DR. KENNY AND HOSPITAL BYLAWS.

Waikato Argus, Volume V, Issue 339, 10 September 1898, Page 3

DR. KENNY AND HOSPITAL BYLAWS.

It will be remembered that at last meeting of the Waikato Hospital and Charitable Aid Board, a letter was read from Dr. Brewis, making certaiu charges against the Surgeon Superintendent of the hospital. This was referred to Dr. Kenny, for an explanation. At the Board's meeting on Thursday last, the following letters were read in connection with the case :

Mr Chairman and Gentlemen, —" I beg to acknowledge the receipt of a letter, dated 10th August, IS9B, addressed to you by Dr. Rrewis containing several terious charges against me—serious, indeed, had they been true, but without foundation, as this letter will prove. The facts of the case referred to are as follows:—On the evenini' of Sunday, July 17th, Mr Muleahy asked me U, come and attend his wife. I asked him if any other doctor was in attendance. He told me Dr. Brewis had seen thecasp, but that his services had been dispensed with. I then told him I would go if I got permission. Next day, July ISt-h, I received the following : July 17th. " Dr Kenny : Dear Sir,—ln reference to Mrs Mulcahy's case, in the absence of a copy of the Hospital by-laws, I am not sure if I have the power to grant permission for you to attend her. However, as it appears to be a serious case, I don't offer any objection to your going.— Yours faithfully, W. Dei, Chairman W.H. andC.A. Beard." In the afternoon of the same day after I had finished my Hospital work, I went and saw the late Mrs Muleahy. I found her very ill. In my opinion she required the constant care of her medical attendant. As it was impossible for me to give her that attention iu her own home, and as there was not the slightest risk in moving her, I advised her to be taken to the Hospital. An order for admission was secured, and she was admitted soon after 4 p.m. on July 19th. Next morning, July 20th, I telegraphed for Dr. Murdoch. He arrived in the afternoon. We then both examined our patient, and after a long and careful consultation, decided that it would be safer abd better for her not to undergo operation that day. but wait until the next. Dr. Murdoch remained here all night, and about midday on the 21st July my patient was operated upon. All went well until suddenly she developed symptoms of embolism, from which condition she died tome 13 hours afterwards. The principal risks of the condition she was in are those of inevitable hemorrhage. She ran safely through there and did not die of hemorrhage, but from embolism, as reported to you on the 11th of August last, an accident which any woman in similar circumstances is liable to, and which when it occurs is nearly always fatal. The late Mrs Muleahy had ceased to be Dr. Brewis' patient before I visited her, so that, instead of my interfering with Dr. Brewis' case.and vibiting his patient, he was really interfering with me, and visiting my patient, and guilty of the very act he accuses me of. Dr. Brewis next accuses me of devoting the greater part of my time to carrying ou private practice throughout the district. Gentlemen, during the past 23 weeks I have treated 155 patients in your hospital, and I have peiformed 42 surgical operations under chloroform, including several major operations. All I can say is, that if Dr. Brewis' statement was true, I could not possibly have accomplished this work without an extra pair of hands and an extra body to travel round the country, while I left one at home to do your work. Next, Dr. Brewis states that I ttop his patients in the street, aud endeavour, by discrediting him, to persuade them to go into the hospital. Gentlemen, this is not true. We have had far more to do during the past sixmonths than we really cared tor, and would have beeu glad of a spell. But it is true that scores of people seek my advice, that the number is daily increasing, and that my usual answer is : "I can't attend you outside, if you want my treatment you must come into the hospital." Dr. Brewis then goes on to say : "HI send a patient there, he contradicts my diagnosis, scoffs at my treatment and tries in every way to injure my reputation, and if any further assistance is required, I who have attended the case, am boycotted, etc.. etc. It is well Dr. Brewis prefaces this accusation with an " if," for as a matter of fact he rarely ever sends cases to the hospital until they are past, recovery ; but when he cannot manage the case himself endeavours to send it to Auckland, or indeed anywhere, rather than to the Waikato Hospital. But here to a certain extent Dr. Brewis is right, for I regret to say that I have often been compelled to reverse Dr. Brewis' diagnosis and treatment. Surely, gentlemen, you would not have me uphold an opinion or continue a course of treatment that 1 knew was wrong, and as for my not seeking his assistance, etc., it would not tend to the establishment of confidence of my patients in myself, if I coutiuued to employ the services of the very man they left", because they hai lost faith iu him. I cannot prevent patients leaving him and coming to me, nor yet do I consider it a cause foridame. For this state of matters I think Dr. Brewis has got to thank himself. Myauswer to Dr. Brewis' letter may, therefore, be summed up as follows : 1. Dr. Brewi3 did not meet me leaving the house. 1 was out of sight of it and over a mile away. 2. I did not visit Dr. Brewis' patient ; but my own. 3. She was not taken to the hospital that night ; but on the following day, iu broad daylight. 4. She was not kept two days longer, for the purposes ascribtd by Dr. Brewis. 5. The delay was purposely enforced, and iu the opinion of two medical men increased her chances of recovery. G. I broke no Hospital by-law without the knowledge and sanction of the chairman. 7. I risked nothing of my patient's life, but did all that human power could do to save it. 8. The greater part of my time is not spent in private practice throughout the district. 9. 1 do not stop people in the street in order to get them to come into the Hospital. 10. I do contradict Dr. Brewis' diagnosis and treatment when I consider them wrong. Dr. Brewis finally accuses me of petty spite and ignorance of the elementary principles of professional ethics. Gentlemen, I will auswer this charge by asking you to read the two following letters, which J received a few days ago from a late Hospital patient, Mr J. H. Edwards, of Otorohanga. I think they will throw a little light on this matter: — " Jesmond, Hamilton, 25/8/98. Mr J. 11. Edwards.—Sir: I understand that, while you were in the Waikato Hospital, Dr. Murdoch, of Cambridge, wus called in by Dr. [Kenny to consult on your case, and that you were charged a fee of five guineas. Would you mind letting me know if it was by your own wish that Dr. Murdoch was called in, or were you in any way in the matter? Another patient, in the same ward as you, complains that Dr. Kenny sometimes did not visit the ward for two or three days at a time. Is this true ? I should be glad of an early reply, if you feel inclined to answer my queries.—Yours faithfully, A Skymouk Bbrwis, M.D." Kiokio, Otorohanga, Aug. 29th, 1898. " Dr. Brewis : Sir.-In answer to the two queries contained in your letter of the 25th inst., and in reply to the first question, Dr. Kenny suggested to me in my own interest the advisability_ of calling in another doctor to assist him in a consultation over my case, being a particularly difficult one. The medical man was to be chosen by me. I decided on

Dr. Murdoch, of Cambridge, because he was already partly acquainted with the case before I had entered the hospital. 1 did pay a fee of five guineas to Dr. Murdoch. There was no coercion whatever. Had there been such I would have immediately resented it. In reply to the second query I caunot remember that Dr. Kenny absented himself from the ward for two or three days at a time, but I do rem?mber that he frequently visited me while I was in the hospital and seemed to be very muoh wrapped up in the case. 1 cannot sveak too highly of the kindness, care and attention paid to nic by Dr. Kenny and his staff of nurses.—Yours truly, J. H. lidwakes. " Gentlemen,—For what object did Dr. Brewis wrote this letter to an ex-pal tent of mine, or if it was an example of professional ethics, or devoid of petty spite, [ leave you to decide.—l have the honour to be, gentlemen, your obedient scrvaut, Geo. G. Kenny, M. 8., Resident Surgeon Superintendent. 1o the Chairman Waikato Hospital and Charitable Aml Board: Sir, —"In the report of the last meeting of your Board, as published in the Waikato AtSGCS of Saturday, August 13th, I notice a letter from Dr. A. Seymour Brewis, of Hamilton, in which he charges your House Surgeon with unwarrantably interfering with him in a certain case wlv.eh occurred a little way out of Hamilton. As Dr. Brewis has described this cise somewhat minutely, I don't think I am wrong in coming to the conclusion that he refers to the case of my late wife, who died recently in your Hospital under circumstances similar to those described. Under ordinary circumstances I would never think of interfering in a doctors' quarrel, but as Dr. Brewis has given your Board on'y a onesided statement of the case, I leel it will be to the best interests of all parties, including the general public, if I give your Board the whole truth about this most painful case. Dr. Brewis attended my late wife professionally for the first time on Saturday, July loth. He next saw her on Sunday, the 17th, in the afternoon. He then informed me that my wife would have to undergo a serious operation, and that he did not wisli to deceive me, telling me at the same lime that the chances against her pulling through were 20 to 1. He also slated that he could not perform the operation by himself, and that I would have to engage another doctor. I suggested that Dr. Kenny Ehould be invited to assist at the operation, as my wife had great confidence in him. To this Dr. Brewis objected, saying he would not work with Dr. Keuny on any terms. He then advibed me to engage either Dr. Murdoch or Dr. Waddington to assist him. I objected to both of these gentlemen, not because I had anything against either of them, but because they were strangers to me, and because a doctor of high reputation was within easy distance who had attended my family in years gone by, and who woulct, I felt sure, assist if requested to do so. In the meantime I left Dr. Brewis for a few minutes to see my wife, and as soon as I saw her she told me she would rather die than have anything more to do with Dr. Brewis. Ou enquiring her reason for such a sudden revulsion of feeling against the doctor, she gave me what appears to be a good reason. I cannot put this into writing, but 1 am quite prepared to state it before the Board, if necessary. Seeing that my wife had lost all confidence in Dr. Brewis. I determined to take the case out of his hands altosether. I therefore told him that my wife was not prepared to undergo the operation for some time, and on the following morning I sent a note to his residence, requesting him not to call again until fent for. Late on the same eveuing of Sunday, 17th, I went to see Dr. Kenny and begged of him to come and attend my wife privately, but he refused to do so without a permit from some member of your Board. I was now thoroughly alarmed, and believed my wife's life was in serious dancer. I, therefore, »veut to see your Chairman, Mr William Dey, about 11 p.m. on the same night, and explained the case to him, and. after some trouble in convincing him that it was a case of life or death, he consented to give me a permit for Dr. Kenny to attend her. On presenting this permit to the doctor he visited my wife on the afternoon of Monday, the 18th, and, after ex amining her, he told me that she would have to undergo a serious operation, and that if she could be got into the Hospital her chances of recovery would be greatly increased. I agreed with this view, knowing well tkat the nursing staff ami internal arrangements for such cases at the Hospital were altogether superior to anything I could possibly provide. I therefore rode into town in company with Dr. Keuny to see your Chairman, for the purpose of getting a permit for the admission of my wife to the Hospital, which he kindly gave me. About a mile from my residence on outroad to Hamilton we met Dr. Brewis, evidently going to pay another visit, after receiving a note that he was not to call again until sent for. On Tuesday, the 19th, my wife was taken to the Hospital, your House Surgeon superintending the removal himself. Two days later she died. Gentlemen, I believe the foregoing to be a fair statement of the ease. I have little more to &.dd, only to give honour where, I believe, honour is due. I am the greatest sufferer in this case. I have lost all that worthy men hold dear—the devoted wife and faithful companion of 20 years ; yet, in the face of all this, I have" still the greatest possible confidence in Dr. Kenny ; I believe if unwearying attention and high medical skill could have saved her, lie would have done it. I have also to thank your nursing staff for their generous attention to my wife during her last illness "—I am, sir, your obedient servant, MICHAEL Mtjlcaiiy. Cambridge, September 7th, 1893. " To the Chairman and Members of the Waikato Hospital Board.—Gentlemen,— With reference to the recent lamented death alter confinement in your hospital, I wish to inform you of a few facts. First, however, I should like you to know that I am no partisan in this matter, being on perfectly friendly terms with Dr. Brewis as well as Dr. Kenny, whose estrangement no one regrets more than I do. The case affects myself, particularly in that I understand Dr. Kenny is accused of too great delay. Now the last night of that delay was more especially by my advice after a long talk over the case and a full investigation into its various points. Dr. Kenny aud I agreed that the dangerous symptoms having been arrested, the night's rest, with constant feeding, etc., would give the patient a better chance. To laymen it would be impossible to explain all the ins and outs of a case like this. Some authorities counsel more delay, some less. This, however, I can assure that we both, I am certain, acted conscientiously for the best. Those cases are amongst the most dangerous in midwifery. When the cass was concluded the patient seemed to have an excellent chance of recovery, and I was much surprised and disappointed to hear that she had died from embolism, an accident which may happen >fter any confinement. In this 1 speak with some authority, for I have practiced midwifery for more than twenty years with wonderful success. Hoping you will pardon the unavoidable prolixity of this letter,—l remain, gentlemen, yours truly, Jamis Mukdoch." The Chairman said the question before the Board was, whether the doctor had broken the by-laws of the Hospital, aud whether the chairmau or any member of the Board had power to give the doctor permission to go out of the Hospital. In this instance, lie understood the doctor had told the applicant that permission could bo obtained from the chairman or three members of the Board, but not to go to the chairman, as he would not give permission. Under the circumstances, be did uot thiuk any member would re-

fuse to give permission. Had he done wrong in giving this permission ? Mr Chepmell thought the wholu question was, whether the doctor had broken the by-laws. From the correspondence, it appeared that the doctor had ptrn ission to do so. Mr Furzu did not think permissiou was given. In his letter, the chairman said he did not object. Mr Chepmell : In a case of life and death any ordinary man would lake that as permission, and in bis opinion, Dr. Kenny was exonerated from all blame. MrFiuze: Weha\e to keep the bylaws, and the doctor has not. Mr Chepmell: Iu this ease the chairman was responsible for the doctoi's action, and the Board has nothing to do with the doctors' quarrel. I move that the explanation of the surgeon superintendent be considered satis - factory, and that Dr. Brewis' letter be rec ived. Mr McGuiik : Under the circumstances the Chairman should get: every credit for tlr: action he had taken and in the cause ot humanity he would not have done ritfht in retusing his permission. Mr Primrose said that while ho occupied the position of Chairman he had never once withheld his permission in a case of urgency, and the present Chairman was perfectly justified iu taking the step he had done. Mr Furze proposed an amendment that an enquiry be held into the whole matter. In taking a maternity case into the Hospital the doctor had broken one of the rules. Mr Chepmell said the rules meutioned weie exceptional circumstances. Who, he asked, were to be the judges ? Mr Furze thought if they looked at it in that light, exceptional circumstances would covtr anything. This state of affairs had been going on for some time. It was now quite a scandal aud people thought the Board were frightened of the doctor. About 20 per cent, of the people of Hamilton were attended by Dr. Kenny. He had mentioned one case at a former meeting and a subscription of £5 6s from tl.e gentleman followed immediately afterwards. Dr. Kenny did not attempt to confute the charges, but simply denied them, and he proposed that a committee be appointed to look into the matter. , Mr Bach said they had heard all sorts of remarks outside ; but they hud nothing definite to go on. He knew something about the case in question, and it was one of the most difficult operations in surgery. Dr. Murdoch had spent the night in Hamilton over it. and the delay in operating was mutually agreed upon between the two doctors. There was no charge against Dr. Kenny, and the members should have been informed at last meeting that permission to attend the case had been given by the Chairmau. Mr Teasdale thought if the Chairman had spoken what he kne.v at last meeting it would have eased the minds of the members considerably. If Dr. Kenny was always going about attending private patients the practice should be stopped, and in future he should not be allowed to go out except in cases of this kind, when he had permission from the Chairman. Mr Chepmell objected to the expression " going about." The Board knew nothing about that. Mr Eurze : " I do." Mr Chepmell : People should not make charges unless they were prepared to back them up. Mr Edwards' letter lent a most unpleasant aspect to the whole affair. It looked as if Dr. Brewis was going out of his way to obtain charges agaiust the surgeon. If it had not been for this letter he would have been inclined to make his motion a little less brusque. Mr Primrose: During his term, Dr. Kenny must have treated some thousands of cases, and had taken the very best care of them. Many patients considered the doctor should be continually at their bedside, aud these were generally the ones who needed his services least. Mr Chepmell said the number of patients treated iu tiie Waikato Hospital was the sixth highest in the colony. Individually, the stay of each patient was the lowest; the death-rate was" almost the lowest, arid the expenditure was the third lowest in the colony, and yet one surgeon-did all the work singlehanded. Mr Furze's amendment failed to find a seconder, and the motion, on being put, was carried, Mr Furze alone dissenting. OUTSIDE PATIENTS. The Chairman said that since the Muleahy incident he had had an application to allow Dr. Kenny to attend a private patient. He wished to know what action he was to take in such cases. It was not fair to put the chairman in a position of having to refuse. After some discussion the Board expressed its confidence in the chairman, and decided to leave this matter solely to his rliscretiou.