It’s a split-second decision that no-one should ever have to make. With an attacker kneeling over his chest, pinning him to the floor, Dr Michael Wong had to instantly process a terrifying image before him. A crazed man was lifting his arm high above his shoulder, preparing to plunge a knife into the renowned neurosurgeon again, and he was powerless to stop it.
In a moment of extraordinary clarity, amid sheer chaos, the doctor turned his head to the side just as the 19-centimetre steel blade was thrust down, missing his eye by millimetres.
The moment still haunts him. “I remember thinking, ‘I don’t want a brain injury’ so I moved my head so he wouldn’t be able to stab me through the eye socket – instead the blow landed on my skull,” Dr Wong recalls. In a few frenzied minutes in the corridors of Melbourne’s Footscray Hospital, Dr Wong was stabbed 14 times. He lost his body’s entire supply of blood. His wounds were so deep, onlookers believe they could actually see his lungs.
“It is a miracle I’m alive,” he says, the fine translucent scars that crisscross his hands visible as he sips a cup of tea at his Melbourne home. “If I’d been walking to my car or outside the hospital somewhere else, I would’ve died, without doubt.”
Others haven’t been so fortunate. Tragically, Dr Patrick Pritzwald- Stegmann died after being punched outside Melbourne’s Box Hill Hospital in May 2017, part of a wave of rising violence against healthcare workers.
“I consider myself very lucky,” Dr Wong says, “and I now see this as a positive experience. The learnings are so important, you only have one life. I was working very long hours, always on call and hardly ever spent time with my family. I’ve re-prioritised my life and I have a far greater appreciation of what a patient goes through – an empathy and a human understanding that I may not have had before. I see things through a patient’s eyes now. You have to make sense of difficulties, then move on.”
It was just after 8am on the morning of February 18, 2014, and Dr Michael Wong arrived at the hospital to begin a long day of treating patients with complex brain and spinal issues. As he walked into the hospital foyer, coffee cup in one hand, mobile phone in the other, he dialled the number of his registrar to check if he was going straight to clinic or seeing patients on the wards first.
But just as he pressed the call button he felt a hard shove from behind. He assumed he’d been accidentally knocked in the public hospital’s busy entrance, but when his foot slipped on blood he realised this was far more sinister.
He’d been stabbed, and his attacker was one of his own patients, an Iranian refugee who’d been diagnosed as paranoid schizophrenic.
Over and over again Kareem Al-Salami stabbed the surgeon in the back, face, chest, hands, forearms, torso, stomach and legs until onlookers including a nurse, a leukaemia patient and a hospital intern risked their own lives to intervene. They saved Dr Wong’s life by distracting the attacker then, using the thick pool of the doctor’s own blood, sliding him into the emergency department where trauma medics began to try and save his life. He required six litres of blood transfusions before being placed in an induced coma. Surgeons worked for hours, stitching their colleague back together. A cardiothoracic team removed part of his lung to stem the bleeding, while three plastic surgeons mended severed tendons and muscles in his arms and hands.
“I didn’t realise I was stabbed at first, it just felt like someone pushed me really hard. “I thought it was kids mucking around, then I sort of blanked out and woke with him over me and I realised what was happening,” Dr Wong recalls. “He stabbed me at the back of my chest and it severed an artery in my lung. I was aware of being breathless but didn’t know he had punctured my lung.
“I woke up in intensive care. It was 2am and I was alone. I knew where I was and that something had happened, but from the time I went into theatre, it faded out. When I woke, my biggest fear was that I may have had a stroke, so I moved one side of my body and then the other. Both sides worked. I knew then that everything would be okay.”
It had taken Dr Wong 16 years of intense study to become a neurosurgeon and spinal specialist, but the fine hands that had performed thousands of complex brain and spinal operations, and saved many lives, had suffered horrific injuries.
In that moment alone in in the middle of the night, he vowed he would make a full recovery, but it was a long road. With his hands and arms plastered to the elbow, he could not eat, dress, pick anything up, shower or even go to the toilet without help. His wife Christine and children Charles, then 11, and Charlotte, seven, came to the rescue.
“Poor Charles had to help me go to the toilet; that was very humbling,” Dr Wong recalls. “They all helped me to do everything. I was like Edward Scissorhands!” he jokes. “I gained a whole new appreciation for my family while I was at home.”
When the plaster casts were removed, the doctor’s hands were curled up so tight he couldn’t open them, and few of the medical team supporting him thought he would ever operate again, but he was determined. He began intense and painful hand therapy as soon as he could to stretch his skin and regain muscle movement.
“During the initial phase I thought I might not ever work again, I thought I might not be able to use my hands and that was very scary. If I couldn’t use my hands, I couldn’t work. The hand therapist looked at me and didn’t say too much. I don’t think she gave me much chance of going back to work. But I had an advantage: I knew the human body well and I know its healing capabilities, so I pushed myself hard and I wasn’t afraid of a bit of pain – I knew it would be good for me,” he says, joyfully wriggling his fingers and flexing his hands to show how far he’s come.
Every day for weeks, Dr Wong massaged his hands and, using squeezy balls stashed in every corner of the house and even the console of the car, he exercised his hands until he regained full use. He also worked on his overall physical recovery. “I did exercise like I’ve never done before,” he says. “I pushed and pushed myself. I reasoned, ‘I am a surgeon, the body is a machine’.”
Three months after the attack, Dr Wong walked back into his practice and, greeted by hundreds of cards, boxes of flowers and gifts from long- time patients, went back to work. It would be perfectly understandable if he never spoke another word of the terrifying ordeal, but the 2017 death of cardiothoracic surgeon Dr Pritzwald-Stegmann prompted the softly-spoken surgeon to find his voice.
“I didn’t want what happened to me to happen to another person, but it did happen again and a wonderful man lost his life,” he says. “Who will be next? Violence in our hospitals is growing and we have to do something about it. Patrick’s death really rocked me. I was very lucky, Patrick was not. His death was just so awful and so unnecessary.”
According to WorkSafe Victoria, 95 per cent of healthcare workers have experienced some sort of verbal or physical assault while at work. In 2015-16, Victorian hospitals reported 8627 violent incidents, staggering figures that are replicated around the country. In 2017, a nurse from Wyong Hospital on the Central Coast of NSW was held hostage by a knife- wielding patient, an attack that was mirrored at the Royal Melbourne Hospital days later, and an audit of Queensland hospitals documented a terrifying cache of weapons such as knives and knuckle-dusters that had been smuggled into health services.
“Our hospitals should be the safest place to be, but they are not,” adds Dr Wong. “We can’t just cry and move on, we must do something about this.”
Christine Wong, herself a consultant physician, says the attack on her husband brought a new focus to the couple professionally and personally. They don’t sweat the small stuff and family time is a priority. She says that despite their initial fears, the attack has had a positive impact on their lives: “Michael is home a lot more – which is wonderful. I’d been worried for some time that he was working too hard – he worked seven days a week and was on call 24/7. When the hospital rang me that morning and told me to come straight away, I thought Michael had collapsed or had a heart attack, and that wouldn’t have surprised me. This has forced him to slow down, and we now look for the positives in every single day which is a good thing.”
She and her husband have both forgiven his attacker: “The man who attacked Michael came to Australia by boat; he had no community around him, no support services and he couldn’t speak English. He was frustrated and felt very isolated. His contact with Michael was one of the few ‘social’ interactions he had with the community.”
Learning from his own experience, since the attack, Dr Wong, now 47, has made a conscious decision to take on fewer patients but to spend more time with them, focusing on a wide, holistic approach to their care, giving his patients “the gift of time”.
“Our practice has changed a lot,” he says. “The system dictates that you see as many people as you possibly can, cookie-cutter medicine. I refuse to do that now. We give extra time to our patients and our emphasis is on how we can help them overall, not just patching them up and getting them out the door as quickly as we can.”
Dr Wong hasn’t walked back through the doors of Footscray Hospital, where the attack took place, since that day. That chapter of his life is now closed. But he insists, overall, his life has changed for the good: “You only have one life to live, you must make the most of it. Every day is a miracle and I now focus on how I can make every day better.”
FORGIVE AND SUPPORT
In 2016 the Victorian Supreme Court found Kareem Al- Salami not guilty of attempted murder due to mental impairment. He was ordered to spend up to 25 years in a secure forensic mental health facility.
Dr Wong and his physician wife are campaigning for greater mental health funding and support for refugees. “We are both immigrants to this country, so we are well aware of the struggles of a foreign culture coming to Australia,” he says. “This country is incredibly generous, but we need to help people settle into the community, to support people who are isolated and help them get the best start so they can make a valuable contribution.”