Ideas for a brighter future for all

A BETTER FUTURE FOR ALL

In Adversity's Face: Kerry O'Brien in conversation with Dr Dinesh Palipana OAM
In partnership with HOTA, Home of the Arts, Griffith University's A better future for all series continued with Dr Dinesh Palipana OAM joining Kerry O’Brien.

Critically injured in a traffic accident while still a medical student more than a decade ago, Dr Dinesh Palipana OAM has broken more barriers than most people even face in a lifetime. 

Queensland’s first quadriplegic medical intern and graduate, Dinesh is now a senior resident doctor at the Gold Coast University Hospital and Senior Lecturer in Griffith’s School of Medicine and Dentistry. A Griffith graduate and Queensland’s 2021 Australian of the Year, he is also a tireless advocate for people with disabilities. 

As co-lead researcher on the University’s BioSpine physical rehabilitation project, he has made himself a willing subject in work that seeks to make everyday life better for patients with spinal cord injury, and even see them one day walk again. There is still much to be done, of course—but, for a man as seasoned at tackling big challenges as Dinesh, the future is looking brighter every day. 

Griffith University was delighted to welcome Dinesh as our guest for the conversation series, A Better Future for All, at HOTA, Home of the Arts, on the Gold Coast. Host Kerry O’Brien and Dinesh delved into the good doctor’s extraordinary life and work, in what was an evening of insightful, emotional, and candid conversation. 

Dr Dinesh Palipana OAM

Doctor. Lawyer. Academic. Advocate. Queensland’s Australian of the Year. 

All these words—and more—could be used to describe the extraordinary individual that is Dr Dinesh Palipana OAM. But, for all the Griffith University graduate’s many accomplishments, there’s one term that continues to shadow him, even as he works to overcome it: quadriplegic. 

While studying for his Doctor of Medicine in 2010, Dinesh was involved in a serious accident that left him without feeling or movement below his chest. Despite this life-changing event, Dinesh never lost his resolve to complete his degree.  

After a period of recovery in his home country of Sri Lanka, he returned to Griffith to finish what he started, becoming Queensland’s first quadriplegic medical intern and graduate in 2016.  

In just five years, he has become a senior resident doctor at the Gold Coast University Hospital, and was recently made a Senior Lecturer in Griffith’s School of Medicine and Dentistry. 

As an adjunct research fellow at Griffith’s Menzies Health Institute Queensland, he is co-lead researcher on the University’s BioSpine physical rehabilitation project. Using electronic muscle stimulation and a brain-connected computer interface, the groundbreaking project seeks to help restore motor function for patients with spinal cord injury to ultimately see them walk again. 

Already holding a law degree before he became a doctor, Dinesh has made a lifelong habit of high achievement.  

He is the co-founder of Doctors with Disabilities Australia (DWDA), which works with the Australian Medical Association to improve access to education and employment for medical professionals with disabilities. Despite his busy schedule, he also finds the time to work with the Gold Coast Titans Physical Disability Rugby League (PDRL) team. 

Among it all, Dinesh has developed a growing reputation as a vocal advocate and activist. Alongside his work with DWDA, he has appeared at events such as TEDx, and was a witness to the Disability Royal Commission on equitable treatment for people with disabilities. He has also collaborated with Griffith to introduce two new scholarships and provide support for ongoing spinal cord research.  

A multi-award winner, Dinesh has been nationally and globally recognised for his work, complementing this year’s state honours with major achievements including Junior Doctor of the Year, the Henry Viscardi Achievement Award, and a Medal of the Order of Australia.

 


Professor Carolyn Evans, Vice Chancellor and President, Griffith University

Good evening, ladies and gentlemen and welcome.  My name is Carolyn Evans, I'm the Vice Chancellor and President of Griffith University.  Griffith University is proud to be theco-host of this event alongside HOTA, the Home of the Arts, here on the beautiful Gold Coast.  HOTA and Griffith proudly acknowledge the traditional custodians of the lands on which we meet tonight, the Koombumerri families of the Yugambeh language region.  And we pay our respects to elders past and present and recognise their continuing connections to the lands, waters and extended communities throughout Southeast Queensland.

Could I also acknowledge here tonight Councillors from the Gold Coast City Council, Chair of the HOTA Board of Directors; Professor Emeritus Ned Pankhurst, and other colleagues from both HOTA and Griffith; the Honourable Ronald Sackville AO, Chair of the Disabilities Royal Commission; Mr Ian Langdon, Chair of the Gold Coast Health and Hospital Service Board; Mr Steve Mitchell, CEO of the Gold Coast Titans. So close, Steve.  So close!  And Perry Cross, the Executive and President and Tom Ray, the Chairman of the Perry Cross Foundation, a wonderful supporter of Griffith's research, about which I hope you hear a bit more later. 

So, I'm so delighted to welcome you here in person to another edition of A Better Future for All, Griffith and HOTA's series of important conversations hosted by Australian journalism great, Kerry O'Brien.  This month we're privileged to have as our guest Dr Dinesh Palipana.  Dinesh is one of those very smart overachieving people who is qualified as both a lawyer and a doctor. He's a Griffith alumni, having completed his doctorate of medicine with the university, in 2016, and, as you'll hear, remains an active and engaged part of the Griffith community. 
What makes Dinesh's story remarkable is the circumstances surrounding his path to graduation.  While studying or his degree, in 2010, he was involved in a serious accident that left him without feeling or movement below his chest. Tonight, he's going to share more of that story with us and how he faced down adversity to become a leader, not just here on the Gold Coast but, indeed, across Queensland and Australia.

 Dinesh has become a tireless and dedicated advocate and activist for people with disabilities while continuing to achieve highly in his professional activities. He's the co-founder of Doctors With Disabilities Australia, an organisation that works in tandem with the Australian Medical Association to improve access to education and employment for medical professionals with disabilities. You might hear a bit more tonight about how that's not straightforward. He's also appeared at a range of high-profile events, including as a speaker at thought leadership expo TEDx and as the Culturally and Linguistically Diverse Senior Advisor to the Disability Royal Commission. Just five years after graduating, he's become a senior resident doctor at the Gold Coast University Hospital and was recently also made a Senior Lecturer at Griffith's School of Medicine and Dentistry. He also works as team doctor for the Gold Coast Titans Physical Disability Rugby League team.

In addition to these commitments, Dinesh serves as an adjunct research fellow at Griffith's Menzies Health Institute Queensland, where he is the co-lead researcher on the ground-breaking BioSpine physical rehabilitation project.  This project uses electronic muscle stimulation and a brain-connected computer interface to help restore motor function for patients with spinal cord injury, hopefully, over time, increasing function and maybe one day seeing them walk again.  Given his history, I'm sure none of you will be surprised to hear Dinesh has won several awards over the years, having been recognised both nationally and globally for his work as a doctor and advocate.
In 2019, alongside accolades including being the winner of the global Henry Viscardi Achievement Award and earning the title Junior Doctor of the Year, Dinesh was recipient of the Medal of the Order of Australia. This year, we're very proud to say he was named as Queensland's own Australian of the Year. On top of all of that, he's just a great bloke, down to earth, humble, funny, smart and good company. I know that you are going to enjoy tonight's discussion.Kerry, over to you. 

Kerry O’Brien: Dinesh, I've wondered more than once what it must be like for a person in full health with the promise of a big future ahead of them and stretching out before them who's suddenly had that promise snatched from them. Independence becomes dependence. Their whole life crashes around their ears. You'd already graduated in law and were well on the way to becoming a doctor when your car spun out of control on Brisbane's Gateway Bridge. You woke in intensive care in a Brisbane hospital. A quadriplegic for life.  You felt like you'd been cut off at the chest you said. And when you tried to sleep you felt the awful sensation of falling. How long did it take you to find hope?

Dr. Dinesh Palipana: I think in this world we're so quick to take away hope from people. And I see it in the practice of medicine all the time. But hope is really all you have. Hope is what keeps you going. Hope is what helps you hang on for a better tomorrow, for a better life. Interestingly, that hope came immediately after the accident. I was in the ambulance and there was a doctor who had actually given me a lecture not long before I had the crash. And I was talking to him. And I connected with him because I said, "You actually taught me." And he, he said to me that "Everything will be OK." He made me feel safe. And he said that I was in good hands. And I knew, I knew that he was a capable doctor. But he gave me hope, which was really important. And all these years later I'm telling you about that, and I think that's a really powerful impact that he's made on me. And I think people don't often remember what you do for them, but they remember how you make them feel. And that's what he taught me about medicine. So, I was lucky enough to have someone at that point in time that gave me hope. And there were moments along the way where I just had to renew that hope and keep going.

O’Brien: You've said that you couldn't look in a mirror for a long time. What were you avoiding? What didn't you want to see?

Palipana: Well, I'm a pretty vain guy,

O’Brien: Not much room for vanity at that point, Dinesh.

Palipana: I didn't actually realise this or reflect on it until last year when I was called up by the Children's Hospital about a little one who had a spinal cord injury, and I went to visit them and their mum told me that this little kid just refused to look in the mirror for the longest time, and then I thought back and realised that I didn't look in a mirror for a year or two.

O’Brien: Wow.

Palipana: I look in the mirror all the time now.

O’Brien: (Laughs) Like what you see?

Palipana: I like it. But I think it is difficult coming to terms with a new physical self. I think it is difficult seeing yourself in a different form, because when you see yourself, you have to accept what life has become and how your life has changed. And I think for a long time I didn't want to accept that. So, it took a while because looking in the mirror was a reminder to myself what had happened.

O’Brien: Yeah. When you think now about what it took to climb out of the morass that you were in and create a new life, what is it that you think you drew on? You've talked about the doctor, and there would have been other people around you, but inside you, was it the essence of courage? Was it some kind of irrepressible optimism? Was it stubbornness? Was it a combination of all of these things? What was it?

Palipana: I think you draw on different things at different times to keep going. It was hard.  When I woke up in the intensive care unit, just coming to terms with what had happened, like I said, I felt like my body was cut off below the chest, I couldn't sleep because I felt like I was falling. I had to ask for drugs all the time just to fall asleep. I couldn't lift my arms. I couldn't talk, sit, breathe, eat. Actually, the hospital ran out of flavoured jelly (laughs), so they had the tasteless thickened fluid, which I got really frustrated with, but eventually I could eat and got a steak from the pub across the road. All of those things, it was really hard. And small things get to you as well. So, at different times I think you just have to draw on different bits of strength.  I remember looking outside the window once after I left the ICU and just not knowing when I would be outside again. And I just remembered that feeling because it was such a sinking feeling. I love being outside.

O’Brien: All the things you would have associated with being outside. All of the physical things.

Palipana: Exactly. But and then at a point in time there was a group of us, four of us in one area in the hospital, and we all had spinal cord injuries, and there was a man who was probably in his 40s or 50s, he had a family, and I remember him so well because his wife used to bring me fresh towels in the morning and she used to say hello and we had a chat. He was from north Queensland somewhere. And one afternoon we were all back in bed after the day's therapies and everything. I had some friends there. And suddenly some alarms went off and he died in front of our eyes. And, you know, for those heart-wrenching moments you just have to draw on whatever strength you have to keep going. And sometimes you just got to dig deep. And I don't know, I don't know what it was, but you just either give up or keep going, and I just had to choose to keep going.

O’Brien: Even before the accident when you were a law student you suffered from depression and agoraphobia. You wouldn't leave your home for weeks at a time. What lifted you out of that condition? And did you ever get to the bottom of what caused it?

Palipana: Yeah, I often reflect on that experience because now I have a spinal cord injury and I have lost motor function below the chest and in my fingers. And you could say that I have paralysis. The funny thing is, the depression and that experience was far more paralysing than the spinal cord injury has been, because like you said I didn't leave the house, I didn't engage with the community. I lost friends. I couldn't hold down a job. I suffered at university. So, all these things became a problem. And I think that's really the significance of mental health issues, which we talk about more and more in society these days. But sometimes I think those things, while there is a biological component to it, it is also a signpost, at least for me it was, to adjust my sails a bit and rethink life. I didn't really have a good reason for a lot of the things I was doing at the time, whether it was law school, some of the friendships that I had, some of the activities that I engaged in. And so, I did a lot of soul searching, and that's when I decided to become a doctor because I realised the power of doing something for another human-being at that level. When I started seeing a doctor and when I started interacting with the health system and when I started turning a corner with the depression, my entire world changed. And so, I thought what if I could do that for someone. And there was a purity that I saw in the practice of medicine because, really, it can transcend a lot of the things we have, it can transcend our prejudices, it can transcend our borders, it can transcend all these things, and you can go to someone and do something for them with what you have in your brain. So, I decided that's what I wanted to do. And once I changed my sails and started heading a different direction, my entire life changed and I became a new person, and I think that was what helped me get out of that experience.

O’Brien: Did any sign of the depression has come back since? One would think that if you had that tendency, if you were prone to that, boy, you sure had the reason to be depressed after the accident.

Palipana: Yeah, and I thought I would be, too, but I haven't felt that low, and I haven't had panic attacks like that. Haven't been anxious like that since then.

O’Brien: I wondered when we were talking about this and then we talked about your early childhood growing up in Sri Lanka, which was war-torn, it was an earlier stage of the civil war that was to last for 25 bloody years. There was a communist insurrection.  And it was all so brutal in terms of what was going on both sides. And as a young boy you were witnessing that on a streets of Sri Lanka. Can you talk about that for just a moment?

Palipana: Yeah, absolutely. You know, the funny thing is I've spoken about these experiences before and I've had some very stern talkings to from people in Sri Lanka about mentioning these experiences, but I think it really happened and it is a part of history and I think we have to learn from it. But one of the most striking memories that I have, and for a long time I didn't actually think this happened, I thought it was a dream, maybe something I saw on TV, but a few years ago I talked to my mum because it was something that was transient, and it came to my head. It was a memory of me, mum and dad driving down a road. And we saw piles of tyres on the side of the road. And they were -- they had smoke coming out of it. They were on fire. As we got close to them, we realised, or, at least, I saw bodies inside. And this was a way that they punished people at the time. They used to burn, burn people in piles of tyres. So, I asked mum this, and she said, "Yeah, you actually saw that, and we were there." So, it was a real memory. And funnily enough this morning I was talking to her about it again. I was like, "I can't believe that really happened because it feels like a dream." She said -- we talked about it a bit more and she said, "I wonder if you remember what you saw after that, after we passed the tyres." And I said, "I can't." She said, "Well, their bodies were actually beheaded and their heads were on stakes lined up along the road after the tyres." And where we lived there were -- mum said there was a stage and they used to execute a lot of the young people that were involved in, you know, whatever views that they had. So, there was a great deal of violence and suffering.

O’Brien: Which must have impacted in ways that you will never know, I suspect. Your mother has clearly been the dominant influence and support in your life, the driving force in the family decision to leave Sri Lanka for a safer life in Australia and in supporting you particularly since the accident. Tell me about your mother and her part in your recovery.

Palipana: Yeah, I call her 'The Mothership'. So, she's taught me so much. When I was growing up, she was really the one who drove our move to Australia. She was the one who went around to schools. She was the one who taught me how to shave. She was the one who taught me how to drive. Interestingly, in our first driving lesson I got into the car, and we started driving and she's like, "How do you know how to use my car so well?" That was because when she went to work I used to drive it around the block. But she's taught me so much. And over the last few years, in particular, she's taught me about strength and courage and persistence and love and patience. So, she has been amazing, but I think she's also shaped my views on gender and some of the conversations that we have in society about that these days.

O’Brien: Yeah. In hospital you also had the support of friends, but one friend, in particular, who left the words of a poem pinned to the curtain in your room as you lay there between hope and despair. I would like you to read the words of that poem to us.

Palipana: So, the poem my friend hung up it was on the curtains, it was pretty dirty curtains actually, but she just printed out this poem and pinned it to the curtain where I could see it every day, all the time. The poem is Invictus, and the poem goes:

 

Out of the night that covers me

Black as the pit from pole to pole

I thank whatever Gods may be

For my unconquerable soul

In the fell clutch of circumstance

I have not winced nor cried aloud

Under the bludgeoning of chance

My head is bloody, but unbowed

Beyond this place of wrath and tears

Looms but the horror of the shade

And yet the menace of the years

Finds, and shall find, me unafraid

It matters not how strait the gate

How charged with punishments the scroll

I am the master of my fate

I am the captain of my soul.

O’Brien: Pretty potent. So, what impact did that have on you? Did it have the desired effect?

Palipana: Definitely. It had the desired effect. Invictus means undefeated. And I was reminded every day not to bow down, I was reminded every day I could choose how I feel, and I could still choose my destiny and what my soul feels. And that has really been cemented in my person to today. And it's definitely held me in good stead.

O’Brien: I'm going to pursue that a little bit later. In fact, we're probably pursuing it all the way through this conversation. After a great deal of what I imagine must have been gruelling physiotherapy and the mental stressors and the mental battles, you then had to be accepted back into medical school and, ultimately, accepted as a doctor. You've since said, "It's not physical incapacity that threatens to stop people. It is the attitude of other people." So, how did that apply to you?

Palipana: So, I was lucky enough to have people in my life - if we're talking professionally and my career - I was lucky enough to have people in my life that really thought that it was worth trying, thought it was worth giving this a go and thought it was the right thing to go through. There were people with a strong moral compass, and it was people that were willing to take a personal and professional risk to do that. And I think when we think about a lot of challenges that we face in society, that's the kind of people that we need, right, we need people that believe in the right thing and that will take the risk to do that. So, I had people like that in the medical school at the university that, overwhelmingly, fought against the odds and made sure that I came back and helped me in so many different ways. But the structure was not so supportive at the time. There was a policy that came out for medical schools across Australia and New Zealand that looked at excluding medical students with disabilities from studying medicine. And I saw one of the emails circulating by one of the committee members and it said that "This should allow us the legal protection to exclude someone with a disability from studying medicine."

O’Brien: Must have that legal protection.

Palipana: Got to have the legal protection. Yeah, those lawyers, right. So that felt like a very, it felt like a knife to the heart, actually, because to, to be discriminated against for something that you cannot change about yourself it is a, it is a deeply hurtful thing.

O’Brien: In a very calculating way.

Palipana: In a very calculating way, yep. But fortunately, I had good people. And because of them I eventually graduated. But I encountered very different attitudes along the way. Today I work in the busiest emergency department in the country, and I work under people that have been incredibly accepting of me along the whole way. I remember meeting the very first emergency physician who bought me a cup of tea, met my mum and she asked me about my life and she said, "Great. We can't wait to have you and we'll make it work." And ever since then I've felt like a part of the family there. When I was struggling to get a job after I graduated, they -- in fact, there's someone in this very room, and some of them offered up their salaries to take money off the table so I could be employed. So, there were people that believed in that. And today I work full-time in that department. But then there were competing attitudes as well along the way. So, once, I came across -- I was going to rotate as a junior doctor to a department that was -- that is a specialty that is not very physical at all; so the doctors there work at a desk, and they use a computer for their work, but the leadership of that department gave me a call one day and they said, "Look, we just cannot have a person with a spinal cord injury in our department.  So, if you ever want to work here you either have to work for free or find your own money to do it." Then they said, "You cannot tell anyone that I told you this either." So here we are.

O’Brien: In other words, I didn't say it.

Palipana: Yeah. So, there were attitudes like that along the way.

O’Brien: Yeah. There was another, wasn't there, who essentially said also in a private call, "We can't have you taking a job from an able-bodied person"?

Palipana: Yeah. So, this is in my first or second year as a doctor. There was someone, a person who looked after all the junior doctors at the time. And one evening, about 6 or 7pm they gave me a call and they said, "I'm just driving but I thought I'd give you a call to discuss your future." And I said, "OK." That's a bit weird. I never really talk to you much, but... Then we had a chat and he said, "For your future it is unfair that you take a job away from someone who is able-bodied to do clinical medicine, so you should consider letting other people do that and doing something non-clinical, like research, or education, or something, but I think you should leave it to someone who doesn't have a disability." 

O’Brien: Does it jar, and I know that the terminology around disability is difficult because the term "Disabled" is a negative connotation, "dis", not "able". So, when somebody says, directly applies "able body", that is the opposite of you, does that jar?

Palipana: The word "disabled" is a very contentious word in the community. There's a part of the community that says, well, it is not a bad word, and you should be able to say "disability" without any issue and it should be a positive thing. And there are parts of the community that say you shouldn't. And there are parts of the community that use terms like "differently abled". For example, in Sri Lanka that's the preferred term, but then in Australia it is found to be offensive. So, there are different words. But, I guess, in the traditional sense of the word, do I feel disabled? Not really, because 11 years after the accident I'm sitting on a stage here talking to Kerry O'Brien.

O’Brien: That could be described as a disability.  (Laughs)

Palipana: Um, so I've never really felt any less abled, really. I mean, before the -- I feel like I've done more after the accident happened than I ever have before in my life.

O’Brien: So, when there is something that you physically cannot do, there must be some things in your practice in an emergency department that another doctor may be able to do that you have to find a way around, but I'm assuming that you do just find a way around.

O’Brien: Rectal exams are...

O’Brien: So, there are some things that it is an advantage not to have to do.

Palipana: Exactly. Well, the thing is we have hundreds of patients come through this emergency department.  And not all of them, and in fact many of them don't need any physical things done to them. I can use a stethoscope. I can examine someone's abdomen. I can see if someone's neurological system is working properly. So, there are plenty of patients for me to see. And, by and large, I'm independent. So, any patient who needs a procedure or something complex, there are other doctors that are willing to jump at the chance.

O’Brien: Are you a better doctor now for having experienced what it was like to be an extremely vulnerable patient?

Palipana: Definitely. I think back to when I was a medical student before the accident happened, and I think you get into this zone sometimes when you're a junior doctor where you are just going through the – it is about the paperwork, it is about the list of jobs that you have to do through the day and you get into the minutiae of the medicine and you become part of the machine, and it is easy to forget the patient, but I was the patient. And being the patient is incredibly scary. It is disempowering. It is -- I work in the emergency department today, but I will not go to a hospital unless I am dying. And that's interesting, isn't it. Like there's this place -- it is like a pilot saying I wouldn't want to be a passenger on a plane, but it is because I just have, I just remember what it was like. And I, I just hated it so much.

O’Brien: I think it is different, isn't it, than being a pilot as a passenger because as a patient you -- it was absolutely fundamentally important to you, on many levels I would imagine, just the straight clinical level, the fear of something going wrong, but then at the emotional level to be treated as a human, to be treated with compassion, to be treated with dignity.

Palipana: I didn't often feel that way. I mean, I was in -- for a period of time I was in a unit where I was sharing a room with three other people, and I think when illness sometimes happens it is a great equaliser because you get everyone from all walks of life thrown into this one situation. And it was hard because there were some people that were angry, throwing things around at night, threatening to kill me sometimes - (laughs) - and then through the morning you go do – for example, you go to the shower and there's human waste everywhere.  There was a lot that was undignified about that experience. And it just -- I just didn't want to be in that situation again. But the good thing that came out of it was I remember what it was like and I think of that experience when I see my own patients today. And a lot of the interactions that I've had that have been memorable, and I've read some things that people have written online after seeing me in the emergency department. You know, it is not the medical care itself, it is like the chat that we had, or it is the cup of tea that you can get them.  It is those simple things that make someone feel like a human-being, that makes them feel dignified and cared for, those are the powerful things that matter.

O’Brien: Hippocrates, he of the Hippocratic Oath, observed that wherever the art of medicine is loved there is also a love of humanity. Does it surprise you how often empathy can go missing in that relationship between doctor and patient?

Palipana: Absolutely. And I think that's, again, a part of the machinery that becomes medicine.  Because there's so much going on. And there's so much happening. And people -- it is easy to shift your mindset into the workings of a hospital rather than the patient, because a patient has to be the centre of everything that we do. But I think it is also part of reminding ourselves why we became doctors. For me, it was to do something for my fellow human, but there has to be a love of humanity in what we do because otherwise you just end up doing more damage than good, I think, and I can't agree with Hippocrates more.

O’Brien: Well, there are many strands these days to what you do, and one of them is you teach. Can you teach empathy? And I wonder when you look out at your students, and I won't ask you to comment, well, obviously you won't comment specifically, but when you see the students occupying those seats that you occupied as a student yourself, and you can see the ones who have the empathy naturally, the ones who feel that love of humanity and those that might struggle to be able to feel that or articulate that, you must wonder at times about the selection processes and how many students are delivered into medical schools who actually do have the requisite skills beyond just being good practitioners of medicine.

Palipana: Yeah. I think the -- we have to do that at the selection, right. I'm not sure, and we -- there's a lot of work that happens in medical schools to teach empathy, to teach communication, to teach how to connect with people, because that is so, so important. But I don't know how easy it is to teach that, and I don't know how easy it is to understand that --

O’Brien: If you don't have it innately, yep.

Palipana: Yep. And I think a large part of it comes to the selection process, and we have to look at why does someone want to be a doctor.

O’Brien: There's more to it than just being the brightest person in the room.

Palipana: Yeah, absolutely. And I think it is, it is important to have people that can connect with patients, that can understand. Medicine goes beyond, even beyond the human interactions that we have because we're a part of conversations, too. For example, right now there is a conversation about voluntary assisted dying, so the medical profession is a part of that conversation. If you don't have empathy for the people that are going through these processes, I wonder how much you can contribute meaningfully to those conversations. But I think it is about picking the right people at the start, understanding why they want to be a doctor and making sure that they have the right motivations.

O’Brien: When we put together all of the elements that helped you build a new future after the accident they're really quite considerable. You already had a law degree which gave you the confidence to advocate for yourself. You had an incredibly determined, capable and inspirational mother. You had demonstrated real ability and capacity at medical school before the accident and subsequently that helped give you access back into that career, and you passed your course with flying colours. You also found important support in the medical profession and in the media when a hospital job couldn't be found for you, and you had a strong desire to beat the odds. Now not everyone with serious disability can be expected to summon all those resources, can they, to meet those challenges in which case, what happens to them?

Palipana: And this is why I feel I have a responsibility to tell the story, to talk about it, to be a part of the things like the Disability Royal Commission, because the reality is there are so many people without voices, there are so many disparities in people with disabilities. There's a health disparity, education, employment, but all these things also mean that there's difficulty in accessing advocacy, difficulty in having a voice; for example, if people have difficulty with the NDIS, the NDIS commands the law firm Minter Ellison, one of the biggest law firms in the country, with innumerable resources, how is someone from a country town undergoing a significant disability, already marginalised, going to fight that machine? It is going to be difficult. So, there are a lot of people that don't have voices, but I think it is important for those that do have voices to tell the stories, to advocate for them. And I get emails all the time from people that are going through difficult times. And I always take the time to do something about it. But it is important to have allies as well. And I've had allies. They haven't had a disability themselves, but they saw the value in being an ally. And I think having allies for whatever we do matters. So, if you see something that's going on that's unjust, that seems immoral, then I think speak up and that's how we -- that's how we have a voice for the people that don't.

O’Brien: You are an example of a person whose life could so much have gone the other way, and the potential that you have now been fulfilling and will continue to fulfil is known and it is seen and it is there. You must wonder, we all should wonder how much untapped potential there is out there locked up in people with disability because of attitude.

Palipana: Absolutely. There's -- I've actually been telling anyone that, as an introduction to me, to introduce me as Australia's most handsome doctor, but no-one's done that yet, but that's the only untapped potential that I'm trying to getting into. But we've seen what people can do. Dylan Alcott just won the Golden Slam. The Paralympics have such a strong viewership. And we see people in the Paralympics doing amazing things. We see journalists like Nas Campanella. We see all sorts of people doing amazing things around this world. So, but we need to give people a chance, and that's -- if we break down everything, if we break it down from all the laws, all the treaties, everything that we have, we just need to enable people and we need to give them a chance, because I had a chance and that's why I'm here today chatting with you. If we just give people a chance, if we just think beyond the barriers that we in our heads, we can let people tap that potential 

O’Brien: It is interesting, isn't it, because those people you're talking about who have the barrier in their heads they see the barriers in front of you, not the barriers in front of them. In a sense, I mean your life has become a model that others might follow, and you mention Dylan Alcott, in the same way that we see sporting heroes like Dylan Alcott or Kurt Fearnley, and as you become ambassadors hopefully you're changing society attitudes and breaking down prejudice. But that strikes me as similar to the way that Indigenous sporting heroes over many decades like Lionel Rose, as a boxer, a world champion boxer, or a Cathy Freeman, or Nicky Winmar, or many others, were idolised, but that didn't necessarily reduce the racism or the prejudice. Maybe it has been like a slow drip. But in a way there has been an inference or implication that the people -- that you're special, you break the mould, because you've somehow risen above your disability or, in their case, they've broken out of those negative stereotypes. But the implication is that you're different, you're not the norm. And the norm is back there. There's a kind of two-edge sword in having the heroes as examples, isn't there?

Palipana: Yeah. And I think seeing some of these things though, the more and more we see it, the more and more it is normalised. And just storytelling is really powerful. For example, I was having a discussion with someone recently about intimacy and disability, and they were doing a lot of work around normalising the conversation of intimacy and disability. And I think having conversations, telling these things, and putting it in front of people's eyes, because a lot of it is the fear of the unknown and a lot of it is thinking, OK, they're different, but if we tell stories and if we put in front of people's eyes and if we make it a part of society, then it becomes normal. And I think that's what we need to keep doing. There have been a lot of medical students after me with various disabilities that have come. There's someone in -- who recently had a spinal cord injury actually, but the road for them is now paved, and so it should -- no-one should have an excuse not to give them a job or put them through medical school.  So, paving these roads is important I think.

O’Brien: But, of course different types of impairment are also viewed differently by some in society.  Some with people with disability might be more easily embraced than others. Those with intellectual disability for instance can be branded as stupid or even worse. Those pejorative terms.

Palipana: Yeah, and that's tragic. I think the way we do that is -- I think it is a reflection of us in society. And if we're thinking in that way, then it is time for us to take a deep look at ourselves. But you're right, that does happen, and I think that's a reflection on society.

O’Brien: You gave evidence to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People With Disability and they subsequently invited you to be one of their Senior Advisors. As a Senior Advisor to the Commission, what are some of the most serious concerns that you have personally expressed to the Commission? And I know the impact of the pandemic on people of disability is one thing, but what are the key messages that you want to see that Commission pursue?

Palipana: There are challenges in every aspect of life for people with disabilities; health, education, employment, access in the community, domestic violence, financial abuse. All these things are an issue. I think the most startling thing for me over the last year, which really highlights society's views around the world has been the pandemic and how people with disabilities have been treated or viewed during the pandemic. And one of the most difficult things for me to see was the value of life and how we stratify that value of life. One of the hidden things about a spinal cord injury is that my lung function is very different, it is about 35% of what's expected for someone of my characteristics. So, last year we started thinking about COVID, what if I were to get COVID. It would potentially be a catastrophic event. But we also started seeing reports from around the world about health care rationing affecting people with disabilities during COVID. And there was a flowchart that I came across from a very developed nation, and it was something like “complex decision-making during the pandemic for intensive care”. And the first question they asked is "Does this person have a disability?" And it outlined a few things like Parkinson's, autism, intellectual disability. And if the answer was "Yes", then it goes off into a different decision tree and you could refer them to palliative care or decline intensive care or ventilation. And there were reports coming out from all around the world that people were being sent home because it was better they die at home than in a hospital. So, this is one of the things we talked about over the last year --

O’Brien: Better that they die at that home for them, or better that they die at home to clear the hospital bed?

Palipana: Probably a bit of both, I imagine was the mindset. I actually had a discussion with one of my best friends, who is a doctor, who I have -- we've been friends for a long time, and they are a decision-maker for some of these pandemic-related things, and they've always been very frank with me about things and they said, "Look, the bottom line is we need to give ventilators for people who will survive and that might not be you, so...". Yeah, I think it was a very confronting thing, but it is a topic that we tackled. But I think it fundamentally shows how we value life and how we think about people. And I can't remember who said it, but there's a saying where it says, "A true reflection of society is how it treats its most vulnerable members."

O’Brien: Gandhi?

Palipana: Gandhi, yeah.  But it has been a test of our humanity over the last year.

O’Brien: How do you think we're scoring on that out of 10 at the moment?

Palipana: After growing up in the environment that I did, I feel incredibly lucky to be a part of this country. I think Australia has done a lot better than other parts of the world. I think conversations like we've had at the Disability Royal Commission have contributed to rapid responses and changes, and there have been a lot of work done to support people with disabilities through the pandemic. So, I think we've done better than most nations to be honest, and I think we're doing well so far.

O’Brien: The British philosopher, Jonathan Wolff, questions how a just and equal society should deal with disability. He asks whether society should seek to change the person or change the world.  How easy should it be to bring people with disability inside the tent rather than continue to treat them as second-class citizens, in the sense that Wolff is talking about, rather than put it on the person to change, to change the world around the person.

Palipana: To bring a person with disability inside the tent. You know, they say -- there's a Japanese saying that "My barn having burnt down, I can now see the moon", so maybe we should take the tent away and we can all see the sky. But it is about inclusion and acceptance.  I don't think it benefits the person themselves, it benefits the entire world.

O’Brien: I mean, it is a big challenge to actually think about what that means, when your cities and our towns have grown up in the way they have, over centuries in some cases. And buildings are old buildings and, you know, buildings might have small lifts and they might have no room to put a ramp, or whatever. But I can remember in one of the towns near where I live now there is a local guy, lovely guy, who also is quadriplegic and he also relies on a wheelchair for his access through the town. I was standing at the top of the street, and he was down the bottom of the street, and I was working my way down and I was going to talk to him when I got to him, but and he had disappeared. I was trying to work out where he'd gone.  And so, I was looking at all of the shopfronts as I walked down the street. I could tell just by mere glance whether he would be in any of the shops because most of them he couldn't get into.  So, there were two shops out of about 12 on that street where a person like him could actually access it. There's a great little local general store there where he would be able to get his wheelchair access into the store, but the lanes are so narrow that he'd have a great deal of trouble getting around. So, when you're talking about changing the world around the person, you're talking about physically changing a great deal, aren't you?

Palipana: Absolutely, but --

O’Brien: What's the dividend?

Palipana: I wonder if we're thinking about this the wrong way though. So going to the example about having narrow aisles in a shop. I wonder how much we pay in public liability insurance for people that slip and fall, or trip on things. What if the aisles were wider? You could have more people go through, it would be safer, and it would be more accessible not just for someone in a wheelchair but for everyone. So, I think we have to -- and it is the same with -- if you have a bigger elevator, you could fit more people in it. It might be more energy efficient.  So, accessibility helps everyone, it helps the elderly, it helps reduce injuries, it helps efficiency.  So, if we start to look at things in that way and start to see this universal design as something that benefits the whole of society, I think that shift in thinking makes us realise that it is an investment rather than a cost.

O’Brien: It would open up a whole new world, wouldn't it? It would create a different world.  It would create a more complete world for us all.

Palipana: Absolutely. And, look, the thing is, it could be any one of us that experiences these things. You know, the amount of people that we see in the emergency department. They wake up one morning and they go about their life and they have a stroke. Or we all get, we all age, we all get elderly, and our physical capacities change, so it could be anyone. And there's a large part of the Australian population that's affected by something like this. But also, if you don't have any of these things affecting you it still makes it accessible. So, I think just that thinking it changes the world in a better way.

O’Brien: I look at your story, Dinesh, and I see three areas where prejudice applies. I'd be surprised if you haven't at different points experienced racism. You've experienced what it is like to suffer a mental illness.  And you now spend your life in a wheelchair. I wonder if you've thought about the nature of prejudice, and what it represents, and how best to respond to prejudice, how do you deal with prejudice, how do you turn prejudice around?

Palipana:  Funnily enough, earlier this year I was at an event and someone said, "Jeez, you've had depression, you have a disability and you're a migrant. You tick so many boxes. You should be a shoo-in for awards." 

O’Brien: You missed out on the one about coming by boat.

Palipana: Yeah.

O’Brien:  You've arrived on a plane with a visa.

Palipana:  Oh.  But I actually -- being a migrant never entered my mind until that point --

O’Brien: Yeah.

Palipana: -- interestingly enough.  I have felt like a part of -- I've very much felt like a part of Australia. I think one of the advantages that I've had is that as soon as we moved to Australia we lived in Byron Bay, and it was a very little town. Everyone was very accepting. And I was able to -- you know, I just felt like home. So, I think that held me in good stead. And there are two ways in which I have dealt with prejudice: one is I've got very annoyed and agitated and I've just fought back. I mean some of these things you just have to fight back, right? But to get to that point it has been a graded approach. First, I try to talk to people and talk through if they're fearful about something, or if they feel that something might be a barrier. The first step is just to start a conversation. And often through having those conversations and through interacting people realise that, wait a sec, what I thought wasn't correct at all. One of the big things was – one of the most memorable things for me was when I was in my first year as a doctor. I rotated through a certain department, and there was a very senior, terrifying doctor, and I went through this term and at the end of it we sat down and had a chat. And they said that, when I first heard that you were coming to our department I had so many thoughts. I didn't think it would work. I was sceptical. And I just had all these different ideas. But today, after spending a couple of months with you, my thoughts about what medicine should look like, what a doctor needs to look like are different and I'm ashamed that I thought that way."  And that, that conversation really sticks in my mind. But it is an example, isn't it, because we all fear things in our heads, but if we face that and if we interact with that and if we talk to that then it doesn't become a fear at all. So, I think just really engaging and understanding is one of the big steps. But failing all that, I just get angry.

O’Brien: I want to spend the time that's left talking about the spinal cord research that you're now heavily involved in. What is the promise of that research? How real is the promise of that research?

Palipana: Well, we talked about hope earlier. And hope is everything. In everything that we do as humanity, we keep going because there is a hope for ourselves, for a better tomorrow, a hope for a better life, hope for a better world. And it is the same with spinal cord injury. The moment this happened I started looking around at all the different bits of research that was happening and thinking about will I stand up again, will I walk again? The very last thing I did standing up was to give my mum a hug. Hug the people we love. I think that's really important.  So, I gave my mum a hug and stepped into the car. And that was it. But I started looking at all these signs. And I think what we understand about the brain and spinal cord is so -- there's a whole world in there and there's so much we don't understand, but over the years there's been some incredible advances, some with stem cells, and the other interesting bit of science that came out was using electrical stimulation and also a thought control. Because if you think about rehabilitation, it is a very passive process today, but using thought control where we have a headset that can actually read my thoughts and --

O’Brien:  I do hope you control your thoughts.

Palipana: Exactly! I would be very embarrassed. But it essentially, I have to think about walking or have to think about moving my legs. And we have equipment that zaps my legs into action. So that's a very active process of rehabilitation. And we use some drug therapy. Not the type from Byron Bay, but other therapeutic stuff. And some of the science around the world has shown and it has been amazing actually. For the first time in human history, we've seen people start to move again that have been paralysed for years. So, this is what we're doing. And it is really exciting. I am the guinea pig. And I hope to one day -- maybe I'll stand on this stage and have another chat with you. That's the hope.

O’Brien: And how strongly do you feel, how strongly are you invested in the hope, in the sense that behind the hope that there is a possibility, that you do actually see a possibility?

Palipana: It is the big, big dream. It is the big dream. In my first year of medical school, I went to a lecture by Graham Clark, who was the inventor of the cochlear implant, and he talked about his journey. He was a surgeon that had a practice and a family, but he made a lot of sacrifices early on because he believed and he wanted people to hear again. So he gave up financial security and there was a period of time somewhere along that journey where he was collecting money with a tin on the street, I think some people were, and the technology wasn't there, and it was, you know, it was decades ago, but he kept persisting and he kept this dream alive and he kept at it, and today people can enjoy the cochlear implant and hear again. So, I think we have to dream big and we have to persist and we have to keep going. There are so many dreamers around the world. We've had people like Bill Gates and Elon Musk. All these people who have changed how society is. So, I have a big dream too, and I am confident.

O’Brien: Of course, research is a mixed story in Australia, too. Medical research, I've had some insight to medical research and the extent to which those people with those dreams have to go so often ‘cap in hand’, and how the researchers working in so many parts of the medical science field are working from 3 month to 3 month not knowing whether they're going to be able to finish their project because the money might run out. That is such a depressing story when you hear it and when you see it in a country that has such wealth.

Palipana: Yeah, I have three thoughts about that: with our own research I've been lucky enough to have a team that are very passionate. There have been friends. They are so invested in this work. And we do it, we have fun. There's a love for it, why we do it, and that makes a difference. So, that helps us overcome some of these barriers that we face.  Secondly, I think there's an attitude that Australia can't. When I first started talking to a very prominent doctor about this research he said, "We just can't do that in this country. We need to look to the US or UK." And I was really dejected. I remember that conversation and I thought --

O’Brien: This country as produced amazing things across so many fields. 

Palipana: Exactly.  But we need to start believing that and we need to know that we are capable, we're well-resourced, we're an economic powerhouse. We have so much science and capability in this nation to do everything. We can change the world. So, we need to start believing that. And thirdly, we need to look at new economies. And this is what research is about. If we start creating these technologies in our home, it provides an economic future as well. And I think these are the reflections that I have on research, but we, we have the capability to do that.

O’Brien: Dinesh, this has been a wonderful conversation.  Thank you very much.

Palipana: Thanks for having me. 

Ned Pankurst, Home of the Arts Board Chair

I'm Ned Pankhurst, I'm the HOTA Board Chair, and it is my pleasure and privilege to thank everyone for joining us here tonight. On behalf of HOTA, Home of the Arts and Griffith University, I would like to express my thanks both to Kerry and Dinesh. I think we expected that Dinesh's story would be one of courage, optimism, determination and achievement. And we weren't disappointed. But I think the thing that impresses me, on the occasions where I've had the privilege to meet Dinesh, is his essential warmth and the generosity of spirit with which he expresses those sentiments. That was on display tonight. And it is expressed in all the things that he does for other people. Dinesh, it has been a privilege to listen to the conversation. And to Kerry, thank you again for your skill, intellect and humanity that you bring to these events. We're absolutely delighted to have been able to share this with you tonight. So, please join me again in thanking Dinesh and Kerry.

And you don't get out without the advertisement. We're delighted to partner with Griffith University to present series of events with the country's brightest minds and influential thinkers. Tonight, I'm happy to announce the next event in our A Better Future for All Series.  Our next chapter takes place on Tuesday, 12th October with Kerry in conversation with actress and director, Rachel Griffiths AM. You'll be able to find information on Griffith's website, or at hota.com.au. So, thank you again for joining us and we look forward to seeing you next time. 

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