’re not fully there or that you’re not around 100 per cent, your referrals and your business falls off a cliff.’
But then he died. And it all had to change.
He’s cut back to three days a week, job-sharing with another oncologist, and has regretfully let go of everything but Cabrini. All of which has led to new issues: how he feels now when he’s at home and his wife is at work? How he feels when he bumps into patients or their family members everywhere he goes – and they’re everywhere – and they ask the former workaholic: how come you’re not at work? And for some reason he feels like he needs to come up with a better answer than I’ve had to slow down. Ian doesn’t mind golf and loves a weekly game of tennis, but doesn’t want to do either of those things multiple times per week. Working out how to fill a day is a new and not entirely comfortable experience.
Plus there’s a need to feel like he’s still giving back, beyond working with the patients he has. To that end, he recently joined a large hospital’s board and is seeing if that can work with his need to control stress levels.
But he doesn’t doubt the road he is now required to be on, and even finds new blooms among the post-death landscape.
As he edged back into work after his cardiac arrest, many of his long-time patients confided that they had thought for months beforehand that he’d been looking terrible, unhealthy and drained, but hadn’t wanted to say anything. He was able to talk to them about that – in a now two-way conversation about health. It opened new levels of communication and trust with patients.
‘I see it as an interesting new opportunity to talk to my patients who are dying,’ he said. ‘We have a shared experience now. They know about my mortality, as well as theirs. I have a real empathy.’