Since the demise of former Tamil Nadu chief minister J Jayalalithaa, there has been a great deal of mystery shrouding the cause of her illness, her treatment and her death. To this end, the Justice Arumugasamy Commission was formed to probe these circumstances. Recently, the committee made stunning allegations of medical negligence and criminal conspiracy in her treatment.
The Standing Counsel of the Commission has summoned London-based intensivist Dr Richard Beale. He is expected to appear before the panel through video-conferencing on 9 January.
But who is Dr Richard Beale? Why is his deposition important? What role did he play in Jayalalithaa's treatment?
Who Is Richard Beale ?
Dr Richard Beale is a Consultant in Intensive Care Medicine and Clinical Director for Perioperative, Critical Care and Pain Services at Guy's and St Thomas' NHS Foundation Trust. His clinical and research interests include sepsis, haemodynamic monitoring, advanced ventilation, nutrition in the critically ill, and ICU informatics.
He is also a professor of intensive care medicine at King’s College, London.
He is the immediate past chair of the research committee of the European Society of Intensive Care Medicine (ESICM), has been on the steering committee of the surviving sepsis campaign since 2004, and is frequently invited as a speaker at national and international meetings.
What Was His Role in Jayalalithaa’s Treatment?
Jayalalithaa was admitted to Apollo Hospital, Greams Road, Chennai on 22 September 2016, with fever and dehydration. The hospital had issued a statement saying she was under observation and that she was subsisting on a "normal diet."
Ministers, MLAs and AIADMK party members had dismissed rumours that Jayalalithaa would be flown to Singapore for further treatment.
Eight days later, on 30 September 2016, Dr Richard Beale was flown in, given that his area of expertise was acute lung injury, sepsis and multi-organ failure. He left Chennai two days later, but continued to guide the medical team attending to Jayalalithaa.
On 6 October 2016, reports claimed that a three-member team of doctors from All India Institute of Medical Sciences (AIIMS) consisting of pulmonologist GC Khilnani, cardiologist Nitish Naik and anaesthetist Anjan Trikha examined Jayalalithaa. The treatment plan then followed was based on detailed discussions with Dr Beale. It included appropriate antibiotics, respiratory support and other clinical measures to treat the infection.
On 13 October, the AIIMS doctors along with Dr Beale visited Apollo Hospital to examine Jayalalithaa again.
On 7 February 2017, Dr Beale addressed the press regarding the rumours floating around about her death.
The reason why Dr Beale’s deposition is crucial is because this will be the first time that doctors open up about the leader’s medical condition in detail. Dr Beale had previously conducted a press conference in which he answered some of the rumours floating around about Jayalalithaa’s death. In that press conference, however, he could not fully answer all questions due to doctor-patient confidentiality. His deposition will be important because he will have to answer all questions.
Here are some of the rumours and claims he addressed in that 2017 press conference:
“Nothing Suspicious About Her Death”
Citing the timeline of events, he started from the beginning, saying, “She was short of breath and an ambulance was immediately called for. The immediate diagnosis was respiratory failure due to infection. Sepsis is the word we use to describe the body’s reaction to a serious infection. It provokes an inflammatory response in the body. So even if we have removed the source of the infection, the process of sepsis causes damage across all organs... and that’s what happened in her case.”
Dr Beale said there was nothing suspicious or unusual about her death.
“It Is Not a Normal Practice to Photograph a Patient”
A number of journalists questioned why a picture or CCTV footage of Jayalalithaa was not released, even after doubts of improper treatment was raised. Many had even cited the time of MGR’s hospitalisation back in October 1984. Amidst all the secrecy, a photograph of MGR in hospital gave relief to many and probably even made him win the elections.
“It is absolutely not a normal practice to photograph people who are critical in hospital, for any patient for that matter, this is regarded as an intrusion of privacy of the patient.”Dr Richard Beale
“We Talked About TV, Food, My Kids”
One of the biggest questions media persons and the public had was whether Jayalalithaa was conscious at any time during her hospitalisation. Dr Beale clarified that when she came in initially, she was treated with no invasive ventilation. “As the sepsis regressed and she got more tired, she had to be on ventilation completely. But later in the course when she improved, she was once again interactive.”
“We talked about what she would like to watch on TV, food, rehabilitation, told her about my children... but the point I am trying to make is, we were interacting. She could speak clearly, mouth clearly, I could understand what she was saying.”Dr Richard Beale
“No Conspiracy. Treatment Was Perfectly Straightforward”
Dr Beale had brushed aside the notion of him having any links with the politicians in the state or country.
“It has been quite upsetting to watch from a distance many of the extreme rumours going around, so I always thought at some time it was important to dispel those,” he said.
“Even back at work, office and at home, I’ve been approached with questions on these rumours.”Dr Richard Beale
When asked if it would’ve been a wiser option to transfer her abroad for treatment, he agreed that the issue of transferring her to London was discussed.
“But the question is, is there any particular treatment you get there than where you have come from? The facilities at Apollo are first-rate, the team were high experts and it was being reinforced with extra opinions,” he said.
“Our shared view was that the risk-benefit balance did not justify her transfer and later when she was woken up, we found out that she herself did not wish to go.”Dr Richard Beale
And to counter the many doubts about the marks on her face and around whether any amputation was done, he said, “When she came first in the hospital, our first job was to stabilise her condition. The marks on her face and body could be because of medical tapes. There was no amputation and no transplant.”
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