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Charlie Teo – Finding The Right Balance

By James Hutton on July 21, 2018 in People

The global neurosurgeon, by Jeremy Greive

During the month The Beast caught up with legendary local neurosurgeon Dr Charlie Teo…

How are you this morning Charlie? I’m good, thank you. I didn’t sleep well last night, so apart from that… no, I’m good.

You’re a born and bred Sydney boy; where did you spend your childhood and what are your fondest memories of growing up here? I was a westie, born out at a place called Picnic Point on the Georges River. It was very blue collar. I have fond memories of fishing there and playing cowboys and Indians in the bush, mostly with my sister but also with some of the local kids. I was schooled at Trinity Grammar initially – still living at home – and then I started boarding at The Scots College at nine years old. I was introduced to the Eastern Suburbs from a pretty young age.

When did you move to the Eastern Suburbs to live? Having been schooled in the Eastern Suburbs, with most of my friends being in the Eastern Suburbs, I guess it was a natural progression to the Eastern Suburbs. I went to the University of New South Wales and that’s when I first started living in the Eastern Suburbs, initially on campus at Basser College, then I moved out after my first year at Basser and lived in Kensington, Maroubra, Rosebery, Edgecliff, Bondi Junction… you know, just basically all around the Eastern Suburbs.

What did your parents do when you were growing up? Dad was an obstetrician gynecologist and mum was a nurse, and she ran a baby health check clinic. Dad initially was a GP and then when I was about eight or nine he moved to England to do a three-year fellowship in obstetrics and gynecology. It was also at that time that he divorced mum, so I never actually knew him when he was a specialist; I knew him when he was a general practitioner.

You live with your wife and four daughters; how is it living with five ladies in the same house? It’s probably more emotionally taxing than brain surgery. It’s probably more challenging than anything else I’ve ever done. I mean, I don’t think this is controversial to say, but I don’t understand women – I never have, never will. Despite the fact that I’ve got four daughters, and all my staff are female, and I’m surrounded by females, I still don’t understand them. And they don’t understand me. It’s like ne’er the twain will meet, you know? We’ve just always been like that. I love them dearly, my life wouldn’t be complete without women, but I don’t understand them; it’s been a real challenge.

Have you had any trouble with those pesky Tamarama boys? No, we’ve been pretty lucky. There’s been one or two that I thought were a little bit pesky, but no, mostly they’ve chosen good boys; they’re all worthy to be my sons-in-law. Obviously my daughters haven’t thought so, because they’ve gone through them like their underwear. But no, I’ve liked all of them.

I read that your elder sister Annie used to protect you when you were younger, when you were living around Bankstown; what was she protecting you from? Well, you won’t remember, but you’ll have to at least acknowledge that in those days there were very few Asians. For example, at Scots College, when I was there, there were only two Asians. We were very much a minority group, misunderstood – or not understood at all really – because most people didn’t have exposure to us.

Your background is Chinese and Singaporean, right? Yeah, Singaporean Chinese. We were subjected to racism on a daily basis. It didn’t really bother me too much, and I didn’t quite understand it – I was a bit naïve, I guess – but it bothered my sister terribly. I would turn a blind eye to it, and I’d just sometimes hide, but she would confront them. Like a little rabid dog, she would sort of yap at them, “Don’t you say that…” and she would carry on. She used to try to protect me, protect us both, from racism.

What’s Annie doing now? She’s retired. She was in a business with her husband in investment sort of stuff. I didn’t quite understand it.

Do you ever experience racism now that you’re older and Australians are generally more educated? No. Well, it is a problem for some, but I haven’t noticed it as much. Any sort of racism that I experience now, which is very rare, is very covert. I’m sure it exists, and I have gone on record as saying that I’m sure it exists because people tell me it exists, but thankfully I haven’t been exposed to it as much as I was in the past.

Do you think that some of the anti-Muslim views of Australians are similar to what the Asian immigrants experienced 30 or 40 years ago? Yeah, absolutely it’s the case, because the racism was initially aimed at the ‘wogs’ – the Italians and Greeks – because they were an unknown entity. They were perceived as a threat because they were hardworking and they had good family values, and they stuck together, so a lot of Australians thought they were threatening. Then the Asians came along and they were different because they looked different – again, different values, different culture, so they were a threat. Then the Vietnamese boat people came over. I remember when the Vietnamese boat people were a threat as well. They were vilified and persecuted. Then of course there was the Muslim or Arabic ‘invasion’. They’re also an unknown quantity. We don’t understand their religion; we don’t understand their culture. Thankfully they kind of look the same as us, so I think there are a few of them that haven’t quite experienced the amount of racism that Asians experienced, because we look so different. But it’s exactly the same phenomenon – a new culture coming in, threatening us, threatening our stability and our values – so the natural thing to do is turn against them rather than embrace them, initially at least.

Do you think life in Sydney is better now than it was when you were growing up? Oh, absolutely not. I used to say that Sydney was, and Australia was, the best place to live in the world. I don’t often say that it’s no longer the best place to live in the world, but I certainly think it a lot. We are too entitled and we have things so good that we’re not appreciative of what we’ve got. I do a lot of travelling now; I’m what I call a ‘global neurosurgeon’ who operates on many different continents. Al- most every second week I’m overseas somewhere. Given what we have here in Australia, compared to what other people have and should be thankful for, our level of contentment and happiness is significantly disparate
to what it should be. We have the perfect climate, we have the perfect social welfare, we have very little poverty, we have good education, we have fresh food and we don’t have borders that we have to protect. Well, we do, but you know what I mean.

It’s hard to get here… Yeah, and we don’t have the same extremes of weather that others have. We should be the most thankful, happiest people in the world, but we’re not.

How has that changed between when you were growing up, say, and now? Why have people become so entitled? There was no concept of rage when I grew up. There was courtesy and pleasantries and openness and ‘ockerism’, so people would naturally be open to strangers and naturally be nice to other people. These days you still have that, of course, but it’s not natural, and there’s more rage now. Well, not more – more’s the wrong descriptive – because there was none before. So you have rage now that you didn’t have before. Now there’s road rage, there’s street rage, there’s office rage, there’s even bloody surf rage! What the hell is that all about? The surfer is meant to be your iconic Aussie: the laid back, ‘she’ll be right, mate’, friendly, all-embracing, all-encompassing good guy. Yet now our surfers are upset with other people cutting in on them and invading their beaches. And they demonstrate that. They’re demonstrative in their parochialism and they’re demonstrative in their narrow-mindedness by being openly angry at other surfers. I think it’s terrible.
I think Australians need a really big awakening. They need to go over- seas and see how hard other people have it. The poverty that I see… you go to the Philippines, for example, and you see intense poverty and intense will side by side. You go to Africa and you see intense poverty and malnutrition everywhere. You go to India and you see the terrible conditions that people live in. You go to China and see the loss of human rights. Here we don’t have any of that.

Where do you surf? I bodysurf, I don’t board surf. I mostly go to Bondi and Bronte, and Maroubra a little bit, but mostly Bondi.

Have you seen incidents in the water? Oh, yeah. And my buddies tell me that it happens all the time, and when I try to get on the board – not that I’m good on it – I get a hard time. I’m not a surfer so I’m not quite sure how prevalent it is, but it’s certainly prevalent enough for people to tell me that it’s happening quite often.

Do you think Aussie blokes are worse than other men when it comes to that kind of aggression? It comes in different forms. It’s a little bit less sophisticated here. What I mean by that is, I spent a lot of time in America where there is rage, anger, parochialism, but it’s a little bit more sophisticated and therefore a little more covert. In Australia it’s a little more obvious and overt. We are a very violent nation when it comes to the reporting of violent incidents. Some say that’s because we have a better reporting system, but I would contend that it’s actually true that we are a violent nation. We’re not known as a peaceful, placid sort of country. I kind of like the way that it’s overt, as opposed to covert. At least you know where you stand with an Aussie. I think, with an Aussie bloke, if he doesn’t like you he’ll make it pretty clear that he doesn’t like you, as opposed to other cultures that are nice to your face while behind your back they’re thinking something different. I would rather someone just say, “You’re a prick and I don’t like you.”

Do you think part of the problem is how some of our bigger licensed venues are designed? There is a lot of alcohol-fuelled violence. When you get hundreds of blokes pissed in a big space together, it’s going to cause problems no matter where you are, right? Yeah, I’ve thought about that. I lived in Scandinavia for a few months and they get really drunk. I mean, they drink to get drunk, and yet they don’t have the same degree of violence. In fact, when they get drunk, they’re usually happy drunks or funny drunks, as opposed to aggressive, unhappy drunks. Why should that be? They’ve got testosterone like us, and they’re usually young males like our drinkers, so I’m not quite sure. It’s either genetic – people are inherently happy or unhappy
and alcohol simply brings out their premorbid traits – or it’s that concept I was talking about before, this entitlement and the general rage and general unhappiness that Australians unfortunately have.

What happens to the brain when someone delivers a proper blow to someone else’s head? It’s a combination of things. There’s damage at the actual point of the blow, where you’re hit. That gives you soft tissue injury and skull fractures, and sometimes blood clots. Then there are the consequences of the acceleration and de-acceleration from the blow. That gives you very subtle but very real and very damaging effects, and they’re called shearing injuries. Shearing injuries are really what hurts your brain because, essentially, if you think of the brain as a whole network of very, very fine fibres,when you accelerate or de-accelerate the brain those fibres snap and break, and you get shearing injuries and you get damage to the brain itself, as op- posed to structures outside the brain. It’s the shearing injuries that really hurt the brain.

Have you ever punched someone in the head? Yeah, because I was a bouncer for a few years. I got my black belt when I was a very young boy and to get myself through university, because my father wouldn’t pay for me, I had to earn good money. I started working as a waiter at the Centrepoint Tavern, wearing one of those funny little waistcoats and feeling a little bit embarrassed about it but enjoying it. There was a scuffle one day at Centrepoint Tavern and I helped the bouncers out. There was a guy called Jeff Tunks, his son was Peter Tunks, who was a footballer – real sort of Eastern Suburbs men. Jeff Tunks was so appreciative he asked me if I wanted to be a bouncer, and I thought, “Yeah, better money.” So I was a bouncer for almost five years at Centrepoint Tavern, and at the Chevron Hotel in Kings Cross, so I got in a few scuffles. Jeff used to teach me that a good bouncer is someone who never has to get in a fight, be- cause a good bouncer can always talk his way out of it, settle things down, use psychology, etcetera. I was a good bouncer, because I often didn’t fight, but every now and then you know, you’re a 19 year-old male with a lot of testosterone and a black belt, and some people just piss you off…

You are Australia’s highest profile neurosurgeon; when did you decide that you were going to pursue that specialty? It was one of those specialties that I was very fearful of, and very apprehensive with neurosurgical patients, because it’s a specialty that is really terrible. It’s an unforgiving specialty – any mistake and someone will die. I didn’t like that, so I steered away from neurosurgery and decided to do paediatric surgery – just general paediatric surgery – and started my residency in paediatric surgery. While I was doing paediatric surgery I was exposed to neurosurgery. This was back in 1984…

One year after Michael Jackson released Thriller… And when I was exposed to paediatric neurosurgery I fell in love with it. It was serendipitous, it was fated that I should be exposed to it, and it’s been a love affair ever since.

How hard is it to become qualified to the point where you can actually dig around inside people’s heads? It’s very difficult. It’s a long process of medical school, internship, residency, registrarship, fellowship, and then you’re a fully qualified neurosurgeon. Most fully qualified neurosurgeons don’t become qualified to operate on their own until they’re about 32 to 35, usually 15 years of study after school.

With the advent of social media and the proliferation of misinformation, or ‘fake news’, it’s given rise to a kind of an anti-science conspiracy theorist movement, not just across Australia but the world. Many of my friends have moved up to Byron Bay and Brunswick Heads and gone completely bonkers. All of a sudden they’ve become anti-vaxxers who’d rather listen to their yoga teacher for medical advice than immunologists and scientists who’ve been studying these things for years and years. Does this mistrust of medicine drive you insane? Why do you think there is this ridiculous movement? I think you nailed it by saying it’s mistrusting medicine. You think about this: if the public had a total 100 per cent trust in doctors and medicine, of course it wouldn’t have happened. It’s our fault, it’s doctors’ fault for not being well educated holistically. Medicine, I think, is the art. It’s the art of healing. The art of healing has several different faces to it, one face being traditional medicine, another face being spiritual, another face being emotional, another face being homeopathy, another face being acupuncture, etcetera. So healing someone is not just giving them a tablet; it’s nurturing them, it’s showing you care, it’s altering someone’s diet sometimes. Maybe it’s adding a mineral to their diet, maybe it’s changing their faecal bacterial load. It’s everything, yet doctors have the sense that they’re the only ones who know how to heal people, and what they’ve learned at university is the only way and there’s no other way. So they’re ignorant. Most doctors are ignorant of the other means of healing people, and that ignorance has led to mistrust because it’s pretty obvious that some of those other things work. As soon as those other things work, and the doctor hasn’t endorsed them – not only not endorsed them, but actually condemned them – then it breeds distrust. Why would you trust some- one unless they knew what they were talking about? And clearly we don’t know what we’re talking about when it comes to healing someone. Oh, we know what we’re talking about when it comes to traditional medicine, but we don’t know everything about all the other forms of healing, so we have created that extremist. That per- son who won’t vaccinate their child is doing so because of a mistrust in doctors’ knowledge and doctors’ caring. We created the monster, and it is a monster, because vaccination is good. There are some things that traditional medicine offers that are good. Antibiotics are good, in the appropriate setting. Vaccination is good, and surgery… well, some surgeries are good. If doctors had been better trained, or if doctors were more accepting of other forms of healing, I don’t think this monster would have been created.

Do big pharmaceutical companies really pay doctors? Unfortunately, personal financial gain does play a role in clinical decision making for some practitioners. There are some medical conditions that may be treated with both tablets and surgery. If you pay a physician to put that patient in a drug trial then it would be tempting to hold onto that patient even if you knew they would do bet- ter with surgery. Similarly, a surgeon might recommend an operation
even though the literature shows the eventual outcome is just as good with tablets and physiotherapy! There are two human traits that are responsible for many of your health system failures: greed is the reason a purely privatised system is doomed to fail, laziness is the reason a purely public system fails.

So does that happen to the point where there’s a known cure for something but the pharmaceutical companies will withhold it because they won’t make as much money out of it? Or they’ll lobby government to not let this treatment be used? The extremists speculate that. I’ve never really made a statement about that because I haven’t looked into it, so I’m ignorant. I’d hate to think that’s true, but I guess it could be.

My brother just had several months of chemo; it’s harsh but it’s the only thing that works. So many people say, “Have you tried alternative medicine?” When I ask them what the alternative cure for cancer is, they’ll say, “Oh, hemp oil,” or some other nonsense. What makes these people think that they know more than doctors? I hate to say it, but we’re our own worst enemies. This distrust is basically because of our ignorance. And I include myself
in that, of course, because I didn’t know about homeopathy, and I don’t know enough about osteopathy and chiropractic, and all the other forms of healing. So we’ve created the monster. Wouldn’t it be great if you went and saw a doctor – a real doctor, a real healer – who was knowledge- able at everything? One who knew what selenium could cure, knew what hemp oil could cure, knew about acupuncture? You would have total trust in that person, wouldn’t you?

I suppose so… So the distrust of modern day medical doctors is due to the fact that when people go to them, some arrogantly say, “Oh, this is the only way you can be treated.” Then a person might find out that old mate down the road was treated with something else and they think, “Why the hell didn’t you tell me about that? Now I don’t trust you.” When chemotherapy is actually the right thing to do, they’re not going to listen to you.

What are the biggest obstacles you faced in becoming qualified as a neurosurgeon? I guess it was my colleagues, and the system, because neurosurgery itself was never a hurdle. I’m so passionate about it and love it so much that I just wanted more and more neurosurgery – I couldn’t get enough. But what I hated about neurosurgery and, I guess, what I still hate about it, and medicine in general, is the politics of medicine. Again, I went into medicine with a very naïve and idealistic view of doctors; that there’s politics in everything but politics would never, ever get in the way of patient care or doing the right thing by your patient. That’s very naïve because unfortunately politics is in everything, and there’s more politics in medicine than there is in most other vocations so it’s going to get in the way of patient care and doing the right thing. But it was a real eye opener. It’s been the biggest hurdle in my entire life. That is, understanding or navigating the system.

I read an article on Pharmacynews.com.au, which I must admit I don’t read that often, which said: “Charlie Teo wants to set up his own medical regulator, arguing that AHPRA is acting as judge, jury, and execution- er of doctors’ working lives.” Firstly, is that an accurate quote? Can you explain to our readers what you mean by that? Oh, my God. Okay, so it is 100 per cent accurate. I’d prob- ably be sued, so I’m not going to give you the names, but what I can do is tell you that it goes something like this: Dr. A moves in on Dr. B’s territory. Dr. A is a good bloke, a good doctor, patients love him, so he starts stealing patients off Dr. B. Dr. B
gets threatened, and Dr. B is not the new kid on the block. He’s old and established. He plays tennis with the other doctors, his kids go to school with the medical administrators, his wife has morning tea with the judge’s wife… so he’s very well established. Okay, what does Dr. B do? He goes, “F**k, I’m losing my private practice – Dr. A is invading my territory!”
Dr. A has no support system. It’s very easy to get rid of him. What does Dr. B do? He makes up a complaint about Dr. A. It’s totally vexatious, totally unfounded, totally scurrilous, but who determines if the complaint is legitimate? Well, Dr. B is the chairman of the medical advisory board, so when the com- plaint comes in, who assesses it? He assesses it himself.
I know you’re probably sitting there going, “Well, that’s a hyperbole, Charlie. That would never happen.” But I’m telling you, it happens every day. So Dr. B goes, “Oh, Dr. B, you’ve made a complaint against Dr. A. Yes, it’s a legitimate complaint. I’m going to get someone else because I’m going to go through ‘due process’. I’m going to get someone else to verify if the complaint is legitimate.” So he calls up his buddy, because he’s well established, and says, “Oh, can you just please tick this off and say that this guy’s acting sub-standardly, or he’s got bad results?” His buddy says yes, of course he’s going to, then the hospital administrators, or AHPRA, goes, “Okay, what are we going to do about Dr. A? Who do we ask? Let’s ask Dr. B.”
Hang on, wasn’t Dr. B the same man that made the complaint, and deemed it right? Oh well, doesn’t matter, he’s got the same hat on. Then he puts on a different hat and goes, “He needs to be de-registered.” Then Dr. A has to be de-registered. Can Dr. A have appeal? Of course he can go to appeal. Who does he appeal to? He appeals to Dr. B!

Dr. B himself? I would get sued so I’m not going to say it, but I promise I could give you eight examples of that in neurosurgery.

You spent a decade in the States; what were you doing over there? I wanted to get a job in Australia, of course, but I already had a bad name in Australia, from my colleagues, who then…

From Dr. B? All the Dr. Bs. They all knew that I was a troublemaker, that I had a big mouth, that I couldn’t be silenced, that I was a good neurosurgeon and that I was going to basically be a disruptor and a thorn in their sides. So very kindly they said to me when I came back, “Charlie, I think you’d do well in the States; the Americans will love you and I think you should stay there.” So I did a fellowship over there, came back and interviewed with a few people, and thankfully I met a neurosurgeon called Peter Maloney down in Wollongong, and a guy called Tony Bookallil up in Newcastle, and they were kind enough and manly enough to say, “Charlie, I would never have you as my partner in Australia. You are just way too big for Australia. Get the hell out of here and go back to America.” So I went back to America.
Tony was a really lovely man. He’s dead now, but Peter Maloney, he was not a lovely man but he was an honest man. They both really opened my eyes, and I said, “Shit, I’m not wanted here. I’ll get the hell back to America,” where I was really wanted and loved. I had a great career over there.

You’re renowned for operating on people who’ve been told that their tumours are inoperable, and you’ve received criticism as a result. Some neurosurgeons say you’re “too radical, offering false hope to patients who are believed to have an incurable brain cancer or a brain tumour that is too dangerously located”. Who are the people saying this and why are they saying it? It’s too much to cover in a short period of time. You could go to my TEDx talk. I gave a TEDx talk about this whole concept. Why am I offering surgery to someone in a relatively hopeless situation? Let’s presume that all my colleagues are altruistic, humanistic, philanthropic, kind, caring doctors, okay? Let’s presume that they’re all like that. They see a patient with a tumour that they think is either not worth operating on or physically can’t be operated on. So to say to that patient, “It’s inoperable,” they’re doing it out of the goodness of their heart and the best interests of the patient. That patient then comes to see me and I go, “Well, I think it is worth operating on, because my risk- benefit ratio is different to theirs, because I’m a great neurosurgeon.” I don’t say that, but you know what I mean, that’s what I’m thinking.

“I’ve got very steady hands”… Yeah, and I not only think that, but I also believe in patient autonomy. Basi- cally, patient autonomy is respecting a patient’s wishes. So as long as you are open with that patient – “This is a difficult operation. Chance of success is very low. I could kill you. I could maim you. I give you no guaran- tees…” – if the patient still decides to go ahead I’ll give it a shot, even if it’s only a one in a hundred chance that it might work, especially when the alternative is death. And yeah, with neurosurgery it mostly is. It’s mostly, “You’re going to die, or we’ll give it a shot.”
So then I operate on the patient. I get the tumour out. Everyone’s happy. They pat me on the back. They’re my greatest advocates from then on. How does it make the other neurosurgeon look? It makes the other neurosurgeon look bad. So they think, in their minds, that I’m trying to make them look bad. Even if I’m not trying, I am making them look bad. So when that surgeon looks bad he has two alternatives, two options. The first option is to go, “Oh my God, Charlie Teo, he’s amazing. I’m going to go and learn his technique,” or, “I’m going to refer patients to him.” Alternatively, they go, “That f*cker, I’m going to destroy him.”

I imagine there are a lot of big egos in neurosurgery and it would be hard for other surgeons to say to you, “How do you do that? Can you show me what you do?” Yeah, it takes a very strong ego, and it takes a very confident person, and a very altruistic, caring person to go, “I’m not as good as you. I’d like to learn your techniques. I’m going to upskill. I’m going to take time away from my family. I’m going to pay money. I’m going to come and do a course. I’m going to go overseas and learn techniques, so I can be as good as you and get the same results as you.” It takes a lot. Really, it takes ego, pride, money, sacrifice, upskilling. Compare that
to instead saying to your patients, “Oh, Charlie Teo is a f*cking cowboy. He charges all this money. He failed his exams…” and all the other things they’ve told their patients. Then, if that doesn’t work, they go to Dr. B and what does Dr. B do? He writes a statement, he takes an advertisement out in the newspaper, he goes on TV… he basically tries to vilify me.

Did you fail an exam? Yeah, absolutely I did. I didn’t fail it just once, I failed it three times.

Is that standard when you’re studying something so intense? No, it’s very rare to fail the final exams three times.

When you spend your days saving people’s lives, including these ‘one in a hundreds’ with ‘inoperable’ brain cancer, how do you stay grounded? This is a very philosophical question. My answer to you is based on my reading of philosophy, and my general sort of wisdom that comes with 60 years of life. That is, it’s all about balance in your life. I’ve seen people who are great neurosurgeons, great doctors, but they have no balance, and they become consumed by the pettiness of life and the pettiness of their jobs, and politics, and they be- come the Dr. Bs. So I credit my family, my hobbies, my interests outside of medicine, my westie upbringing, the racism that I’ve experienced, the fact that I’ve always been a minority… I credit all those things with making me the person who I am, the person who knows that I’m no better a person than anyone else. My mother really taught me that. My mother taught me, “Charles, don’t ever think that you’re above anyone else. Don’t ever think that someone who has a menial job like a cleaner, or something like that, can’t offer you something that you don’t know or you won’t benefit from.” It was a great lesson. That’s why I treat all people the same, because I know that we’re all simple little pawns on a huge sort of chess board and none of us are any better than anyone else.

Do mobile phones give you brain cancer? The anti-mobile phone people want me to say yes. The mobile phone people want me to say no. I will just have to say this: I don’t know. But I’m very concerned. Here’s what I’d like you to know: it’s not just me who’s concerned. The World Health Organization has classified mobile phones as potential carcinogens. Again, do a fact check and you’ll see that they are now listed under potential carcinogens group 2-B, I think, or 2-A. That means that 300 independent scientists, who work for the World Health Organization, who assess all the literature, still feel the same way as I do, that they are potentially a cancer-causing agent. I’ve been condemned for making statements by Dr. B and my colleagues, but it’s no longer just me, it’s the World Health Organization.

You’re looking at brain scans all the time; do you notice that people’s brains generally look different since the age of mobiles? Absolutely. The study that most people quote is the Interphone study. The Interphone study was a study paid for by the telecoms, unfortunately, but still it was very controversial. It was a very large study. The null hypothesis was that mobile phones do not cause brain cancer. Well, the study came out, delayed, but it still came out and it showed that mobile phones didnot cause brain cancer. But if you read the small print it went on to say, “However, if you just look at the high usage patients – and high usage was more than half an hour a day – there is a more than two times higher in- stance of cancer on the side of usage.” So even the Interphone study, which is the study that everyone holds up as showing that there’s no link, if you read the fine print there is a disturbing trend that ‘high’ mobile phone users will have a higher incidence of brain cancer on the side of usage.

I’m interested to know how those results look for an ‘ultra high’ user… Well, the good news is that the study was done when mobile phones emitted more energy than they do these days. Many of the phones they looked at were the bricks that you’d hold against your head, and everyone admits that they were bad. So these days, these modern phones don’t emit as much energy and probably aren’t as dangerous. Furthermore, a lot of young kids, which is a more susceptible group, now text and they don’t hold them against their head as much. So that’s the good news, that the trend is getting better with the phones themselves, and the trend is getting better in terms of the way you use your phone.

Do you turn off all your wifi around the house at night? No, I haven’t got to that stage of obsessiveness. It’s probably a good thing to do, but I don’t.

Brain cancer kills more kids in Australia than any other disease; has the survival rate improved much in recent times? The short answer is no. The long answer is that there are some types of brain cancer where chemotherapy has made a huge difference – it’s a tumour called a medulloblastoma. But in terms of the most common type of brain cancer, which is called a malignant glioma, we haven’t made much difference.

Did you have much involvement in the ‘coward punch’ law reforms? My only involvement is being a friend of Danny Green’s. Danny Green has a charity set up called Stop the Coward’s Punch. He asked me to be a spokesperson and to support his movement, so that’s my only involvement.

Do you think that shutting down the city’s nightlife was a disproportionate response, or do you think it was necessary? I think it was a necessary awakening, because I certainly don’t think it’s been a good thing in terms of commercialism for Sydney. I mean, Sydney’s gone dead now. Melbourne’s taken over as the nightlife capital of Australia. So from a commercial viewpoint it was a terrible decision. From a social awareness point of view it made everyone talk. It brought up the conversation that needed to be had, and that is, “What the hell are we doing? We’re all getting drunk, and we’re acting like idiots, and good people who want to enjoy themselves and go to a nightclub are suffering for it.” So I thought it was great, because it really brought up the conversation. It made people think, “Shit, we better do something now about it.”

You recently left your original not-for-profit to launch the Charlie Teo Foundation; why has this caused so much controversy? Firstly, the statement I’d like to make is that I left the old foundation because I just thought we could do it better, not because they’re bad people and not because I didn’t believe in the cause that they were following. I have taken the high road and wish them the best of luck, it’s a great foundation. Of course I’m going to say it’s a great foundation; I set it up. It was my foundation and they’re still doing great work, but now there’s this controversy, so what have people focused on? They’ve focused on the statement that I made, that I think that the overhead costs of most charities are too high. I haven’t put a figure on what I think is too high, what is too low, or what is acceptable, but I think, in general, the statement is that when charities become large and corporatised, their overheads consume too much of the donated money.

So administration costs were eating up too much of people’s donations? Yeah, but here’s the problem with your statement: the problem with your statement is that most large
charities know that they consume a lot of money, and they’ve got to spin it so that the public don’t know that, so how do they spin it? Because there’s no regulation on how to report, there’s no definition of what is overheads and what isn’t. So they talk about admin costs versus direct costs, versus indirect costs, versus this, versus that… so the poor old lay person, including myself, gets totally confused when you go to their profit and loss statements. Let’s talk about the pub test…

I like pub tests… Okay, here’s the pub test: if a person told you that they made $10, but they spent $8 making that $10, you would think that only $2 was profit, wouldn’t you?

Yeah… Okay, so what happens is that because that sounds so bad, “I made $10 million, and I only gave $2 million to research…” they talk about ‘awareness’. That’s just one topic. Awareness is where you are still doing things for the cause – you’re raising awareness – but you’re not actually giving money to research. So what can be included under ‘awareness’? Well, it turns out that a lot of charities include everyone’s salary under ‘awareness’, because that’s what they’re doing, after all – they are increasing awareness, they are on the phone making phone calls, they’re printing literature. So, Charity A for for example report 15 per cent admin costs. You would think that admin costs would include people’s salaries.

Yeah, of course… Nope. $3.1 million worth of salaries are not included in admin costs. If you read the fine print you can find all the actual figures on the ACNC website.

Well, that sounds ridiculous… It is ridiculous, and I think it’s almost like lying, and it’s so unfair. It’s so unfair, because it’s hard-earned money. There are so many good charities out there – they’re all good, they’re all worthy causes – so how do you choose which one you give your money to? It’s your money. I don’t care if you got it off your family, I don’t care if you inherited it, I don’t care if you got it by cleaning a toilet. It’s hard-earned money.

It’s money you could have spent on yourself… Exactly, it’s money you could have spent on yourself. So you’ve chosen to give it to someone else; I think the least that a charity can do is to be transparent in wherethe money’s going and not spin it so that it looks good. That’s the least we can do, so that’s what the Charlie Teo Foundation’s going to do. That’s our catch phrase: openness. We’re going to be very, very open about where the money’s going.

Can you tell us a bit about the new foundation? Yeah, so the new foundation is called the Charlie Teo Foundation, and it has the same agenda as the Cure Brain Cancer Foundation, and that is to try and find treatments and possibly a cure for brain cancer. But it has two main differences. The first is that we are going to keep our overhead costs low. We’re not going to spin it, we’re not going to call them admin costs versus direct versus indirect costs. We’re going to keep our overheads low. That’s the first thing, and we’re going to be really transparent about it. The second thing is that we are going to fund disruptively. If you look at universities traditionally, it’s not the universities that have come up with a cure for cancer and stuff, it’s these one-off mad scientists who come up with a theory and it’s a cure for the disease. Look at peptic ulcers and those two crazy Australians over in Perth, Barry Marshall and Robin Warren, who tested antibiotics on themselves.

The Helicobacter pylori guys? Yeah, they were two crazy guys, no one funded them, no one backed them and they had to test the theory on themselves. I want to find the Barry Marshall and Robin Warren of brain cancer. That’s what we’re going to fund; we’re going to try to fund disruptive projects that may not be mainstream but could be the answer.

How can people contribute? We have fundraisers during the year. Our major fundraiser is a ball, which we’ve just had, but our next funder is the City2Surf, so if your readers are going to do the City2Surf on August 12, they can designate a charity of choice and we’d like them to designate the Charlie Teo Foundation, and that will raise money for us.

What are your favourite and least favourite things about the Eastern Suburbs? My favourite thing about the Eastern Suburbs is that you don’t have to leave the Eastern Suburbs, ever. It’s got everything. It’s got beaches and walks, parks and good people, great food and retail, schools and hospitals. The bad thing is that most people don’t leave ever, and that most people in the Eastern Suburbs don’t appreciate what they’ve got here.

What’s your opinion on the current state of healthcare in Australia? What would you do to make it better? Oh, again, it’s a little bit too complex to answer, because there are so many different perspectives on healthcare.

Is it well funded enough? Yeah, it’s well funded enough. When some- thing goes wrong with healthcare, like someone sits in emergency for too long and dies, when the waiting lists are too long, when there’s some problem with something, everyone jumps up and down and says, “Oh, it’s a terrible health system. We need more money.” So the government, to get votes, uses it as a platform to get votes, “We’re going to give you so many more millions of dollars…” But in my mind they’re pouring money into a broken system, so it’s never going to fix it.
I guess to really simplify it, it goes like this: hospitals are funded with a certain amount per year and hospital administrators are judged on how well they can keep to that budget. When they go over budget they are demonised, they are persecuted, and they’re punished the next year by either being demoted, fired, or getting less money, to make up for the money that they overspent. With that system the most efficient hospital is an empty hospital, because you don’t go over your budget.
So how do you maintain an empty hospital? Well, you certainly don’t have somebody like Charlie Teo operating there, that’s for sure, because Charlie Teo brings in patients from all around the world and from interstate, as well as more complex cases. Instead, you’ve got to encourage a system that encourages an empty hospital. What kind of doctors do you want? Do you want bad doctors? They’re not going to bring in patients. Do you want staff that are rude to people? You’re not going to go to a hospital where staff are rude to you. You’ll want an inefficient emergency room, where people are waiting for hours and hours. You’re not going to go to that emergency room.
So what happens? They fall into budget. You fill your emergency room with rude people, you fill your hospital with bad doctors, and what do you have? You have an incredibly efficient system that falls within budget.

Congratulations, you get your bonus! Yeah, and the administrators are happy. Congratulations, you get your bonus.

Do you think the old system, where they had the nurses’ colleges attached to the hospitals, is better than the current system, where the nurses go to university? I liked the old system, because I think nursing is something that you learn on the job. It’s very hard to learn nursing in a university. But there are also some really good things about the university-trained nurses. They’re much more knowledgeable. If you could have a system that picked caring, compassionate people to do nursing, and then trained them well in universities, that’s your ideal situation. Unfortunately, it’s sometimes hard to get into nursing because it is a selective situation where they can only let a certain number in, so you may be filtering out people who would have been great nurses because they’re kind and compassionate but they didn’t get the marks; they’re not university type people. I guess if I had to choose the system, even though there’s good and bad with both, I would choose the old system.

In an ideal world, what does the future hold for Charlie Teo? In the ideal world I would like my legacy to be to leave the Australian health system in better shape than I came into it. By that I mean I’d like to change the culture of mediocrity, the tall poppy syndrome. I’d like the culture to be one of a reward of excellence, firstly. Secondly, the degree of medical bullying in Australia is rife and it is destroying our medical system; I would like to finish my career by saying I’ve had an impact on bullying, and that it’s now better – I don’t think we’ll ever get rid of it, but I’d like it to be better than it was – and that now we have a standard that’s higher than it was, because we no longer reward mediocrity and we reward excellence.

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