OBITUARY

Associate Professor Andrew Dent, AM

Andrew Dent, the former director of the St. Vincent’sHospital, Melbourne ED, died on 10 June 2008 at the ageof 53 years. His life and career spanned many experi-ences in different countries, and he encountered a greatnumber of people who came to respect, admire and lovehim. Andrew died as he lived his life, totally selfless,dedicated to his work and completely supported byhis family. He was a great man who helped shapeemergency medicine (EM) and medical education bothin Australia and beyond through clinical example,research and inspirational advocacy.

A Melbourne graduate; Andrew began his career asa general surgeon in the UK where he undertook hisspecialist training. From there, he spent 2 years livingand working at the Shisong Catholic Mission Hospital

in the Cameroon, West Africa. After spending sometime at home in Melbourne and developing a new careerpathway in EM at the Austin Hospital, Andrew took hisyoung family to East New Britain Province in PapuaNew Guinea (PNG), where he worked at the St. Mary’sCatholic Mission Hospital in Vunapope. His skills asboth an emergency physician and surgeon were essen-tial when the Rabaul volcano erupted in 1994, sendingthe region into chaos and subsequently renderingthe hospital and local areas uninhabitable. Andrewcommenced at St. Vincent’s Hospital in 1995 where hequickly took up a leadership role as the director ofthe ED. With strengths in medical education, academicresearch and great personal charisma and integrity,Andrew established a cohesive and highly functionaldepartment during his 12 years of leadership. He wasforced to step down from this role in June 2007 with thesudden and devastating diagnosis of colon cancer. Trueto his great strength of will and character, Andrewcontinued to teach and work at St. Vincent’s throughouthis illness and treatment, and often during times ofimmense pain and frailty. He managed to maintain hispresence at St. Vincent’s until a new ED director hadcommenced, not long before his death.

Andrew achieved a great number of awards andqualifications, although these were largely unheraldedduring his life, mainly through his own preference.Apart from his Fellowships in Surgery and EmergencyMedicine, Andrew was also a Fellow of the AustralasianCollege of Tropical Medicine and completed a Mastersin Public Health in the International Health stream in2002. He was an enthusiastic researcher who publishedand presented papers exploring the themes of interna-tional medicine, medical education and the many issuesfacing vulnerable people who attend the ED. Althoughhe published papers early in his career based on hisexperience in Africa and PNG, Andrew was in his mostprolific research period around the time of his diagnosis.His research on the educational needs of junior doctorsas well as specialist emergency physicians has been ofgreat import in shaping curriculum and educational

doi: 10.1111/j.1742-6723.2008.01125.xEmergency Medicine Australasia (2008) 20, 444–446

© 2008 The AuthorJournal compilation © 2008 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine

opportunities for these groups. Similarly, his researchon drug and alcohol issues, frequent ED attenders andhomeless patients in the ED has kept alive the psy-chosocial aspects of EM and challenged conventionalthinking about the role of ED in engaging with theseissues. Andrew was awarded the Australasian Collegefor Emergency Medicine teaching excellence award in2004, and made a member of the Order of the Interna-tional Federation of Emergency Medicine at the Inter-national EM Conference in San Francisco, USA in Aprilthis year. Most recently, the day before he died, Andrewwas made a member of the Order of Australia forservice to EM as an academic, researcher and educator.

Andrew has been a driving force in the development ofEM both at St. Vincent’s and the wider medical commu-nity. Within his own ED, Andrew oversaw numerousphysical expansions and improvements, pioneered the‘EMU – emergency medical unit’ in response to increas-ing demand and access block in the early 2000s,introduced novel paperless IT systems for medical andadministrative documentation and trained, recruited andprofessionally developed a cohort of dedicated and loyalemergency physicians and trainees. Andrew enshrinedthe role of EM research by creating and staffing theEmergency Practice Innovation Centre, which has con-sistently produced research of high clinical and academicimport, and attracted stand-alone project funding sinceits inception. He was an open-minded recruiter of staff,with a special interest in people who had experienced lifeand work in developing countries, and those who werefrom other nations, exemplified by his nurturing of EMtrainees from Iran. Because of his unequivocal focus onpatients and their well-being, Andrew broke down hier-archies within his workplace, such that any member ofstaff had equal and valid contributions to make, and allfelt valued and flourished as team members. Andrewwas a true visionary with a powerful social conscience,and he moulded the St. Vincent’s ED so that it epitomizedthe values it espoused: justice, unity, excellence, humandignity and compassion.

While leading in EM, Andrew maintained a widerfocus on medical education and the needs of doctors at alllevels of training and experience. He was the Director ofIntern Training at St. Vincent’s and, as a result, becamea mentor for junior doctors in the hospital. More formally,Andrew was a member of the Postgraduate MedicalCouncil of Victoria, where his contribution to theeducation of junior medical staff was greatly valued, andhelped develop the undergraduate EM curriculum andassessment for the University of Melbourne. He regu-larly gave up his weekends to travel to rural Victoria for

the training of general practitioners, and was an admiredfacilitator and great leader within the Early Managementof Severe Trauma courses. Andrew pioneered simulationas an educational tool, using his staff for role play, wellbefore technology helped develop this practice. Since thearrival of high-fidelity simulation, Andrew was integralin using it for training of medical staff at all levels,especially within EM, and was a foundation for thedevelopment of the Education Centre at St. Vincent’s.One of his greatest and lasting legacies has been thedevelopment of the Advanced and Complex MedicalEmergencies course for the professional development ofFellows of the Australasian College for Emergency Medi-cine, and the comprehensive learning needs analysis thatshaped it. Andrew was the inspiration and driving forcefor this novel and exciting course, developed with enor-mous commitment and skill for the benefit of his EMcolleagues throughout Australasia.

Andrew’s vision of care and compassion was notconfined to St. Vincent’s nor Victoria, but rather encom-passed the world and in particular the Pacific region. Hemaintained his links with PNG and gave a medical andsocial conscience to a multinational oil company as itsmedical director. Through his advocacy and because ofthe enormous esteem in which he was held, Andrewestablished preventative health programmes in HIV/AIDS and malaria reaching small communities through-out the Southern Highlands and Gulf Provinces in PNG,in addition to the resourcing, training, staffing andsupport provided to community health clinics in thoseregions. His support for this service included personal24-h on-call availability. Andrew’s desire was to buildcapacity in PNG, and so his emphasis was on trainingand mentoring local medical and nursing staff. Heassisted in the development of the specialist EM train-ing programme at the University of Port Moresby, andexamined the first PNG emergency physician under thisprogramme. Andrew delivered several Early Manage-ment of Severe Trauma courses in PNG and facilitatedand hosted clinical placements for doctors and nursesfrom the Pacific region at St. Vincent’s Hospital. Impor-tantly, he fostered enthusiasm among his St. Vincent’scolleagues, and empowered them to share his Pacificinvolvement and expand their networks in the region.Andrew travelled to PNG regularly and had a great lovefor the country and people, which was reciprocated bythe many people he met and inspired. The year after hisdiagnosis was used to enshrine Andrew’s lasting legacyfor the benefit of building support and medical capacityin the Pacific region with the establishment of the St.Vincent’s Pacific Health Fund.

Obituary

445© 2008 The AuthorJournal compilation © 2008 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine

It is difficult to paint a picture of Andrew withoutresorting to a long list of his achievements and activities.These things, however, do give us a glimpse of hisamazing capacity and enthusiasm for work, his visionand priorities, and finally a small window into the per-sonal qualities that made him so admired and loved.Fundamentally, Andrew was a good and gentle soul,who truly and unambiguously subordinated his ownneeds to those of others. This made him a man of greatintegrity, who believed in values of compassion andjustice, and lived, worked and breathed these values. Allhis colleagues and those who encountered him recog-nized and admired this quality and those lucky enough toget to know Andrew developed a deep respect, love andloyalty for him. He could be frustrating at times, model-ling a work ethic that others could not follow, but hisleadership was enabling and inspiring. People workedhard for Andrew not out of a sense of obligation or duty,but rather because he inspired them to a new height andbelieved that they had the capacity to get there.

The theme of selfless service pervaded Andrew’sfuneral, where hundreds of people representing family,medical, corporate and social services attended. Thedignity and respect with which so many people stood tohonour Andrew was a powerful testimony to his life.His untimely death at the peak of his career is a greattragedy and, for his wife, two sons and those very closeto him, utterly devastating. It is nearly impossible tofind meaning and hope within such a great loss, exceptto say that the living example of Andrew Dent gives usa vision of what a person can be and do, and inspires usto follow his example.Vale Andrew Dent.Requiescat in Pace.

Georgina Phillips

Emergency Physician

St. Vincent’s Hospital, Melbourne, Victoria, Australia

G Phillips

446 © 2008 The AuthorJournal compilation © 2008 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine