λ Tony’s blog λ

A friend of mine, Brad Clow, has received demands to remove one of his blog posts by a lawyer. This post contains a letter that I wrote to the Medical Health Board of Queensland in March 2009. The letter mentions the name of a doctor, from whom I have also received recent threats of legal action; specifically allegations of defamation. Brad has removed the name of this doctor.

These threats are without any legal basis at all and a cursory read of The Defamation Act 2005 makes this really quite apparent. Specifically, sections 25 and 31. Neither myself nor Brad have made any defamatory claims against Dr Michael McEniery, however, I do have honestly held opinions which are based on facts which are substantially true. These opinions and facts will be made available for public viewing after I have sought advice from legal experts. Advice in this regard is most welcome and I promise a remarkable and quite alarming story.

It took me a little over a year longer to finally determine the correct diagnosis. I had an entrapment neuropathy of the superficial peroneal nerve 10cm proximal to the lateral malleolus causing traction injury and subsequent foraminal stenosis at the right L5 nerve root, resulting in severe neurological deficit. I also had anteromedial osseous impingement syndrome (caused by tibia/talus collision from foot drop) and four improperly installed screws causing (painful) interference in the talar joint. It is now 6 months since surgical resolution and I am left with some neurological deficit. It is not known if I will fully recover, though the treating surgeon is hopeful.

Brad’s original post, before he yielded to the legal demands, follows.

We received a copy of this yesterday evening. Please note Tony is a friend of mine and this is genuine.

To The Medical Board of Queensland,

My complaint is rather lengthy. It relates to an injury and subsequent treatment of that injury by various doctors and surgeons. I am not primarily complaining about any particular individual of the medical institution, rather, that I still have not been diagnosed and treated for my condition. I am desperately seeking diagnosis and a treatment. Some doctors may believe they have diagnosed my condition, but they have been wrong and this has been proven surgically. The best diagnosis available today is my own humble conjecture, which is terrifyingly inadequate.

On 28 July 2007, I suffered a severe inversion sprain to my right ankle. I’d suffered a few previous sprains, but this one was much worse than others. I was kicking a football rather hard when I landed incorrectly. I was not weight-bearing for about 5-6 days. During that time I was a very fit athlete playing A1-grade tournament squash and was very active with many other hobbies.

Over the following months after the injury, I tried returning to sport and I could feel I had something wrong in my ankle. I hoped it would resolve, but it didn’t. I could not put my joint into dorsiflexion due to a mechanical impingement and this resulted in muscle atrophy. Subsequently, I became very ill. Nevertheless, I pushed on with my sporting endeavours expecting my body to overcome the problem like it had many others in the past.

Eventually I conceded in January 2008 and sought help from Dr. Michael McEniery. We tried various treatments including a cortico-steroid injection and obtained MRI radiographs. Over time, this condition worsened to the point where I was forced to discontinue sport in May 2008. I have not been active since. I sought help from an orthopaedic surgeon, Dr. Greg Sterling, who prescribed a Broestrom Repair and medial arthroscopy since my complaint was mostly anteromedial.

At the time, I was very medically-illiterate and put much faith in medical doctors. I assumed a positive outcome from surgery, simply because I’d had surgery in the past for various conditions and I was always better afterward. The procedure was performed on 15 September 2008 and the medial arthroscopy revealed deltoid ligament damage which was also repaired along with the ATFL and CFL.

I wore a cast for 2 weeks and an orthodic boot thereafter. Although I was in pretty intense pain, I’d attributed this to the recent surgery and thought it would resolve. It didn’t. In October 2008, I knew I was in big trouble – I had similar symptoms to pre-operative but they were now much worse. I immediately sought help from Dr. Greg Sterling who requested another MRI but in November 2008, could see nothing wrong. He said “see you in January 2009”. The prospect of waiting so long in agony was traumatising.

Around the same time, I’d sought help from Dr. McEniery who claimed I was exaggerating my symptoms and attributing too much attention to my condition. This blatant oversight added further to my trauma – and he’d almost convinced a member of my family of these falsehoods. I was suffering psychologically and I sought immediate help from Prince Charles Mental Health Unit.

I was discharged as an outpatient but I knew I was not mentally ill – I was in incredible pain and agony from a misdiagnosis by an orthopaedic surgeon. I set out to conquer the problem myself – scared and ill-educated on the subject matter – and was faced by the foreign medical protocols and language.

As my stress levels grew, I was admitted to the Prince Charles Mental Health Unit by Dr. John Reinders under a de facto ITO. I was also forced to take anti-psychotic medication. This is because of some of the desperate language I was using, for example, “do I have to operate on myself?” and Dr. Reinders felt I may be a harm to myself.

I’d never been so low in my life. When taking anti-psychotic medication, you are very much unaware of your surroundings. It was only during a lull in the effect of the medication, that I decided I needed to get out of the hospital and do what I can for my ankle – I was convinced the doctors had erred and that this was a huge mistake. I requested a Psychiatric evaluation and was declared “in severe distress, but mentally healthy” and I was discharged.

I set about understanding ankle anatomy, conditions of the ankle and general medical protocols. I quickly learned that I had at least soft tissue impingement. Indeed, I had tissue trapped in the joint that was under permanent pressure due to the recent surgery – even when not weight bearing. This is as painful as you might imagine it to be and a little more given multiple pathologies.

I sought help from Dr. Andrew Wines (Foot & Ankle Orthopaedic Surgeon) in Sydney who prescribed an arthroscopic debridement. This was performed under GA on 11 December 2008. To quote his remark, “you had a chunk of tissue about the size of my finger in there”. I was immediately weight bearing post-operative and the local aneasthetic provided some relief. As a result of this anaesthesis, I was under the false impression that my troubles were over. They weren’t.

After a few days I knew I still had a severe and painful problem though I no longer had the problem of tissue impingement. It felt like I had bone impingement on dorsiflexion and I sought answers from medical literature. I eventually stumbled on Anteromedial Osseous Impingement Syndrome for which MRI radiography is inconclusive for diagnosis. I used my January 2009 appointment with Dr. Sterling to ask for a request form for a CAT radiograph and weight-bearing Xray. Dr. Sterling also made an appointment with Dr. Michael Lutz to determine if he could unravel this mysterious problem of mine.

Upon obtaining these radiographs, I saw immediately that I had a bone spur in the location of my pain. I sought assistance from Dr. Andrew Wines (again in Sydney) who agreed with me to some extent but wanted a second opinion in order to ensure he was not suffering a bias. I applaud this decision. I used my upcoming appointment with Dr. Lutz to achieve this second opinion. Dr. Lutz agreed that an open incision to excise osteophytes on my tibia may be appropriate and I was informed of the risks .

Dr. Wines performed an arthrotomic tibial ostectomy on 04 March 2009 under GA at Royal North Shore Hospital. I flew home the next day – I was weight bearing without assistance. Again, the anaesthetic provided a false belief that my problems were over.

Unfortunately, I still have the same problem I started with – I cannot put my ankle into dorsiflexion. Many doctors might attribute this to the recent surgery, but I know I am experiencing precisely the same symptoms that I have done for the last 18 months. Although the localised and extreme pain caused by a bone spur has been resolved, I still have bone impingement on dorsiflexion that is not localised. I also know that this is due to a very definite mechanical limitation, since I have had a Physiotherapist in the past attempt to push my joint past this point with intense force to no avail.

As a result of this inability for dorsiflexion, my muscles have atrophied up to my thoracic spine. Subsequently, I find breathing difficult and any position uncomfortable except for lying down. This has caused immense stress especially while I have maintained a full-time job (Computing Science Researcher) and I am considering indefinite unpaid sick leave. Unfortunately, a consequence of this is that I will no longer be able to afford regular flights to Sydney for treatment, radiographs and so on, therefore, I must continue the battle under all circumstances and despite exhaustion.

I have long maintained that my symptoms are only observable while I am weight-bearing and in an attempt at dorsiflexion. This means that surgeons who operate cannot check for resolution of these symptoms, MRI and CAT radiographs cannot exhibit them and the only weight-bearing Xray I have was not in dorsiflexion because the Radiographer would not allow it (images only per requesting doctor instructions).

Unfortunately, I still have quite a large battle ahead but I am at a complete loss with respect to how I should go about it and that is why I have written to you, my state medical authority.

Is there a radiographic machine available in Queensland that will exhibit my bone impingement while in dorsiflexion and while weight-bearing? Better still, is there a doctor who is prepared to do the hard work of figuring this problem out? I am more than willing to make many sacrifices to ensure it. These are rhetorical questions – I don’t know what the right questions are.

I am desperately seeking a diagnosis and treatment, 19 months after an initial injury and I know that my time is limited with regard to the amount of stress and pain that I can continue to endure. This is simply unsustainable.

Please advise.

Thank you for your time. Confidentiality is not requested and you may share this information with whoever you see fit.

Took me a while to recall the right keywords to come up with this excellent interview between a representative of the Canadian Government and Ezra Levant.

http://www.news.com.au/couriermail/story/0,23739,22427799-5007200,00.html

PHILIP Lamattina’s spectacular effort at Willowbank near Ipswich on Saturday night has already assumed legend status among Australia’s drag racing fraternity.

He miraculously escaped unscathed from the 500km/h smash that destroyed his $250,000 Top Fuel dragster.

The publisher(s) of this story oughtta be ashamed of themselves. Everyone knows (note: I am exempt from accusations of argumentum ad populum fallacies because I am (and circular reasoning too, got it?)) that SPEED KILLS! Here these journalists are implicitly refuting the known established perversion… er… correction, of the laws of Physics and our understanding of space and time! This is nothing short of failure of reason and I now expect deaths on our roads to increase substantially. All because of some irresponsible journalist(s)!

Actually, I take it back. You see, it was a miracle. Yes, notice the use of the adverb, ‘miraculous’ in the second paragraph. Instead of contradicting our government’s established scientimplistic (yes, I made that up :)) understanding, the article exonerates itself by attributing the whole affair to a miracle. This is permitted under the laws of illogic, which any person is free to invent for themselves, right? Of course.

So you see, that makes sense now. Phew!

Dear Prime Minister John Howard of Australia,
Many of my readers may not be aware that all people over the age of 18 are required to vote in elections by law in Australia. The exceptions are (of course) the organisations with an artificially heightened religious status such as Jehovah’s Witnesses.

I was de-listed to vote years ago and when I contacted your Australian Electoral Commission (AEC) to apply for conscientious objector status, I was told I needed to belong to a religious cult in order to be eligible and that I am not permitted to think for myself under Australian law. I resented this implication and I have since not ever enrolled to vote. Nevertheless, the AEC operator told me that to be a conscientious objector and at the same time, exist independently of a religious cult/organisation, that I simply should not enrol to vote — to break the law — go figure? I hadn’t voted before this time, since I had always submitted an empty voting ballot form. I won’t bore you with my somewhat complicated reasons why (relative to your comprehension skills that is).

But this is not the reason I write to you. No, it is the very rare victory that Science has had recently. I am writing to you to make a deal. I will forgive the implication that Australians are not permitted to think for themselves if you follow the lead of the UK government and even more, I will submit one vote for you! I will even forgive you for taking away my firearm licence those many years ago just because some psycho 2500km away went berzerk with a semi-automatic rifle. I know you do not possess critical thinking skills Mr. Howard, and neither do your nemeses, but I will forgive you for that.

You see, the UK government have recently announced that Intelligent Design has no part in a school that teaches Science; how great is that for our society!? This announcement has tipped me over the edge and given me some hope — I will do just about anything to have the same for our vulnerable Australian children. Please Mr. Howard!

So, I implore you, please follow suit, for the sake of my children and their well-being if anything. But of course, I know all you care about at the end of the day is my vote and believe me, you will get it! I will even vote for a government; that’s how desperate I am to save my children from the Monotheistic attacks that are conducted so readily and openly in so many civilisations today, including the one that you currently govern.

So, how about it?

On 28 April 2006, I was charged by a police officer for obstruction under Police Powers and Responsibilities Act 2000 Section 444 (since amended to Section 790). The police officer alleged at the time that my holding of a sign that reads ‘Police Speed Trap Ahead 50′ — with emphasis on the 50 indicating the speed limit in that area — constituted an offence, obstruction.

I subsequently entered a plea of not guilty (after one adjournment) and made several attempts to obtain a Brief of Evidence from the police prosecution. Their incompetence would normally astound me, but these days I just roll my eyes — in fact, a demonstration of competence itself would invoke surprise (know of one?). Of course, no brief was available, for days, then weeks, then months and in the meantime, I had spent countless hours on putting together a defence.

Finally, the day before the trial, still without a brief (roll eyes now), the police prosecutor rings me and attempts to negotiate — in the usual friendly/manipulative manner as expected. After the usual banter (trying to obtain information from me), I am offered a ‘guilty plea for no conviction’ deal, which I immediately decline and hang up the phone with, ’see ya tomorrow mate’. I then travelled to the police station to request a brief of evidence, knowing I wouldn’t receive one, but adding to my record of attempts to obtain it, that I would be presenting to the magistrate the following day. A couple of hours later, I receive another phone call to be notified that the charge has been dropped.

This occurred for two reasons.

1. The police prosecution was too incompetent to get their act together to pursue the charge
2. But most importantly, the police do not want to set a legal (lawful) precedent for this behaviour

The police prosecution clearly believed that there was a strong possibility that my not guilty plea would pay off. If it were successful, a subsequent appearance on television (see the first one below) would have propagated the legality of this activity among the public and the police definitely do not want an informed public even if it means that I ‘get off’. Instead, it is best to leave the issue ‘blurred’ and continue pursuing ‘offenders’ such as myself, who otherwise do not know any better and enter a guilty plea on the day in court (I understand that many police officers genuinely believe that they are performing a public duty, but let’s leave that side issue).

Although I am not a lawyer, this activity is not illegal if it is executed correctly. I encourage any member of the public who is concerned about road-safety in Australia to engage in this lawful behaviour, although I do not accept any liability for any adverse consequences that you may encounter, including, among other things, a criminal conviction.

To engage in this behaviour legally in Queensland (other states may be similar), ensure the following:

• stand well away from the police speed trap, a few hundred metres at least
• if approached by anyone, do not offer comment under any circumstances
• if approached by a police officer, he/she may request your name, address and may also request “evidence of the correctness of the stated name and address” (see PPRA2000 Section 40)
• Comply if you are asked for name and address, but under no circumstances should you offer further comment on the matter — police are very well trained at extracting this information to ensure your conviction, so it is up to you exercising discipline to keep yourself safe. This request is almost certainly a demand under PPRA 2000 Section 41 where the police officer “reasonably suspects the person has committed an offence”, even though you probably haven’t. Do not pursue this ambiguity with the police officer at the scene.

What about flashing vehicle headlights? If you flash your headlights to warn other motorists of an impending speed trap, a police officer will almost certainly issue you with an infringement notice of Rule 218 of the Australia Road Rules (Transport Operations Regulation 1999 in Queensland). It is important in this case to fulfill your legal obligations (name, address and produce valid driver’s licence) but offer no other comment — why? Because you may not have committed an offence, that’s why.

Let’s take a look at Rule 218 of the ARR (Part 13 Division 1):

218 Using headlights on high-beam
(1) The driver of a vehicle must not use the vehicle’s headlights on
high-beam, or allow the vehicle’s headlights to be used on
high-beam, if the driver is driving:
(a) less than 200 metres behind a vehicle travelling in the
same direction as the driver; or
(b) less than 200 metres from an oncoming vehicle.
Offence provision.
Note High-beam and oncoming vehicle are defined in the dictionary.
(2) However, if the driver is overtaking a vehicle, the driver may
briefly switch the headlights from low-beam to high-beam
immediately before the driver begins to overtake the vehicle.
Note Low-beam and overtake are defined in the dictionary.
Diagrams follow

Your infringement notice is for part (1) of Section 218, but a police officer almost certainly will not ask you if you used your signals for part (2). Have you ever asked yourself why ADR (Australian Design Rules) compliant vehicles have a high-beam flasher switch? Of course, because it is entirely legal to flash your high-beam headlights under some circumstances.

If you wish to warn opposing traffic of an impending speed trap, ensure that you flash your headlights under legal circumstances — while overtaking a vehicle, briefly from low-beam to high-beam and immediately before overtaking the vehicle. Do not feel tempted to justify this action on the side of the road with a manipulative police officer! Simply enter your not guilty plea in the court and explain to the magistrate that you were acting legally and responsibly under Rule 218 of the ARR.