Vale! Jack the Back

Dr.John O’Brien, or dad, was the world’s first full-time spinal surgeon. He left Sydney on the P&O Himalaya in 1963 and never returned home. On May 4, he passed away in Limerick, Ireland.

The following was read out at the funeral mass for John O’Brien held at St.Mary’s Church, Ballycommon in Co. Tipperary, Ireland, on May 6th. You can watch the video at the end of the article.

“What’s your story, John O’Brien? What’s your beginning, middle and end? Who is your audience? What is your goal? Why did you leave Australia? Why does any of this matter? Who are you?” These are some of the questions I asked dad when he told me he wanted to write a memoir. And he looked quite taken back. We were sitting in the Banana Leaf Apolo on Singapore’s Racecourse Rd.

He was thinking of something more academic. But I wanted him to understand his responsibility to his audience. He had this burning ambition, a sense of urgency and a wonderful pioneering story, that I believed in. This conversation kickstarted a series of discussions about his life. I said to him: “It’s your story, mate, it’s no one else’s. Go out and tell it.”

We talked extensively about his life: his motives, the places he lived, the people he operated on, the lives he saved, and I injected into these conversations some ideas to guide him. We went on this journey together, him the narrator of his own life, me the son, editor and friend. I loved talking to him. And he toiled with this epic writing project for years, working with his friend, the Irish poet Eleanor Hooker. After a while he showed me a first draft.

His early years read like a Peter Weir film, maybe something to sit alongside Gallipoli or Picnic at Hanging Rock. I wondered through his life on the page and measured it next to mine. From his family farm in Robertson, New South Wales, he introduced me to war-time Australia, a world I had no idea about: his evacuation to the countryside during World War II and his tough school years.

Through his words he gave me back the gift of my own Australian heritage.

I got through his student day hustles — including driving a cab — and his medical training at St.Vincents Hospital in Sydney and then this scene jumped off the page and into my heart.

I’ll read you an extract from dad’s draft memoir:

‘I was 25 when I sailed from Darling Harbour thinking I would be away from the country for two or three years gaining my post graduate degree in surgery and returning to practice in or near Sydney. On June the 12th, 1963, I sailed on the P&O Himalaya embarking on a Pacific route from Sydney to Vancouver. My parents and sister Catherine drove me down to Darling Harbour. Playing on the car radio was Frank Sinatra:

Fly Me to the Moon
Let me play among the stars
Let me see what spring is like on Jupiter and Mars.

Those words seemed appropriate for me, he writes. I was a heading away from home but when would I return?’

He never went back. From then on he would be the overseas O’Brien, locked into a duality between home and an adopted country. And that country changed. His quest to learn and grow took him all over the world: Canada, Scotland, Hong Kong, Sweden, England, and Ireland. He was a proud Australian and a proud Irishman too.

I learned things about him I never knew: his time in 60s London and his work as a doctor at the Australian High Commission doing medical examinations on the 10 pound poms, his role as ship’s surgeon on the Hardwick Grange to Buenos Aires. Man, he hustled hard in Australia as a student, and then he hustled harder in Europe. Australians had to. The hard graft was in the genes.

As I got through the pages it was clear to me there were two parts of his professional and personal life that stood apart. He valued his work and life in Hong Kong and Oswestry above everything else. In Hong Kong, he started to move mountains in spinal care, training under Professor Hodgson — or Hoddie as he used to call him — he met Eileen, moved into a flat in Sandy Bay and started his family. Madeleine and Genevieve are Hong Kong babies.

He did groundbreaking work here pioneering anterior posterior fusion (operating on the lower spine through the stomach). At the Duchess of Kent Hospital at Sandy Bay, his spinal procedures changed the lives of children suffering tubercolosis of the spine.

For John O’Brien knowledge was to be shared, not hoarded. Learning came first. This was uncommon. surgeons had started being characterised as arrogant superior beings, the phrase ‘God complex’ was bandied around. But he set up a way of bringing experts into his clinics and into his life, changing their lives in the process and changing patients’ lives too.

They came from Texas to Tokyo to see what he was doing and to learn alongside Jack the Back at his Center for Spinal Studies in Oswestry, the first such center in Europe. They took their learnings back home, spinal medicine grew and thrived as a result. Patients crippled by severe disorders would walk again. He established the Oswestry Disability Index, an international standard for measuring lower back pain that is still used today. His family grew as well: there was me, JD, and Antonia and more medical milestones followed.

His peers still laud his work and character today. In his nomination for a Lifetime achievement award by the International Society for the Study of the Lumbar Spine (ISSLS), an organisation he co-founded, they write:

‘He introduced the concept of a multidisciplinary team to assess, investigate and treat patients with chronic low back pain. He scoured the world to find scientists and engineers of all disciplines to contribute to the understanding of back pain. Many active investigators today can trace back his influence on themselves or their teachers or their teacher’s teachers.

‘He made Oswestry (not the easiest place to access) a ‘Mecca’’ for all with a serious interest in understanding the spine. All were welcomed; all were expected to contribute presentations, practical research, and clinical input; all were entertained in the remarkable setting of the border country between England and Wales and its numerous hosteleries.”

I remember putting my feet into his enormous shoes as a little boy and sliding them over the red tiles of our kitchen in Oswestry. They were such big shoes. He wanted his family to be a part of his revolution, and he took us on the ride. Eileen became an expert in hosting medics, and toured the world with him. She described herself as the world’s best non-practising spinal surgeon.

We did ward rounds with him; we’d go to church, stop off at the mess for crisps and a fizzy drink. In the hospital, he would move between beds, pulling back the white curtain to reveal four small children. Imagine their faces as we stood around their beds playing with the bedsheets, fiddling with their grapes and flowers. It was a neat trick. I’ve taken my kids into work, but I’d never introduce them to my clients. I realise now what a masterstroke this was: it thrilled his patients and removed the ‘white coat effect’. It also kept his kids involved in his world.

Sure, we got bored of the chat and medical jargon and some patients were nicer than others.

It made our family strangely comfortable in hospitals. Four of us would follow him into the London Clinic on Harley Street; at various stages we worked for him, or in my case for the Clinic as a night porter… I would deliver blood samples to pathology. It was at the London Clinic that I started properly reading newspapers, before I dropped them off on the nursing floors. I suppose I can thank him for my journalism career because he hard-wired into me the scientist’s desire for knowledge. He asked more questions than he answered.

Many months, even years went by as he put his story together. And I would be on call to discuss it with him. I loved it. Each call. “Who’s your audience,” I would ask him. “Students, family or the world?” There were bumps in the road. He would stall, procrastinate and linger. But that happens with all good yarns.

In life, dad found other people far more fascinating than himself. This was disarming, bewildering, sometimes confusing to people. Many times friends of mine would come away from dinner startled, amazed. “Your dad is quite a legend,” they would say. Not that we knew… he was just dad. To some he was the pioneer of medicine who didn’t seem to know how to blow his own trumpet.

Imagine what it was like for the surgeons he trained. They came to Oswestry or London to work alongside this pioneer and dad would bring them into his home. It was a short walk from the operating theatre to a house full of kids. Sometimes, even dad didn’t know who was staying. Usually the surgeons were dumbstruck. They loved it. One minute, they were making split second clinical decisions, the next they were elbows deep in the trials and tribulations of the 90s British teenager: whether to play Womderwall by Oasis or Common People by Pulp.

I watched their transformation through the expressions on their faces. I saw the awe, that they had witnessed a master of his art in two distinct settings — the operating theatre and at home. How could this be? But this was just dad. He loved people. He would come back from a visit to the local shop with a very good understanding of the shopkeeper’s life and back story, but probably not all of the things he intended to buy in the shop. Stories came first.

This curiosity and fascination propelled him into the world, disarming people left, right and center with his wit and charm. Why keep this to Australia alone? When the whole world is out there, why stay here? He kept moving. And it’s a gift he passed on to his kids.

I left London for Scotland, I left Scotland for Australia, I left Australia for Laos and Laos for New Zealand, New Zealand for Singapore, Singapore for Amsterdam. I have him to thank for this.

We inherited his duality, working in England, but fundamentally Australian at heart. I have done long discussions with my own friends on my home and my identity. There is another wonderful Australian expat, Nick Cave, who sums this up: “I hold nothing but the deepest gratitude and affection for the country that has looked after me for most of my life, and that has given me so much, personally and professionally, but at the same time I remain faithful to my inherent nature, shaped by where I was born and raised. I carry my Australianness with me, not as an overbearing identity, but as a true and treasured pride.”

Maybe you should ghostwrite your dad’s book? I got asked. Now why on earth would I do that? What right do I have to take dad’s story, the one he told in his beautiful house on Loch Derg to his poet friend over many hours, months and years. The truth is I am so afraid I will lose his voice.

Besides, his story almost feels too big for me, spanning so many decades, thousands of patients, five children, 15 grandchildren, and the many, many awards and accolades. What if I edited it and bits of him disappeared? I’ve never told anyone this, but from that moment in the Banana Leaf Apollo I knew he had to go on this journey himself. I knew it would end here too. I had no intention of helping him. “This is your story, dad, tell it any way you want. The world needs to hear it. And I’ll be with you all the way.”

A year or so after that Banana Leaf Apollo discussion, I had a visit from uncle Jim. If dad’s story wasn’t clear to me before, it was then. He talked about his brother’s work in Hong Kong. His eyes burned with pride. He marvelled at his work, the same way a boy marvels at Superman. I got a sense of the great inertia behind dad’s story: all the people who loved him, respected him and championed him and his career were all willing him to get it all down. I stood back.

“Do it for Australia, mate, do it for the thousands of medical students out there who need to learn about the origins of spinal care. And the man who made it all possible. Do it for your children. Do it for their children.”

His grandkids, who are sitting here today, may not know that grandad’s story is one for the ages. Stories need to be told to be heard: they live by their retelling, they die when they’re forgotten. He’s done his bit, now it’s your job to carry his story forward. I’m talking to you: Blaise, Daen, Archie, Lily, Romy, Grayson, Juno, Cashel, Rhea, Elodie, Finn, Charlie, George, Jack. And baby Quinn. Because this is your story too.

Cherish every chapter, every port of call. And remember that boy surgeon at Darling Harbour who said goodbye to his family and went on a journey to save lives. And never went home.

Embrace that same spirit of discovery that he did in getting on that ship. I’m so proud of everything he’s achieved and how he’s handled his life, building a life of such dignity, pride and bliss here in Ireland with you, Maeve. From me, Madeleine, Genevieve, JD and Antonia… thank you for giving him 10 years of happiness, love and support. You have built something together which is very special and your calm, poise and strength inspires me every day. You are a credit to your family, and your family is a credit to you.

So let me ask that question again: What’s your story, John O’Brien? The boy who left Australia on a wing and a prayer; the family man, who loved life and all of its weird people; the surgeon who became a medical collosus in spinal care. Take your pick.

“I think your story’s great, dad,” I told him at the Banana Leaf Apollo. “But you have to be the one to tell it, not me.” And he did. He did it. Best story I’ve heard. You have earned your rest many times over, mate. We are all so proud of you. We love you. But rest now and I will find you in the stars.

Vale John O’Brien!

To watch the full eulogy, click on the link below at 48 mins