Eminent pediatrician, Dr Bob Birrell has died.

 

LEONGATHA and Stony Creek’s Dr Bob Birrell OAM has died.

He passed away overnight on Wednesday night this week, in the Leongatha hospital, aged 88.

Hundreds of exasperated local parents will be forever grateful to Dr Birrell, an eminent Melbourne paediatrician, for his skills in diagnosing and treating conditions from which their children, and subsequently the whole family, were suffering.

That he decided halfway through his career that he loved South Gippsland and wanted to move here with his family was a gift to the health of local families.

But his work and reputation extended well beyond the local district where he made a profound impact on the health and wellbeing of the state’s children, especially those most vulnerable.

A tribute to Dr Robert Birrell OAM on the occasion of a significant award from the Royal Children’s Hospital, by Alumni President, Dr Kevin Collins on April 27, 2017 provides some insignt:

The late Dr Bob Birrell OAM and his wife Jan after receiving an award from the Royal Children’s Hospital.

“In 1966, Dr Robert Gregory Birrell, senior assistant physician to medical outpatients at RCH was 33 years old. A 33-year-old paediatrician at the Royal Children’s Hospital then and now would surely be seen as a very junior member of the consultant staff.

“This very junior person, together with his older and better-known brother, the late Dr John Birrell, police surgeon, had the temerity to write an article in 1966 in the Medical Journal of Australia entitled ‘The Maltreatment Syndrome in Children’. As they noted, this was the second such article in Australia, with a similar paper on the ‘Battered Child Syndrome’ published from the Adelaide Children’s Hospital the previous year. The landmark article from the United States by Kempe, Silverman and others first reporting the ‘Battered Child Syndrome’ had appeared in 1962.

“The Birrells documented eight cases of physically abused children who had come to the notice of the police, some of whom had been treated at the Royal Children’s Hospital. The text was accompanied by eloquent photographs of children with bruising, lacerations, frostbite, scalds and fractured limbs. They recommended that there should be legislation along the American lines so that suspected cases of child abuse be notified to a central social agency.

“Almost prophetically, they wrote: “We realised very early one of the main reasons why the maltreatment syndrome is not well-recognised, and this is the general attitude of disbelief and incredulity that people would or could do such things to little children. This attitude is widespread, extending to housewife, doctor, lawyer and even policeman. The hospital staff, orientated in attitude of necessity towards treatment rather than prevention, tends often not to think of violence, particularly when faced by neatly dressed and plausible husband or wife”.

“The second article by Bob and his brother, published in 1968, was entitled ‘The Maltreatment Syndrome in Children: a Hospital Survey’, and began with a quotation from the interesting psychiatrist RD Laing: “Husbands and wives can drive each other mad but they can get a divorce. Children are stuck with their parents”.

“Using a range of methods of ascertainment, they summarised the clinical, radiological and social pathology findings in 42 children who had presented to the Royal Children’s Hospital over a 31-month period – that is, more than one a month that they knew of.

“They suggested guidelines for increased clinical suspicion of child maltreatment, insisted that rehabilitating the family should not be undertaken at the risk of further harm to the child and again recommended the guidelines of the American Academy of Paediatrics which included immediate reporting of suspected cases to a legally responsible agency, the keeping of central records and immunity from prosecution of reporting doctors or hospitals.

“So, Bob Birrell and his brother John were pioneers, recommending that our esteemed hospital come up to speed and adopt the best practice as determined by our overseas paediatric colleagues.

“It could also be argued that they were akin to whistle-blowers – not in the strict sense of revealing corruption or malpractice within an organisation, but certainly in the sense of bringing an unpleasant truth to light. Regrettably, they received similar treatment to whistle-blowers.

“Incredible as it may seem to us today, their findings were generally not accepted by Bob’s medical peers and relevant administrators at the time. Attitudes varied from acknowledging that their work was well-intentioned but that its importance had been exaggerated, through to active obstruction of further investigation, of involvement of police or of setting up in-house teams to manage such cases.

“Eventually, the first and most consistent support came from the social work profession, particularly Miss Kath Dawe, chief social worker at the time, and it is probably fair to say that it is out of her support that later child protection teams came into being.

So, for some 50 years, Bob Birrell has effectively been a prophet without honour in his own medical community. Garry Warne and I, together with our alumni colleagues thought it was time to right this wrong and for Bob to enjoy this recognition. I feel very honoured to be part of this celebration, and again thank Anne Smith and Matt Sabin for helping to make this possible.”

Speaking in an article in the Star in May 2017, about the RCH award “for exceptional contributions to paediatrics,” on behalf of the hospital, the Victorian Forensic Paediatric Medical Service and the Royal Children’s Hospital Medical Alumni, Dr Birrell said he was delighted to receive the award, reflecting on the eventual death of a 23 month old patient due to abuse.

The boy was admitted with frost bite, a fractured femur and evidence of past fractures, pressure sores, malnutrition and anaemia.

“I was devastated and could not see how these problems could have developed by accident,” Dr Birrell told the audience at the award presentation.

The police were unable to find anything, but the boy was re-admitted to hospital on a further two occasions over coming years and, after suffering hypothermia and in coma, died.

“I know there was a need to investigate this further, even though it was vigorously discouraged by some staff members,” Dr Birrell said.

There’s a lot more to tell besides, including his work in South Vietnam in the 1960s as a member of the Prince Henry’s Hospital civilian medical team.

In 2001 Bob was awarded an OAM for the work in the field of child abuse.

About Dr Robert Gregory Birrell OAM

Date of birth: 9th of May1933

University attended: The University of Melbourne

Academic qualifications: Fellow of The Royal Australasian College of Physicians.

Positions held in The Royal Children’s Hospital:

* 1958 Junior Resident Medical Officer

* 1959 Medical Registrar

* 1960 Medical Officer to the General Clinic

* 1961 Senior Medical Registrar for 6 months at The Royal Children’s HospitalR.C.H. and 6 months Royal Women’s Hospital

* 1961 Senior Medical Registrar for 6 months at The Royal Women’s Hospital

* 1962 Clinical Supervisor

* 1963 to 1968 Assistant Physician

* 1969 to 1972 Senior Assistant Physician

* 1972 to 1974 Physician

Other positions held:

* Assistant Neonatal Physician and as a Neonatal Physician at The Royal Women’s Hospital between 1963 and 1968 ( Honorary Role)

* Neonatal Physician St Vincent’s Hospital between 1963 and 1964 ( Honorary Role)

Clinical interests: Child Abuse and Protection, Neonatology.

Memorable career moments: The Children’s hospital was the place Bob wished to work on graduation. His Resident and Registrar years included a six month neonatal Registrar position at the Royal Women’s Hospital. With John Coldbeck, he became one of the first two children’s Registrars appointed, allowing for a self-described ‘superb neonatal experience’.

As a Jnr. Resident Bob admitted a grossly abused two-year old to his Surgical ward. He was born with a cleft palate which obviously created home management problems.

He had a fractured femur, multiple areas of frostbite and large pressure sores. Xrays also revealed varying aged fractures. After 5 months rehabilitation he went home as police reported two well-cared-for siblings.

The boy was re-admitted six weeks later, totally blind with a fractured clavicle, and he was moved to the Blind Institute. After two years he again returned home. One month later, he was re-admitted, moribund, dying after a few hours with a dense intracranial hemorrhage.

Bob could not forget this little fellow, despite the lack of interest in the problems of abuse around the hospital and with his brother Dr. John Birrell, Victoria’s first Police Surgeon, he decided to act.

Bob leaves his wife of many years, Jan, a family of four and an extended family.

More details later.