Raw wounds out in open for all to take notice

By FRANCESCA MOLD and FIONA BARBER

GISBORNE - About 20 paces separated the women of Gisborne in the public gallery from the place where they told their stories this week.

In the long walk up the aisle, they passed seven rows of lawyers, bureaucrats, health advocates and media.

At the end were cameras and the high-powered panel charged with investigating their plights.

For some of the women, the journey up the office-issue blue carpet seemed endless, the trip back to family and supporters so much easier.

It was the same walk Dr Michael Bottrill made to tender his apologies and offer sympathy - to those same women - later in the week.

The path ran through an anonymous, sectioned-off room on the first floor of the Quay Pt building - home to the Gisborne cervical cancer inquiry.

It is a place where spilled emotions have reduced the public to tears and dense official evidence has occasionally sent them into a slumber.

The evidence began with those at the heart of the inquiry - the women - and their graphic renditions of a battle with their own health and a system that may have let them down.

Some have developed invasive cancer and endured "barbaric" treatments to kill the disease that they say robbed them of their womanhood.

Others had urgent operations to remove high-grade abnormalities that if left could have developed into cancer.

The women spoke bluntly about their symptoms, the treatment and their feelings about the man who misread their slides.

Their evidence has raised wider issues about treatment from other doctors and the health system in general.

One 26-year-old woman, whose name is suppressed, revealed that she was never told to have a repeat smear, when an earlier test showed results "outside normal limits."

She wept as she told how she asked a Gisborne doctor what it meant to have precancerous cells in her cervix. The doctor gave her a pamphlet and told her to speak to a specialist in Hamilton.

In response to questions, the woman said she believed she was "pushed out the door" possibly because she was Maori and young.

She wants to know why.

After the women's evidence, the Ministry of Health began its case with Dr Bob Boyd, a senior figure in the Department of Health when the national cervical screening programme was being developed.

Dr Boyd said that in each case, somebody had let the woman down. It was not solely the fault of the cervical screening programme or the pathologist.

Some of the women's symptoms should have prompted doctors to do further tests, rather than just accepting a "normal" smear result from Dr Bottrill's lab, he said.

"I would have suggested for some of these cases there are questions why clinical signs were not taken into account."

Dr Boyd said it was extremely difficult to recruit medical specialists for isolated areas. They did not have the opportunity of peer review or even mixing with others in the same field.

In discussing the effectiveness of the cervical screening programme, Dr Boyd revealed that promotional messages were misleading.

He said words such as "prevention" and "eliminate" probably should not have been used in literature because it gave women the idea that they would not develop cancer as long as they had a smear.

Dr Boyd also suggested that statistics about the incidence of cervical cancer were "stretched" to induce politicians to back the programme.

The ministry's evidence was interrupted by the unplanned appearance of the man at the centre of the scandal.

Dr Bottrill was not there to give evidence. His appearance was to counter the emotional whirlwind created by the eight women earlier in the week.

He read his one-page statement on Thursday morning. He apologised, in a carefully worded way, for what they had experienced, then left.

The first week of the inquiry ended with as much drama as it had started. This time it came from outside the inquiry room walls in the form of an earthquake that seemed to take hold of the building and shake it.

A lawyer for the women, Bruce Corkill, joked that he had never had such a dramatic response to his cross-examination. The earthquake was the only thing that appeared to have ruffled the woman in the witness box, Judy Glackin, since beginning her evidence.

At the end of the first week, preparing for the next, everyone is tired.

The public gallery was packed with as many as 100 people on days when the women, or Dr Bottrill, spoke.

Tellingly, as few as six stayed for sessions when health officials read from their hefty volumes.

But while much of the evidence is already documented, mountains of it must still be recorded by official stenographer Grace Rogers, a woman known to hit speeds of 150 words a minute.

While she worked over her laptop, inquiry registrar Tracey Curtin has quietly scooted around organising just about everything else.

At times, the cream-coloured room has been a hall of whispers.

Hushed conversations continued between lawyers and officials - no matter what evidence was being delivered on the main stage.

Laptop computers were tapped almost inaudibly. And - even though it was specifically banned - the proceedings were punctuated by a modern plague, the cellphone call.

Culprits dived for bags buried between stacks of paper until the offending instruments were found and wrestled into silence.

The breach of inquiry etiquette should have come as no surprise.

Here, at every break, the principal players wrest cellphones out of their pockets. For these people, office work continues despite being out of the office. And critical information emerging from the inquiry needs to be passed on, or acted upon.

The other occasional sound that seeps into the inquiry room is the muffled boom of stereos from cars stopped at the traffic lights on Gisborne's main street, Gladstone Rd.

But these have all been distractions. The real action has been up the long aisle in front of the inquiry panel where the truth has been sought.

The heartbeat of the inquiry, however, was 20 paces back in the public gallery, where people sat wearing daffodils, the symbol used by the Cancer Society.

It is there, among the fluctuating numbers, that the women who fought for an investigation have listened and accepted or rejected Dr Bottrill's apologies.

They are now waiting for answers from the health system that paid him.