Olivia Podmore coronial inquiry: Olympian’s episodes of heart arrhythmia were an alarming sign of ‘distress’

• A coronial inquest has begun at the Hamilton District Court into the death of Olympic cyclist Olivia Podmore in a suspected suicide on August 9, 2021, one day after the Tokyo Olympics ended.
• The Herald revealed a litany of misconduct at Cycling NZ relating to Podmore, including pressure on her to lie during a 2018 investigation into impropriety at the sporting body.
• A damning 2022 report by Mike Heron, KC, found a number of cultural and structural deficiencies at Cycling NZ.

WARNING: This story deals with suicide

A forensic psychiatrist has highlighted 10 separate episodes of heart arrhythmia Olivia Podmore experienced in the last 18 months of her life as evidence of an alarming level of stress the athlete was dealing with.

The episodes were often bad enough to send the cyclist to a hospital emergency department and, given they did not appear to be related to cardiac disease, reflected “quite a bit of distress happening”.

Podmore died in a suspected suicide the day after the Tokyo Olympics ended, August 9, 2021, after the track cyclist failed to qualify for that event following a Covid-19-interrupted selection process complicated by several controversies.

Dr Erik Monasterio appeared yesterday and today in the coronial inquest into Podmore’s death in the Hamilton District Court to provide independent expert evidence on the Rio Olmypian’s interaction with medical specialists via High Performance Sports NZ (HPSNZ) and Cycling NZ (CNZ).

While Monasterio admitted, “You have to be very careful … you don’t look back and say people should have known better” after a suicide, he was critical of the lack of action from health professionals treating Podmore in the 18 months before her death.

Monasterio reflected on the identification of severe to very severe symptoms of depression, anxiety and stress in Podmore via structured psychological screening tools, called the DASS-21, in February 2020.

“No specific steps appear to have been taken to better understand the nature and impact of those symptoms, or to provide specific intervention,” the psychiatrist said.

“This seems to be out of keeping with the HPSNZ mental health strategy extant at the time. In my opinion, the lack of response is inadequate, as this clearly identified a significant level of distress. This occurred close to the time that Olympic selections occurred, and with Olivia advised that she would not be included in the Tokyo Olympic Games team.”

Monasterio also commented on clear signs of distress in Podmore’s repeated episodes of heart arrhythmia in the 18 months before her death aged 24.

“It was recognised that symptoms of anxiety and/or side-effect from treatment with paroxetine [an antidepressant] led Olivia to experience cardiac arrythmias and chest pain,” he said.

“This occurred while she experienced prominent symptoms of depression, anxiety and suicide preoccupations. The complex interplay between the side-effect to medications, physiological and psychological symptoms of psychiatric disturbance and uncertainty around risk issues, may have been better elucidated by referral to a psychiatrist.”

Dr Erik Monasterio appeared yesterday and today in the Hamilton District Court for the coronial inquest into Olivia Podmore’s death. Photo / Mike Scott

Monasterio also today disputed some of the observations from a health professional treating Podmore during her time at CNZ who said Podmore was “functioning well day-to-day” in the last year of her life and “was flying”.

The psychiatrist said that such outward signs, especially among performance athletes who often “possess considerable mental resilience”, were not necessarily good indicators of suicidal risk.

Monasterio observed people can be high functioning and suicidal, and a clinical risk assessment is needed above observations of daily demeanour.

He also highlighted the period of the Tokyo Olympics as a particularly vulnerable time.

“The available documentation indicates that Olivia reported she had been unfairly excluded,” he said.

“In my opinion, the combination of these factors is likely to have significantly contributed to the later emergence and persistence of the symptoms of depression, anxiety and suicidal preoccupations (which were consistently identified from January and particularly April 2021). It is not clear, from the available information, what steps were taken to explain and support Olivia for exclusion from the Olympic team.”

Monasterio was also asked to reread Podmore’s final social media post hours before her death where she referenced a “cover-up” at Cycling NZ and a teenage abortion to “keep her Olympic dream alive”.

“It doesn’t take a specialist psychiatrist to see the stress that she is dealing with. But she only made this known after she passed away,” he said.

“It only comes to light after she passed away. Had she shared that in a way that people really understood the conflict, maybe the outcome would have been different.”

Monasterio said Podmore “just felt so disempowered” managing the stress created by the high performance system.

“She had made that very clear, I have been excluded here … significant efforts were made to help Olivia … but the central understanding of what was happening was missing.”

Olympian requested health chats about teen abortion

In the months before she died, Olivia Podmore scheduled two conversations with a health practitioner to specifically discuss her “teenage years” and an abortion she had.

The health practitioner was treating Podmore for many years during her time at Cycling NZ and has given evidence this week in the coronial inquest.

He also revealed he took no notes in his treatment of Podmore during her time in the Cycling NZ system, admitting he has “no excuse” for the lapse and saying “I should be better than that”.

The health practitioner was on the witness stand all of yesterday and touched on many aspects of his treatment of Podmore after she entered the high-performance sports system in 2014 straight out of Middleton Grange – a Christian school in Christchurch.

In his witness brief, the health practitioner gave an account of all his dealings with Podmore and provided details on one of his final interactions with the 24-year-old. He recalled the events by old invoices and his electronic calendar due to the lack of notes.

“In May 2021 … Olivia asked to speak with me about her teenage experiences, specifically about her terminating a pregnancy, to make sure she was using the performance mindset … established in our work to help her keep the right perspective about those years. I spoke with her twice on the phone,” he said.

The health practitioner said the key to these conversations was Podmore “having a non-judgmental regard for herself”.

“We talked about her viewing the decision she made as a teenager in the context of her cycling dream and taking pride in her ability to make such a big decision at such a young age,” he said.

“Olivia was also proud about how she had progressed from that time, and felt that she had done everything possible to be first selected for the Rio Olympics, and then the Tokyo Olympics.

“She felt integrity for following her decision, and that she had actually succeeded. Olivia was very calm, coherent and mature in these calls, despite the grief associated with her decision in retrospect. Olivia wanted to have her own family and this motivation was enhancing her regret that she also felt when looking back on those years.”

Olivia Podmore's mum, Nienke Middleton (left), and stepdad Chris Middleton at the inquest in Hamilton. Photo / Pool

Earlier this week during the inquest, the health practitioner treating Podmore forcefully denied claims he shared confidential medical information within an “old boys’” network of Cycling NZ coaches and support staff at an inquest into the death of the elite cyclist.

The practitioner said he considered there to be “no grey areas” when it comes to sharing an athlete’s medical information.

‘There is no dispute’

At the outset of the coronial inquest, set to run for three weeks, Coroner Louella Dunn said “there is no dispute” Podmore died by suicide.

“The focus of this inquest will be the mental health challenges Olivia faced and the care she received.”

Dunn said the issues the inquest was attempting to answer were:

• What were the circumstances of Podmore’s death?
• What did High Performance Sport NZ and CNZ know of Podmore’s challenges before her death and did they have sufficient knowledge to help her?
• What steps did they take and were they appropriate to address the health challenges?
• If another athlete had the same mental health issues today as Podmore experienced, would the response from HPSNZ and CNZ be different?

Olivia Podmore's brother Mitchell Podmore (front) and their father Phil at the inquest. Photo / Pool

Cyclist Olivia Podmore (inset), her mother Nienke Middleton (left) and Nienke's husband Chris Middleton (right) in Hagley Park. Photo / Joe Allison

Three-year wait for answers

In formal terms, coroners conduct inquests to determine the cause and circumstances of death and identify ways to prevent similar deaths in the future.

About 30 witnesses will appear at the inquest, including Podmore’s mother, Nienke Middleton, and her husband Chris Middleton, who will represent themselves without legal counsel.

“I’ve got to be the lawyer, by default,” Chris Middleton said. “It was probably going to be another $150,000, so we made the fairly simple choice that we’ll do it ourselves.”

The Middletons have already undertaken an extended legal battle to obtain Podmore’s medical records from HPSNZ, costing them tens of thousands of dollars.

More than 1000 medical documents were suppressed before the coronial inquiry, the Middletons say.

Chris said the documents, which they finally obtained in late 2022, made for disturbing reading.

“There’s been an awful lot of noise coming out of [HPSNZ]. They’ve just fought absolutely everything pre-inquest, everything suppressed ... God, it’s just been relentless,” he said.

“There’ll be a lot of nervous people there I would think.”

Nienke said: “We’ve basically had to kick and scream for everything”.

Olivia Podmore (left) with her mother, Nienke Middleton.

There are several non-publication orders for the names of health professionals who worked within the HPSNZ system, as well as a CNZ staff member.

HPSNZ, CNZ and several other witnesses sought non-publication orders through King’s Counsel. In all, there will be four KCs at the inquest – something that riles Chris Middleton given the legal expenses the family have endured over several years.

Other notable witnesses at the inquest include friend and two-time Olympic gold medallist Eric Murray, and close friend Andrew McLean, who was Podmore’s housemate at the time of her death, sharing a residence on the outskirts of Cambridge where she died.

Murray and McLean were with Podmore the weekend before she died, skiing in Queenstown.

Among the coaches speaking at the coronial inquiry will be former CNZ lead track sprint coach Rene Wolff and CNZ high-performance director Martin Barras, as well as the chief executive at the time, Jacques Landry.

All three men resigned from their roles in the six months following Podmore’s death.

Sport NZ chief executive Raelene Castle will also appear as a witness.

“We would like to extend our sympathies to the family and friends of Olivia Podmore. HPSNZ appreciates that the coronial inquest will be a very difficult time for them,” Castle said in a statement.

“It may also be a difficult time for those who worked closely with Olivia within the high-performance system and HPSNZ will be providing support if and when needed.

“Athlete wellbeing is one of the three key focuses of the HPSNZ strategy, and a lot of new initiatives, updated policies and compulsory training have been introduced across the high-performance system over the last four years.

“We are all continuously learning, and the coronial inquiry will be an important next step in the process, as we work to ensure that high-performance sport is a place where all athletes can thrive and succeed.”

Raelene Castle (left), head of High Performance Sport NZ, and Jacques Landry, former chief executive of Cycling New Zealand. Photo / Mike Scott

In her final social media post, hours before she died, Podmore referenced a “cover-up” at CNZ.

In the week after her death, the Herald revealed that Podmore was an athlete cited in the 2018 Heron review who had been pressured to lie by CNZ.

At the end of 2018, Podmore was paid a $20,000-plus sporting grant for welfare reasons that several involved with CNZ and close to her described as questionable.

The Herald has also reported on the personal challenges Podmore faced in the last year of her life after she was told in August 2020 that she would not be selected for the Tokyo Olympics. Podmore was using drugs recreationally during this time, and receiving psychological help.

Many fellow CNZ athletes felt Podmore was unfairly treated during selection for those Olympics. A legal dispute around selection lodged by another CNZ athlete close to Podmore complicated matters further.

Many CNZ athletes the Herald spoke to in 2021 were highly critical of the methods and culture created by Barras, who oversaw the decision to not select Podmore for the Tokyo Games.

Tom Dillane is an Auckland-based journalist covering local government and crime as well as sports investigations. He joined the Herald in 2018 and is deputy head of news.

SUICIDE AND DEPRESSION

Where to get help:
• Lifeline: Call 0800 543 354 or text 4357 (HELP) (available 24/7)
• Suicide Crisis Helpline: Call 0508 828 865 (0508 TAUTOKO) (available 24/7)
• Youth services: (06) 3555 906
• Youthline: Call 0800 376 633 or text 234
• What's Up: Call 0800 942 8787 (11am to 11pm) or webchat (11am to 10.30pm)
• Depression helpline: Call 0800 111 757 or text 4202 (available 24/7)
• Helpline: Need to talk? Call or text 1737
If it is an emergency and you feel like you or someone else is at risk, call 111

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