66 No Other Neurosurgeon Is As Polarising As Dr Charlie Teo

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this is straight talk no tumor is inoperable now what is variable is the outcome one of australia's

most eminent neurosurgeons dr charlie teo charismatic undeniably brilliant when no one

else will even try i was so scared of neurosurgery because it's a very unforgiving specialty the very

mentioned in the book is that it's a very unforgiving specialty and it's a very unforgiving

of a brain tumor sends shivers down your spine the obvious discussion with you is when people

take risks and they don't get the outcome they're hoping for their response the reason i can no

longer operate in australia is boils down to the very fact that i have been taking out tumors that

other people have called inoperable i've had some bad outcomes and they're using those bad outcomes

to say that i should never have operated in the first place unfortunately led to my professional

demise australia's most famous neurosurgeon is also the most

polarizing fight for his professional life you might think he's a dangerous maverick who has no

place in an operating theater i was once told by a mentor that you should charge what you think you

deserve i mean there has been some allegations that you do for all these large amounts of money

okay okay okay let's stop right here i've done 11 000 brain tumors can we please talk about some of

the good results that particular journalist they have blood on their hands i really want them to

know that i want them to know that you know you might not like me you might want to destroy me and

succeed but there's not a day that goes by that i don't see a case it was going to die that i could

save charlie teo welcome to straight talk mate yeah thank you thanks very much for coming in

no it's a pleasure mate i love stuff about the brain all right and like uh i'm always reading

stuff i've got no idea what i'm reading about but i'm always reading stuff you know i know quite a

few neuroscientists who talk about how the brain works etc and as soon as you came in here today

you um i asked you did you want a cup of coffee and you said no no because it's got too much

stimulus in it or whatever stimulates you too much at least what would you call it what you say

it was it's a central nervous system stimulant right yeah and is that bad well if you don't

need a senior stimulant then it's bad because you're taking a drug a therapeutic drug uh at a

therapeutic level that is unnecessary now sure if you need it then some people need a central

nervous system stimulant but i certainly don't a central nervous system being that's your brain

yes the whole central nervous system the brain and the spinal

cord right and in just in terms of what you do being a neurosurgeon the brain is not just the

thing that's in your head it's everything else that's attached to it isn't it like it's all the

stuff goes in your your spinal cord etc is that how it works yeah all the way out to the peripheral

nerves you know just explain how far out neurosurgeon travels so in other words is it to

my fingertips or what are we talking about fingertips absolutely and to my top the tops of

my toes and uh so everywhere that the nervous system extends to yes and a

neurosurgeon um or whatever we call it neurology i guess but does that extend to the eyes is the

are the eyes part of the brain or part of the optic nerve supplies the uh i mean is the uh

conduit by which vision gets to the brain so yes the optic nerve goes all the way into the orbit

and uh so any pathology that involves the optic nerve also involves neurosurgeons

okay so you cover a fair bit of ground yeah so then a neurosurgeon

i mean i'm in the finance game okay so but people say to me oh can you tell me about

blah i i won't know about that because finance covers a lot of areas a bit like

neurosurgeon does yes um but i specialize in certain areas there's certain things i know a

lot about and there's some areas i don't know anything about and i'm really not that interested

in them anyway i have a general view but i don't like that interest in as a neurosurgeon

what is your area what are you mostly interested in yeah well you're absolutely right it it

encompasses so much stuff that you can't really say i'm not interested in it but i'm interested in it

it'd be impossible to be a master of all of neurosurgery spine peripheral nerve brain

vascular pediatric trauma etc etc so we do subspecialize i mean you need a

a demographic a population that allows you to subspecialize if you were on an island with you

know 5 000 people of course you'd be practicing every facet of neurosurgery but in australia we

have a big enough population where we can subspecialize and i subspecialize just in

neuro-oncology which means what

it means tumors of all type malignant and benign uh adults and pediatrics so it's just tumors

adults and kids so the whole range the whole the whole range of of individuals and so when you say

benign and malignant in terms of tumors what does that mean well you know the very the very mention

of a brain tumor sends shivers down your spine and you think immediately of bad things but in fact

there are some benign brain tumors that are not malignant they don't spread they're encapsulated

they're nicely circumscribed and they can be taken out and patients can be cured and so there are

some tumors that actually uh i'm not going to say good to have but you know not bad to have

what's a better outcome exactly i mean if he's got a tumor you want to know it's benign instead

of malignant yeah and what's the difference between the two so what's malignant mean

well unfortunately malignant is more common than benign right it's very sad that uh and

malignant means that you can take it out of your brain and you can take it out of your brain and

still, but invariably will come back again. And therefore, most patients with malignant

brain tumors will need adjuvant treatment, something else apart from surgery, chemotherapy,

radiotherapy, to try and reduce the risk of the tumor coming back again. But the sad news is that

even with adjuvant treatment, most, almost like 90% of malignant brain tumors are going to come

back again and end up killing the patient. And that's statistically now you're talking?

Yes.

Yeah. So that's sort of an accepted statistical outcome.

Yes.

90% will reoccur.

Yes.

Irrespective of the fact that it's been removed and treated after, or you're given further

treatment like chemotherapy, whatever it is.

Exactly.

Well, that's mad. So-

I mean, it's terrible. It's terrible because if you looked at our figures of survival of brain

cancer 50 years ago, for example, it's about the same. We really haven't made too many inroads.

And we haven't changed the landscape that much when it comes to malignant brain tumors.

So what, okay. So let's say I'm talking to my mate, Phil Stricker at St. Vincent's and he's

diagnosed as a prostate cancer or cancer in the prostate, assuming it hasn't sort of leached out.

And he uses one of his, I don't know, I think-

Fancy machines?

Well, yeah. And he uses his robotics and he sent, I think he's got a new thing now where he

hits with an ablation, it's called ablation or something.

Yes.

He hits with an electric.

Electric charge or something along those lines and can blast it on the inside. And he has a very

good success rate.

Yes.

Relatively speaking to what you just told me. Why is the brain, is it because it's harder to

access? Why is the statistical outcomes erring on the negative side with brains relative to say

colon cancer and or prostate cancer?

Well, it's multifactorial.

Which means?

Which means that there's many different reasons why it's bad. Significantly worse than prostate,

for example. Let's just take prostate as an example. So the prostate, man, you can live without it.

Yep.

So the first thing is that you can actually remove the entire prostate

and still live a reasonably good quality life.

Except you might not get a hard-on.

You can still get a hard-on, but you may not produce as much semen.

Yep.

Okay. So that's the first thing. And you can't take the brain out, of course, and survive.

No.

Second thing is that there is a thing called the blood-brain barrier.

Yeah.

It is our-

Anthropologically developed barrier that stops toxins from killing your brain. Your brain being

the most important vital organ in the body. So God in his almighty wisdom or whoever our maker was

created this barrier so that toxins can't cross into the brain. Well, the worst thing about that,

of course, is that means that chemotherapy agents, which are toxins, can't cross into the brain.

And therefore, chemotherapy is not as effective as any other organ.

Unless you inject it straight into the brain.

We can talk about that later, but that's not a bad thought, Mark. Hold on to that.

There's other reasons, of course. There's a thing called a radical resection where you not only take

the tumor out, but you take out normal tissue as well. And for example, if you've got colon cancer,

you can take out the cancer plus a bit of normal colon before and after to ensure that you've got

it all out, all the cells out. Well, you can't do that with the brain. Well, in some areas of the

brain, you can, but in most areas of the brain, you can't. So you can't do that with the brain.

You can't because you're going to take away function.

Some function.

Yeah, some function.

But some function we can live with it. I mean, like if you said to me,

Mark, I'm going to take away something that's going to stop you using your arms or your legs,

but you're going to survive, I'd probably say, okay, if I can do it, go for it.

Yeah. No, that's-

Is that right?

Again, it's a very good point, which we'll talk about later, I'm sure. But yeah,

it's all about risk appetite and what people are willing to put up with for life. But most people

wouldn't be happy putting up with, say, loss of vision or,

loss of speech or loss of your personality for extended life.

Okay. And then there's so many other things as well. A lot of cancers are what we call homogenous.

Every cell looks about the same. And breast cancer, prostate cancer, they're very homogenous

cancers. Whereas brain cancer, there's almost like 300 different cancers in the one cancer.

Every cell is sort of different and has different characteristics. And therefore,

if you find some agent,

that can target one particular cancer cell, brain cancer cell, it's only going to knock out a small

percentage. It's not going to knock out the entire tumor.

In that example, one 300th.

Exactly. Exactly. So, I mean, and I could just keep talking for hours and hours as to why brain

cancer is so deadly. If you think of it like this, if you were the almighty maker of the body,

think of the most deadly cancer you can think of, and that's brain cancer. It's got every

conceivable mechanism for it to survive. It has the-

MDR gene, multi-drug resistant gene. So, it actually builds up resistance to any drug that

you give it. It's got the gene that makes it grow faster once you take it out. So, if you take out,

say, 90% of the tumor, the 10% that remains is going to go, yippee, we've got extra room to

breathe and to multiply, and it grows faster. It grows back?

Yeah. It has innate intelligence. So, there are great studies showing that once you

expose that cancer to, say, some chemotherapy,

other parts of the cancer that are further away start learning, and it starts teaching itself how

to resist that chemotherapy. I'm telling you, it builds its own scaffolding. So, a lot of cancers,

when they grow fast, they strip themselves of their blood supply. But brain cancer is so

intelligent that it builds the blood supply first. It's called neovascularity, and it builds this

blood supply so that it can always survive. I mean, I just, Mark, I'm going forever and ever.

It's that intelligent a cancer. Well, it seems to me that, Charlie, that,

I mean, I want to come back to, a bit later, I just want to park something, the statistical stuff,

the intelligence of the brain, but also the high risk and outcomes, and therefore,

the obvious discussion with you is when people take risks and they don't get the outcome they're

hoping for, their response. And I'll talk about that in a bit, a second, but I just want to just

peel back a little bit. Your enthusiasm with,

stuff about the brain, and maybe I'm just a weirdo, but it's quite infectious to me.

I love all this discussion. And, but then you just started, I could just see you dipping your

toe in a little bit, and I could feel as though you wanted to really carry on about it. You really

love it. You love the mystery of the whole thing, and also its superiority, so to speak, relative

to all of the organs in the body. When did you first discover, when did Charlie Teo first work

out, I love this shit, but this is something I want to dedicate my life to?

Oh, it was all serendipity. I actually chose not to do neurosurgery. I can't, I'll never forget.

I was so scared of neurosurgery that when I was at Nepean Hospital as a young intern,

the system was that you would go and take the first chart off the pile. And so you'd, you know,

you'd go into the room, take the first chart, read it, and it said, you know, kid with a cold,

so you'd go and see the kid with the cold. I remember picking up a folder, the chart,

and it said, you know, a lady with a head injury. And I got, oh, fuck. So I put it down

underneath and picked up the next chart. Let the other dude do it.

Yeah, exactly. I was so scared of neurosurgery because it's a very unforgiving specialty.

You can't make mistakes or people die. It's very emotionally taxing. It's physically taxing. I mean,

it's just everything about neurosurgery is difficult. And because I didn't understand it,

I never had any sort of guidance and teaching about it. And,

it was all sort of a black hole to me. I basically tried to steer away from it.

Eventually I started doing pediatric surgery and because I love kids and I love doing things with

my hands. So I naturally gravitated towards pediatric surgery. And then sadly, the neurosurgery

registrar at the hospital that I was working at fell ill and they asked me to take up his

call roster. So I was thrust into neurosurgery without any choice.

Uh, I had, uh, I mean, I had to then master it and I was lucky enough to, uh, be exposed to a guy

called, uh, John Yelland, a neurosurgeon from Brisbane who, uh, was incredibly inspirational

and motivational. And he inspired me to learn more about neurosurgery and, and Bob's, I mean,

from that moment on, uh, I was captured by it. There's been extra study. I mean, did you have

to, I mean, Oh yeah. I mean, which, uh, what,

what does that mean though? Like, uh, do you have to go and do a whole new course on?

Yeah, absolutely. So I got out of pediatric surgery, which I'd been doing for about three

years. So I sort of, that's how much it captured me. That's how much it stimulated me. I thought

to myself, pediatric surgery, this is boring compared to neurosurgery. And so then you have

to start the whole process again of getting onto a training position, a recognized training position.

So you have to do, you know, non-recognized training for a while,

maybe one or two weeks.

Two years of unaccredited neurosurgery training. You can get a mentor to adopt you. And then you

start your recognized accredited training. And then after that, which is usually four to six

years, you then do a year of fellowship. And then, so it's a long haul. Once you decide you want to

do a subspecialty. So let's say it's 10 year, a 10 year break. It took you 10 years probably to

get your professional qualification such that you would be recognized by the medical profession as

someone who can become a neurosurgeon.

A neurosurgeon, yeah.

On, on your own.

On his own.

Yeah.

Okay. At what age are you now? What are you like 40?

Me?

At that point. No, no, now, at that point. After you, after you, you know, worked under the master.

I was 35.

35, mid thirties.

Yeah.

At which point someone's going to say, okay, Charlie, you can go do this stuff on your own.

Yes.

And what do you do? Do you appoint yourself to, do you try to get an appointment at a hospital?

Yeah. Yeah. You try and get some appointment somewhere at a public or a private hospital,

academic or non-academic. And, you know, depending on what you want to do. I always wanted to do

academic neurosurgery.

Which, what's that mean, academic neurosurgery?

So it means trying to advance the field by doing research, mentoring other neurosurgeons and

teaching.

Publications.

Publications. And that's what I always wanted to do. I didn't want to really go into private

practice. I thought that, you know, I might get influenced by money and that might sort of drive

me. So rather than be exposed to the private practice side of neurosurgery, I chose to go

into academics.

Okay. So, and I think it's important to just establish what that means.

I mean, that's, that's about keeping abreast of all the updates, all the changes and everything

that's going on in the world in relation to neurosurgery.

Yes.

Or everything to do with the brain and that will cancer the brain in your case. But it's also about

doing research too. Did you, were you, was Charlie Teo the dude at a academic hospital with, you

know, three or four PhDs or three or four other young neurosurgeons or neurosurgeons to be writing

papers?

Doing publications, working on and specializing in certain things when it comes to neurosurgery,

like trying to publish something in nature or wherever it is to say, we've just discovered

something?

Yeah.

Was that you?

That's exactly what you're trying to do.

Yeah.

There are two-

A very frustrating process, isn't it?

Oh my God, yes. You have to have a lot of patience because sometimes you can do three years of

research in something and it turns out to be, you know, a dud. And so it's almost like three years

wasted. But there are two avenues of research you can go into. There's,

you know, lab work or, you know, basic science research. And there's clinical research where you,

you know, look at your outcomes and try and design new operations.

Relative to patients.

Exactly.

Yeah.

As opposed to.

As opposed to the lab.

A theoretical hypothesis.

Yeah.

About something.

I never had the personality to go into lab research. I like animals too much and a lot

of it was animal based. You had to operate on dogs or rats or something. And so I went into

clinical research, published a lot of papers, designed new operations.

You know, that sort of stuff.

And can I ask you at that point, did you discover the, I don't want to say inept, inept is the

wrong word, but the system, how shitty the system is? Because, you know, I'm not, I'm

not being critical of anybody, but as soon as something becomes systemized, in other

words, how do I get this published? What I've just done now, this great bit of work that

I spent three years on and my team spent three years on, how do I get this published? And

you get the paper rejected or, because, and it becomes politics because you get peer reviews,

you get people who don't like your personality or just decide they're in a different school

of thought on that particular item.

Yeah.

Did you feel as though during that process at any time, did you feel disencouraged?

Or discouraged?

Your eyes are open. Your eyes are open by that sort of stuff.

Yeah.

And I must say that I'm a bit slow in the way I pick up things. I,

I get.

I guess I'm a little bit naive and I always try and see the good in people. I don't, I

don't see the bad until it's blatantly obvious. You know, my ex-wife, my current partner,

people around me, they often are just flabbergasted the way I can't see the evil or the malice

in people around me, but I don't. And I think.

By choice?

No, not by choice. It's just a naivety, I guess.

This is Charlie.

Yeah, it's me. And so you're absolutely right. For the first few years of my, you know, I've

been doing my research or my career, I used to think everyone was very altruistic and, you

know, did the right thing. I didn't even know the word duplicitous at that time. And then

one thing, two things happened. I don't know how much time we've got, but anyway, you can

cut and edit.

Yeah, go for it.

Yeah. So the first thing that happened was that I wrote a paper and we presented, we,

you know, sent it to the journals, a good paper.

Did you choose good journals, by the way, ranked journals?

Yeah, yes. Ranked journals.

Ranked journals with good H-indexes and all that kind of stuff. And so we submitted

to one of those things and it got rejected. And I thought, gee, it shouldn't have got

rejected. It's a really good paper. No more than maybe three months later, the guy who

rejected it, because it tells you who rejects it, you see their comments. The guy who rejected

it wrote exactly the same paper. And I thought to myself, hang on, that's exactly what we

were saying in our paper. And it was very novel and stuff. So he rejected our paper

so that he could then, you know, get his paper published and be the first to publish.

On that concept, that idea. So that was one thing that really disillusioned me. It's almost

like, oh my God, there's politics in everything.

The next thing was really something really terrible, terrible. And this has unfortunately

led to my professional demise. And it goes like this. A young police officer had an injury

in rural Arkansas. And he got a thing called an extradural hematoma.

Because there's a blood clot or something.

A blood clot. Outside the brain, but very curable. You know, if you get them early enough, take

out the blood clot, they're fine. And even the underlying brain is fine.

Is that from a trauma?

Trauma. It's usually a bloat at the head. And so he presented at a peripheral hospital

where there was a neurosurgeon. And the neurosurgeon was intoxicated at the time. So chose not to

come in to see the patient. The nurse said, well, you know, he's fine at the moment, but

he's got an extradural hematoma. You know, don't you want to come in? And he said, no,

send it off to Arkansas, to Little Rock. And the patient then started deteriorating

and reducing level of consciousness, which means the clot's getting bigger, the brain's

being compromised. It's a real emergency. And it's a great emergency because if you

get in there early enough, you can save their lives. But he never came in and saw the patient

and sent the patient to Little Rock.

Because he was pissed.

Well, we didn't know that at the time.

Something like that.

Yeah. But the presumption was that there was some reason why he wouldn't come in.

He wouldn't come into the emergency room and see the patient.

By the way, that's okay, isn't it, though? Because you're allowed to have a few drinks

or whatever.

Not when you're on call, no.

Oh, he was on call. Okay, got it.

Okay. So the patient comes to Little Rock and he's dead on arrival. And so here's a

young man, contributing member of our society, police officer, who's dead and didn't have

to be dead. So when the case was presented at M&M, I just got furious, hit the roof.

And I said, I'm going to call that neurosurgeon and just tear him to shreds and make sure

he knows that he's responsible for the death of this young man. And my boss said, no, you

won't. You're going to call that man up. You're going to call the neurosurgeon up and say,

thank you very much for your referral. Unfortunately, he died in transit and you're going to suck

dick. You're going to do, you know, you're going to basically play the game.

And I go, what? And I was clearly infuriated by this. And he goes, look, here's the thing.

If you piss that neurosurgeon off, he's not going to refer any patients to us anymore.

If you keep him on side, he's going to refer patients to us. And in the long run,

we're going to save more patients by, by that gesture. And, you know, I hate to say it,

but he's probably right that more patients are going to be saved, even though this guy

didn't get his ass kicked, didn't get reprimanded, takes no responsibility for the death of this

guy. So when I came back to Australia, the same thing happened to me.

Where within six months of being in Australia, I got someone coming to see me from one of the

governing bodies saying, Charlie, what the hell are you doing? I go, what do you mean? He goes,

you're pissing everyone off. You're taking out these tumors that everyone else has called

inoperable. You're making them look bad. What are you doing? I go, well, you know, what do you mean?

What am I doing? I'm doing what I should be doing, taking out a tumor that I think I can

take out with very good results. Thank you very much. And here, by the way, look at,

this x-ray. So I showed the guy the x-ray and go, that x-ray was sent to me from Melbourne

by a mother of a child who's been told that the tumor is inoperable. What would you do? He goes,

well, I'd take it out. I go, yeah, it's a pretty easy tumor. So I'm going to, you want me to write

back to her and say, I agree with the surgeon, it's inoperable and let that child die. He goes,

Charlie, I do that every day. Why? So he doesn't piss off his colleagues.

That's like, uh,

systemization. That's, um, compliance to a system.

Yes. That's exactly what I'm now being reprimanded for. The reason I can no longer operate in

Australia, it boils down to that very fact that I have been taking out tumors that other people

have called inoperable. I've had some bad outcomes. I'll be the first to admit it. And they're using

those bad outcomes to say that I should never have operated in the first place. I should have

towed the party line and I should have called that tumor inoperable, just like,

they called it inoperable. And who is they?

They are medical governing bodies and my colleagues.

So, okay. I want to get down to the bottom of this bit because I know this happens in

most regulated industries and I've seen it in my own industry. It doesn't have the same

outcomes as yours, but nonetheless, there is a they in most regulated industries.

Yes.

Is they made up of, made up of professionals or administrative people? Is it,

administrators who are trying to administer the health system? Who are the they people who

make the judgments on you or is it your colleagues?

So of course there's administrators and professionals in any governing body

because administrators have to call on professionals for their advice.

And so there are doctors who are medical advisors. They call on expert witnesses. These are my,

my colleagues.

And then of course there's a pin pusher, the person behind the, who processes the whole thing.

The worst thing about medical governing bodies is that they have no accountability. So there's no state or federal

jurisdiction over these governing bodies. They have total autonomy and that's fine too if they carry

out due process and due process means, you know, just do the right thing. But the trouble is it's, there's no due process.

It's a broken system because the plaint often, if not most of the time, the plaintiff, judge, jury, and executioner are all the one person.

If you look at one of the complaints that I'm going to be facing soon, the complaint was made by a doctor to the medical governing body in Western Australia.

Well, who was the doctor that was the doctor for the Western Australian medical governing body?

It was the same person who made the complaint.

He was complaining to himself about me.

And then not only that, but then you go through these tribunals.

Well, who sits on the tribunal and who's the judge on the tribunal?

Well, the judge are the neurosurgeons who made the complaints about me.

So you're being judged by your enemies, the plaintiffs.

It's not a proper peer judgment.

No.

It's stacked.

Yeah, it's totally stacked.

It's totally stacked.

And so then you complain about it.

You go, well, hang on.

You know.

So-and-so can't judge me because so-and-so made the complaint.

So they're conflicted.

Yeah.

And not only that, he's in competition with me anyway.

So it's almost like, you know.

He was doubly conflicted.

Yeah.

Double, triple conflicted.

And then they go, okay, no, you're right.

You're right.

Let's now call on the president of the society to adjudicate on this, arbitrate on this.

And he'll come up with a, I'm sure he'll come up with another alternative judge.

So.

So it turns out that the person that they're consulting is probably the person who's wearing this, who's the current judge.

Or president.

Yeah, president.

So he just changes hats and he tells himself this and that and complains to himself.

It's just, oh, my God.

And please don't just take my word for it.

There's been two Senate inquiries into the broken, dysfunctional bullying system, medical governing systems in Australia.

Both Senate inquiries called for a royal commission.

And has there ever been a royal commission?

Nope.

So all the recommendations they came up with to try and reduce bullying and vexatious complaints and sham peer review and all that sort of stuff, all have fallen into nothing.

Nothing has been done about it.

Why is that?

Is that because the medical profession, in terms of how they run their society, you know, in other words, the president of the, wherever it is, you know, who would be looking at the complaints that are being sent.

To them in relation to, say, someone like you.

Is it because their lobby is too powerful?

Because I've seen this in the banking industry, my game.

And there's no point going against the banks because they're so powerful.

I remember, and I don't mind saying this today.

I remember in 2009, I was one of the seven people on the financial services advisory board to the treasurer.

And I advise both liberal treasurer.

Treasurers and Labor treasurers and liberal after that.

And during that period, Labor was in under Kevin Rudd and Wayne Swan was the treasurer.

And I remember sitting with Wayne Swan along with another fellow, another economist.

And we were telling Wayne Swan after the GFC, he'd put in place a whole lot of very intelligent things to help us through the GFC, Australia.

Telling him after a certain period of time, okay, we don't need those anymore.

We've got to stop that.

Otherwise, the banks are going to get way too strong.

And I'll swear this on a stack of Bibles.

Wayne Swan said to me and his other fellow, the last thing I want to do is start taking on the banking system, the banking lobby, because they're one of the most powerful lobbies in the country.

And we've got an election coming up.

I'm already, his words were, I'm already taking on the mining lobby because they decided to put some tax over the mining companies.

And now the mining companies were going against them prior to the election.

And it just seems to me that the banking lobby.

It's even today is so powerful that you'll never, they can have raw commissions.

The banks are doing, well, they're not behaving badly, but the banks still not controlled by anyone, irrespective of the raw commission we had recently.

So are you saying to me that the medical profession in your game is exactly the same?

Yeah, but it's even worse.

So it's exactly the same than it is powerful.

I mean, there's not one politician who wouldn't play golf with a doctor.

I'm sure.

So they are in positions of power, doctors.

I mean, society gives them power.

They can sign things that other people can't sign.

They're given this sort of status and put on a pedestal.

So, yes, they're a powerful lobby group, number one.

But I think the thing that really I find most disturbing is, I mean, I'm not quite sure what word to use, but it's feigned altruism.

It's pretend altruism.

So what doctors can do is, oh, are we going to take your license away in the interest of public safety?

And so they've always got that to fall back.

The public interest position.

Yeah, public interest position.

You know, oh, you don't want a doctor who's going to be a bad doctor operating you.

So are we going to take his license away?

We're going to, you know, we're going to assume he's guilty and he's going to have to prove his innocence.

And so they can always hide behind this feigned altruism or public safety concept.

And so that's incredibly, you can be really abused.

And it is.

It's abused because it means that, you know, I don't like you, Mark.

You're a fellow doctor.

I don't like you.

You're taking my business away.

Bloody hell, all the patients love you.

They don't love me.

You know, I'm not seeing those patients anymore.

You know what I'm going to do?

I'm going to make a complaint about you.

I'm going to say that you fondled one of your patients.

Completely untrue.

You know, I've got no proof of it.

I've got no proof of it.

I've got no proof of it.

I've got no proof of it.

I've got no proof of it.

I've got no proof of it.

I've got no proof of it.

As soon as a medical governing body gets a complaint saying that you've fondled a patient,

what's their response?

They'll shelve you.

Yeah.

They've got to assume that it's right in the interest of public safety.

They take your license away from you.

And then they go, okay, now we're going to investigate you.

We're going to ask some of your colleagues if there's any evidence behind this.

Well, who are they going to ask?

They're going to ask the person who made the complaint about you.

And so the person who makes the complaint about you goes, oh, yeah, you know, I've heard

some stories or some rumors in the operating room.

He is a little bit difficult to get on with.

And so the process goes on and on and on for years and years and years.

You can't earn any money.

You have your restricted trade while this is happening.

You have your reputation tainted.

You lose self-respect.

People look at you sideways in the street saying, oh, my God.

And then, of course, in the end, you might be proven innocent.

But by then, you're shattered.

Your life is shattered.

You've got no money.

You can't fight.

You can't fight it anymore.

Then you've got to recover.

Yeah, then somehow you've got to recover.

So, you know, I'm not the only person who's been subjected to all this vexatious vilification

by colleagues.

It's been happening for centuries.

And I can tell you at least eight neurosurgeons while I've been in Australia for the last

20 years who are either dead because they committed suicide, they've left the country,

they've given up neurosurgery, or they're just broken people.

Well, why is it, though, that those eight surgeons?

And along with Charlie Teo, why is it they choose someone like you, that is, the system

chooses someone like you to out?

In other words, they pull you out of the ranks.

Is it because you are a threat?

Or is it, no, maybe it's not that.

Is it because you just have a high profile?

And by definition, you attract interest?

Or, question, do you go out to attract interest?

In other words, is Charlie saying, well, I'm Charlie Teo.

I do this.

I try to save lives.

That's my position.

I'm happy to tell everybody about it, naive to the consequences of the system trying to

come and chop you down.

Who is Charlie Teo, though?

Then why is it you?

Yeah.

Have you ever examined that?

Oh, my God, Mark.

I have to examine it.

Yeah.

Because you start questioning yourself.

You start saying, oh, shit, maybe I shouldn't have done that.

Or maybe I should have said this.

Or maybe I did do the wrong thing.

And for the last 25 years since I've been in Australia,

been persecuted, from the minute I got back from America,

I've had to do a lot of soul searching.

And, you know, I do take some blame for it.

I take some, you know, it's not just me, of course.

It's professional jealousy.

It's empire building.

It's celebrity studies.

Deceptions or real?

Well, both.

Both.

You know, I'm not a wilting flower.

I'm not someone who has shied away from the media.

So I've got myself to.

If you want to use the word blame for that.

But, you know, like I say, it's a whole, it's a whole lot of things.

First thing is that the medical fraternity is a very conservative fraternity.

By nature, it's very conservative.

IE COVID.

Oh, my God.

Don't even get me started.

Well, you can get me started there because I think.

Well, why not?

Yeah.

So I think what COVID has done is actually shown the public

how conservative doctors are and the system is.

And the mistrust now we all have of the system.

Yeah.

And you should.

You should.

The fact that we were told we couldn't say anything bad about the vaccine.

It was mandated.

You cannot say anything negative about the vaccine.

And if you do, we're going to go gunning for you.

And the public knew that.

The medical governing bodies made it very clear.

And I think the public stood back and go, oh, my God, really?

I mean, what if there is something bad about the vaccine?

Doctors aren't allowed to say that.

And you saw those YouTube videos of American doctors who were saying, you know,

some negative things.

They were absolutely persecuted.

I've got a mate who's retired over it.

He's only 73.

He's a very good doctor, very fit and young for his age.

But he was giving prescriptions out for ivermectin.

And he was on the team that believed that ivermectin, vitamin D,

and doxycycline was going to be at a time when there was no cure.

But there's one way you could treat it if you got it.

Right.

And he was prescribing it.

And he got so much heat from the administration system, not the AMA,

but.

The government.

It was just, it was sending him batty.

Yeah.

So he said, and now we've lost a really good GP.

You have.

Absolutely.

I've been with him for 30 odd years.

Yeah.

And he happened to be a client of mine when I was a lawyer.

But he's a really good guy.

And we lost him.

So that's one example.

That's only one example.

One example.

And I'm sure there's hundreds of them.

Thousands of examples of doctors have been persecuted because they said something contrary

to the party line.

Yeah.

So, yeah, you're right.

So there's one example.

Is that you though, Charlie?

Charlie, you.

Do you feel compelled to say something contrary to the party line because you're a contrarian

or because you believe it's something you should be saying?

No, I'm not contrarian.

I would love to be mainstream.

I would love to be mainstream.

I've never gone out just to say something just to get attention.

You're not a contrarian.

No.

You are saying because you feel as though it needs to be said or done.

Yeah.

You know, when I feel strongly about something that is right or wrong and, you know, it's

in the patient's best interest.

Look.

As a doctor, you take a pledge that from now on, once you're a doctor, it's not about

you, it's not about your survival, it's not about your professional reputation, it's all

about the patient now.

So the patient should always come first.

Which is the Hippocratic Oath.

It's the Hippocratic Oath that we took.

They don't take it anymore, but we took it.

Yeah.

Okay.

And I stood by that and I still stand by it today.

So if by standing up for the patient means that you're going to be contrary, fine.

But, you know.

If you can stand up for a patient and not be contrary, that's even better still.

So, no.

I'm not a contrarian sort of person who just goes out there just to be, you know, just

to say the opposite to the mainstream.

In other words, to attract attention.

Yeah.

You're not after the attention unnecessarily.

No.

No.

Not at all.

Not at all.

Okay.

But if I believe a tumor is operable and I can take it out and everyone else has called

it inoperable, even if evidence-based medicine says I shouldn't touch that tumor, I'm going

to offer it to the patient.

You know.

It's up to the patient if they want.

Take it or not.

Take the offer or not.

But I will offer it to the patient if I think it's the right thing to do.

Let's talk about inoperable.

We don't know.

Us commoners, we don't know what inoperable means.

Like, so neurosurgeons and neurosurgeon, why would someone say this is inoperable?

Yeah.

It's a very good question.

And that is, again, the basis of this whole problem.

What is inoperable?

Well, no tumor is inoperable.

You can take out any tumor.

Even if it's half the body.

Even if it's half the brain, you can take it out.

Even if it's in the most vital part of the brain, you can take it out.

Now, what is variable is the outcome and the acceptance of the outcome.

Right.

So it's nothing about inoperable.

No.

So all tumors are operable.

It's whether it should be done or shouldn't be done.

Okay.

It's about the outcome or the potential further damage or additional damage.

And it's all about your appetite for risk and the patient's appetite for risk.

Can we unpack it a little bit though, please?

I mean, like risk is an area of mind, not in health.

Or medicine, but in other areas.

So appetite for risk, I'll park that for just a second.

Just to break it down a little bit.

The definition of risk for me is not just the probability of an event occurring,

but it's also the probability of the event occurring multiplied by the gravity of the event occurring.

So that's the proper definition of risk.

Okay.

So it's not risky to cross the road because if I get hit by a car, I might live.

But if it's more...

It's more risky if I jump out of an airplane,

even though the probability of my parachute not opening is very low.

If the parachute doesn't open, I'm fucked.

Right.

Okay.

So gravity overtakes.

So can you just break it up into, based on those two concepts,

gravity versus probability of the event occurring,

of what may end up determining that something is inoperable from one neurosurgeon's point of view?

Yeah.

Because that's his point of view or her point of view.

Is that right?

Absolutely.

We all have different points of view.

Correct.

So a individual says,

that's inoperable because gravity and event occurring are quite high.

Can you explain what that might mean?

So if we just take it back one step.

Okay.

For a starter, I don't think any surgeon should say a tumor is inoperable.

They should say, I could take that tumor out, but here are the risks.

Yep.

And it's up to you.

Okay.

But it's up to the surgeon to be very blunt, very honest,

and very transparent about those risks.

Okay.

And you're absolutely right.

There are two sorts of risks.

One is the risk of it happening.

What is it happening though?

Yeah.

What could happen, for example?

Well, it depends on, you know, where you're operating.

Give me an example.

Okay.

Let's talk about a brain.

So one of the diseases that they've identified that I can no longer operate on are brain stem tumors.

Right.

Which is something at the back of the head.

So the brain stem, is that part of the brain that connects the brain to the spinal cord?

Right.

It also contains its own nuclei and own functions,

but it's probably, not probably,

it is the most eloquent part of the brain.

It's about the size of your thumb.

And think about 100 billion neurons packed into a conduit that's the size of your thumb.

And you're talking, in terms of elegant, you mean in an evolutionary sense,

it's functionality.

It's functionality, it's importance, and it's delicateness, I guess,

if there's an, there's got to be a better word, but, you know.

But you can't mess with it.

No, you can't mess with it.

Yep.

Oh, my.

It's so funny you should say that,

because one of the expressions that they use is never mess with the brain stem.

So for over 120 years now, since the start of neurosurgery,

the leaders in neurosurgery have always said, don't touch the brain stem.

And tumors of the brain stem, inoperable.

You know, don't touch them.

It's too high risk.

High risk of what, though?

Okay.

So, for example,

one small error in the brain stem, and you can make a patient locked in.

Now, locked in means that they're conscious, they can move their eyes,

but they can't move anything else.

That's how bad it is.

Okay.

So the gravity, that's how bad it is.

The gravity is, that's pretty fucked.

Yes.

That's equivalent to jumping out of the plane.

Yeah.

So you're just laying there like a vegetable.

That's how bad.

It can be even worse than that.

Well, it can't be much worse than that, but it can be, you know,

where you're fully conscious.

Able to move everything, but can't breathe.

So you have to be a ventilator for the rest of your life.

Right.

That's how bad it is.

It's that delicate a structure that one millimeter too far,

and you can create that sort of scenario where someone is essentially worse than death.

So you're saying in terms of risk and gravity or event and gravity,

that that's an area that is inoperable?

No.

You still think it's operable?

Yes.

Okay.

So now let's talk about the other thing you're talking about,

the chances of the parachute not opening.

It's very low because most parachutes open.

Now, when they don't, the gravity is terrible both ways, gravity and gravity.

But thankfully, most parachutes open.

So what I'm saying is when I operate on the brainstem, thankfully, most times things go well.

Yeah, right.

But when things go bad.

They go very bad.

Oh, my God.

They go very, very bad.

That's interesting.

So when you say when Charlie Teo makes that determination or deduction in his mind about,

yes, this is something I'm prepared to have a go at because Charlie knows statistically

that the parachute always usually opens or the brainstem does not normally get damaged.

Yes.

Is that a statistical thing?

Is that based on data or?

Well,

Well,

when you first start operating on the brainstem, you don't have the stats, of course, because it's your first case.

Is it about Charlie's stats or is it stats generally?

Well, there are no general stats, really.

I mean, because not many people that operate on the brainstem.

There are a few reported series.

Right.

Five patients, six patients, one patient, two patients.

But no, if you looked at the evidence before I started on the brainstem, there was really not much evidence to say I should be operating on the brainstem.

There was a paper out of New York.

There was a paper out of New York by a guy called Fred Epstein, and Fred showed that it could be done.

It was a feasibility study, I guess.

But not clinically based.

No, not really clinically based.

Yeah.

But he was a brave guy.

He was a beautiful person.

His patients trusted him and loved him, and he operated on the brainstem with some really good results and some really bad results.

So he published a paper saying, look, I'm going to be very honest here.

I've got some bad results.

But I've had some really good results, and I think you should start thinking about operating on the brainstem.

So I went and watched him operate.

I saw some of his bad cases, these patients on ventilators in the ward.

Very scary.

But I also saw some of his good outcomes.

So I started after that operating on the brainstem when I was in Arkansas.

And so by the time you've operated on, say, 20, 30 patients, it's incumbent on you then to publish your series.

So I published my first series back in the early 2000s.

In the early 2000s, and said, look, I think this should be done.

43 patients all with inoperable tumors by someone else, of whom 28 of those 43 had good outcomes.

So that's a significant, statistically significant.

Well, when you consider they're all going to die, they've been told it's inoperable, they're all dying, and you can save 28 out of 43.

That's pretty good.

That is, well, in normal statistic analysis, that is significant.

It is.

Very significant.

It is.

It doesn't.

And I don't want to detract from the poor old other people who had bad outcomes.

Yeah.

And so, but, you know, they were published as well.

We published our figures.

And then later, when I got up to 120 brainstem tumors, I published another paper saying that, you know, the majority of patients do well.

Unfortunately, 6% of patients do terribly.

I mean, terribly.

You don't extend their life.

You make them worse.

You sometimes turn them into vegetables.

I mean, really bad outcomes.

And we published that.

So, I published that in World Neurosurgery, the journal World Neurosurgery.

Which is like a leading.

It's a leading journal.

Yep.

I published my first article in Child's Nervous System.

Again, a leading journal.

So, it's out there.

And you have to do that.

Now, a lot of my colleagues have criticized me for not publishing, but they just haven't even looked them up.

I mean, they're just shooting from the hip and saying that I've done something terrible and I haven't published.

But it's published.

It's out there in the literature.

So, when you publish something like that, Charlie?

And you get a significant outcome or a significant result, 20 out of 43, 28 out of 43.

Does that build Charlie Teo's reputation and therefore create some, let's call it peer jealousy or collegiate jealousy from the other side or from others?

Do you think it does?

Do you feel it?

No.

That in itself probably doesn't.

I mean, when I published some of those papers saying I had these fantastic results, I would.

And in America, they believed me.

And it's a real meritocracy.

You know what America's like.

So, I had neurosurgeons from all around the world coming to watch me operate and learning the techniques.

When I came back to Australia and gave the same presentation, I said to one of my colleagues in Melbourne, I said, you know, it's there.

I published it.

It's real.

And she goes, Charlie, no one believes that.

Is that an Australian thing?

It is.

It's, you know, knocking the…

Yeah, you can't get too high up.

Yeah.

Yeah.

So, and I guess, you know, you can't blame…

I don't…

I think it's good to have a healthy degree of skepticism.

Maybe that's a little bit unhealthy when it's that degree.

But, you know, I like the way Australians don't believe people who are sort of big noting themselves all the time and stuff.

So, you know, the fact that they were knocking me down, they would think that I…

They thought that I was publishing those results falsely and that I was just trying to make myself look like a good neurosurgeon.

But they're based on data.

Well, yeah.

But scientists can lie about their data.

Yeah.

They can…

I guess so.

They can make it up and stuff.

But it has to be peer-reviewed though.

I mean…

It has to be peer-reviewed and there's often multiple authors.

So, it's very hard to do it.

But some people do do it.

Yeah.

I'm sure that does happen and we do know Australians who have been through that process.

And if I remember the thalaminoid cases.

Yeah.

I mean, that one goes back a bit.

But for pregnant women who are suffering from morning sickness or whatever during early parts of their pregnancy and we know what happened to him.

But…

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

See, what Americans do is when you publish a paper like that, they go, oh, my God, that's

fantastic.

I have to learn that.

So, they come and watch you and their immediate response is, you know, I'm going to better

myself.

I'm going to try and get those good results.

The immediate response in Australia is, it's bullshit, you know.

Yeah.

Prove it.

Yeah.

Yeah.

Prove it.

Prove it.

Yeah.

Like, that's sort of the doubting Thomas.

Let me see where the wounds are.

Yeah.

And let me put my hand on your side and see where you actually got the spear in there.

Exactly.

Exactly.

When you see that or when you hear that or feel it, does that…

What does that build up to you in you?

Does that build up a resistance towards it or does it make you want to push harder?

How did Charlie Teo feel when he gets that?

No.

No.

It didn't really.

I mean, look, I've managed to survive the system for, you know, my entire career.

40 years.

For 40 years, I've had people wanting to pull me down and I've survived.

How have I survived?

Because I made a pledge to myself right from the get-go that I would treat my patients,

like they were a member of my own family.

And I think that protects you because what it does is it takes away all those extraneous

other influences.

So you're never going to be influenced by money.

You're never going to be influenced by power games and ego.

You're not going to be influenced by, you know, the dinner party you have to attend

that night and you better hurry because when you picture that patient on the table as your

own child or your wife or your loved one, you're going to do the right thing.

And so I make a conscious effort every time I see a patient, I'm going to treat you.

I'm going to make a decision about surgical indications or applications or whatever based

on the fact that you are my child.

I love you and you're part of my family.

And that is what has protected me for all this time.

So how do you, I mean, there has been some allegations that you do it for all these large

amounts of money.

For me, quite frankly, they're not that large amounts of money relative to your scale.

And what you, the outcome you're trying to achieve, how do you work out how much you

charge?

I mean, like, how does it work out?

You know, I mean, I read somewhere in some of the research, like somebody where one of

the operations didn't go well, it was a hundred grand for the operation.

It was allegedly inoperable prior to you getting on board.

How do you work that out?

I mean, just what's your position on that?

I was once told by a mentor that you should charge what you think you deserve.

Yep.

And then people will either take it or not.

Take it or leave it.

I mean, you know, you're not going to force someone to come and see you.

And what is the argument then?

Why is the argument against you?

What is that argument then?

Where are they coming from?

Charlie charged me a hundred grand.

The thing didn't go right.

Are they saying, well, I felt like I had no choice because he presented me an outcome

that I really wanted and I really didn't have a choice.

Do you think that's the argument?

Is that their argument?

Look, I'm not quite sure because firstly, I don't charge a hundred grand.

They tried to, you know, portray that narrative of me being,

I'm money hungry.

But I think it's the fact that, look, I don't know,

but I think it's the fact that everyone else charges so much money.

And so they think that I'm charging.

So when they hear a story, so it was all a guy called Henry Wu.

He's a urologist at RPA.

For some reason, he took a disliking to me and he went public on Twitter

about how much I was charging.

He went to the GoFundMe.

He said, I've got all these patients that are trying to raise money for me.

And he made all these allegations about me charging $100,000.

Well, firstly, it's wrong.

The $100,000 that they had to raise is everything, of course,

the hospital bill, the assistant, the pathologist, the radiologist.

It's not Charlie Tiaz.

No, it's not mine.

It's not mine.

So he got it wrong.

Secondly, I've never not done an operation if someone hasn't been able to pay.

So in other words, of course, I want to get paid.

And we would love to be paid up front.

But we don't insist on it.

The hospital insists on it.

So hospitals have to run like any private practice business.

So they insist on the money up front before they let the patient in.

So that was interpreted as me saying, I'm not going to do your operation

unless you put the money in the bank.

So that is absolutely not the case.

You speak to any patient and they'll tell you that I always say to them,

I don't like talking about the money.

Talk to my staff about it.

But please don't let it influence what I'm recommending.

I think.

I think you need the surgery.

And if you want me to do it, there's going to be some way around it.

And in my career, again, I haven't really wanted this to be known.

But I'll tell you now because it's a straight talk podcast.

More than half my patients I don't charge.

I didn't want to say that publicly.

Because everyone's going to say, don't charge me.

Exactly.

I didn't want to say that publicly 20 years ago.

But I can say it now at the end of my career that I didn't charge police officers.

Fellow doctors, nurses, friends of friends, pensioners who couldn't afford it.

And, you know, there's all these examples of that.

That when you read the social media comments and all that sort of stuff,

people who've said, you know, he never charged me.

Well, I didn't.

And if they needed more than one operation, of course, we'd reduce the fee.

And then if they had needed more than two operations, we wouldn't charge them anything.

So, you know, my career has been based on doing the operation if it needs to be done,

regardless of whether they can pay or not.

And so that's the first thing.

I think a lot of people judge you based on their own criteria.

And a lot of people just don't do that.

A lot of people just do charge.

And money is part of their decision making.

The next thing is that whole concept of trying to demonize Charlie Teo.

So there was a paper called the Saturday Paper.

And there was an article in it that tried to destroy me.

And the journalists spoke to a whole lot of neurosurgeons.

And these neurosurgeons were saying terrible things about me.

So the journalist says to them, well, why don't you take him out?

You know, why don't you make the complaints formal?

And they go, who wants to be seen as the person who kills Bambi?

And so at that stage, my reputation was very good.

Australia's most trusted person.

All these great stories in the media about me saving lives and taking out tumors that

were inoperable.

And so I...

So I was considered sort of a good guy, Bambi, if you will.

So in other words, if you want to destroy Charlie Teo, you've got to try and change

the image of Charlie Teo from Bambi to a demon.

Rapacious, money hungry.

Money hungry, reckless surgeon.

And that's what they've done.

Now, I don't know how, I don't know who's behind it all, but all the media has basically

tried to make me look like I'm some sort of terrible person.

You know, he insists on money, he charges money, he operates on the wrong side of the

brain, he makes terrible politically incorrect jokes, he kissed a nurse on the cheek when

she didn't want to be kissed on the cheek.

So, you know, all these terrible things to destroy the image of Bambi.

And so that's one way of destroying Charlie Teo.

And it worked, it worked because once they came out with all those headline articles

about Charlie Teo, the terrible person, all the colleagues who were sitting back there

jealous and fuming and, you know, wanting to destroy me to go, yes, now we can go in

for the kill.

It was like a, it was like a wolf pack, seeing blood.

Feeding frenzy.

Feeding frenzy.

So having, as soon as those Sydney Morning Herald articles came out in the front, on

the front page.

There were like three complaints from doctors all around Australia saying, yeah, you know,

he operated on this person, he should never have done it and, you know, he didn't look

after this, but he didn't provide post-operative care for this patient and all these complaints

started coming in.

So, so suddenly Bambi was no longer Bambi, Bambi was a demon and now we can go get him

and we can destroy him.

Yeah.

So when Charlie Teo sits down with the patient, patient's family, friends, in terms of full

disclosure to them.

Yeah.

What, what is your process?

You say, okay, there's a brainstem, you know, normally not many people want to do it, largely

has been called inoperable.

I think I can have a crack at it.

Do you try to build them up and give them hope, but so much so that that hope then convinces

them to take the risk or do you somehow pepper that process with the downsides to make them

more even tempered in terms of their decision making?

I mean, it's a hard one.

Oh my God.

Cause you gotta, you gotta, I mean, naturally we want to give, you're, you're a doctor, you're

a professional person.

You want to give them hope.

Yeah.

I mean, that's, otherwise you wouldn't even bother attempting to do something so-called

inoperable.

How does that process work?

Well, that's the soul searching I do because that's exactly the fine line.

I mean, you nailed it, Mark, no one else has asked me that, but you nailed it because that's

exactly the problem.

You've got to instill confidence in your patient.

You've got to give them hope when everyone else has shattered it.

Yeah.

But if you start giving them too much hope, then it takes away the reality of the situation

and then it starts to look like you're convincing them to have surgery.

Yeah.

Especially if you're going to charge them.

I mean, it's, it's self-serving, isn't it?

Yeah.

Yeah.

Well, it looks self-serving.

It looks self-serving.

Yeah.

Okay.

So this is how I do it.

Yeah.

Take me through it.

Yeah.

So you come in with, you've got this brainstem glioma.

It's malignant.

You're going to die from it.

You're probably going to die in the next, say, six to eight weeks.

Yeah.

And I go, Charlie Teo, this guy over in Sydney who takes out brainstem tumors.

So you come over and see me.

The Messiah.

Yeah.

The Messiah.

Okay.

And I go, look, well, firstly, you assume that they understand the gravity of the situation

because they've already been told it's inoperable, they've been told you're going to die.

So they, they know how bad it is and they're looking for hope.

So you're already in a situation where you want to try and give this person hope, but

you don't want to, you know, lie to them either and you don't want to give them false hope.

Or make false promises.

So I go, look, it's a bad situation.

It couldn't get much worse.

You've got to, not only a-

Yeah, I should say those words.

Yeah, yeah.

Yeah, I say that.

You know, it's not only a malignant tumor, brain tumor, but it's in the worst part of

the brain.

I believe, and I trust your other surgeon who says that, you know, it's likely to kill

you in the next two months.

And you've got to trust him that he says it's inoperable because he truly believes that

surgery is not worth it.

Yeah.

Yeah.

Yeah.

It's not worth the risk.

The risk benefit ratio is not such that he should do it.

So you've got to trust him.

He's not doing it because he's a coward.

He's not doing it because he's scared.

He's doing it because he truly believes in your best interest, you should not have this

operation.

I'm going to tell you how I feel about it.

Okay.

So I've been operating on brain stem tumors for the last 20 years, 30 years.

I've had some fantastic results and that's why you're here, but I can tell you right

now that I've also had some terrible results and you might be one of them.

So I'm going to say to you this, that your tumor is operable.

I could take it out.

I truly believe it could buy you some time.

It may even cure you if it's not malignant.

You know, we might have got it wrong and it actually may be a benign tumor.

So there's this chance of cure still.

And if I can't cure you because it's malignant, then I'm hoping it can buy you some time.

Here's the problem.

The problem is that the risk is really high.

I'm talking about a standard risk for a standard operation.

Okay.

A standard operation is about 5%.

But with your tumor, I'm talking 40, 50% chance that you could end up much worse off.

And here are the four potential outcomes is a win-win, win-lose, lose-win, and a lose-lose.

And I go through those four outcomes.

Win-win is where I take out the tumor.

It buys you some time or it cures you.

Everyone's happy.

A win-lose is I take out the tumor, it doesn't make you worse, but it's malignant.

You're still going to die in three months anyway.

A lose-win is where I do the operation.

I'm very aggressive.

And you end up being worse than you were before the operation, but I've been so aggressive

it actually buys you time.

So it buys you time, but in a bad clinical state.

And a lose-lose, this is what I say to patients, thankfully it doesn't happen that often, but

I can tell you now there are patients out there who have lost-lost.

And a lose-lose is where I do the operation, you're much worse off than you were before

surgery.

You're not even dead or paralyzed and it doesn't even buy you any time, no advantage

at all.

And so you can fall into any one of those categories and, you know, and then I'll leave

it up to them.

Do you think that maybe, so the decision making process in that regard, those four outcomes

really depends on the individual and or their advisors or their trusted people who are around

them outside of the medical profession, their appetite for risk.

And everyone's got a different appetite for risk.

So if someone has a high risk appetite, in other words, I'm going for it, I've got nothing

to lose.

If you're one of those types of people, you're probably going to say go for it.

But if you're a person who has a low appetite for risk, just by personality, in the personality

sense, then you may not go for it.

Do you, just listening to you then, I am walking into the Messiah's room.

Yeah.

And you have this reputation, but you also got a, just sitting here now, you've got a

persona about you.

You come across as you do know what you're doing.

Yeah.

I wouldn't know what you know what you're doing.

I wouldn't have a clue.

I'm not a neurosurgeon.

But you just have this persona about you and it's not your fault.

It's just a thing.

Right.

I sort of want to believe you that you're going to do it.

Yeah.

Irrespective of my appetite for risk.

Yeah.

Do you think that you might be a...

victim of your own convincability, your own persona, your own confidence by virtue of

knowing and understanding and believing in what you do.

Yes.

Your own history, your experience.

And as a result of that, people do get convinced and do part with the hard earned and still

some will fall into the bottom two categories, irrespective.

Yeah.

Is that part, I mean, have you done some soul searching around that about Charlie Teoh,

who he is as a person, as a personality?

Yeah.

Yeah.

That's pretty heavy.

No, I haven't really thought of myself as some sort of guru, a messiah, but let's pretend

that someone thinks I am.

You don't think that, but I'm talking about perception of others.

Yeah.

Perception of others.

Yeah.

Look.

If you have that sort of personality, and if people see you as a person, then you're

going to be a mess.

You're going to be a mess.

You're going to be a mess.

You're going to be a mess.

Yeah.

If people see you as this sort of godsend, even though you might not be, then you're

absolutely right.

They could make the wrong decisions based on the fact that they're just taken by your

personality or taken by your confidence.

How do I get around that?

I get around it by basically not even, I wouldn't even recommend it.

I mean, most people would ask you, what would you do?

And I usually say, well, you can't ask me that because everyone's different and this

and that.

Yeah.

Yeah.

Yeah.

But if I'm in a patient's best interest not to have surgery, I will try and convince them

not to have it.

I won't take away the opportunity.

And the little girl in Singapore was a perfect example of that.

I'm sure you've seen my TED Talks.

And so that mother was an aggressive mother.

I really thought that tumor was malignant.

I didn't have my equipment with me.

The entire pediatric neuro-oncology world were in Singapore for a big conference at

the time.

And, you know, I'm sure they would have been waiting with their knives poised for me to

fail.

So I didn't want to do it.

I didn't want to do it for the patient's best interest because I really thought it

was malignant.

And I didn't want to do it for my best interest, both.

So when she said she wants me to do the surgery, I kind of exaggerated some of the downsides.

I said, look, there's probably only a 1% chance this could be benign and she'll do well.

Deep down inside, I thought it was a bit higher than that, but it was.

It was probably only about a 10% chance that she was going to do well, this little girl

was going to do well.

And so I didn't take away the option for her to have surgery, but I did try and convince

her not to have it.

So if I really think someone sees me as a messiah and they just, I'll either not recommend

surgery or I'll try and convince them otherwise.

I mean, for every patient that you've heard of that I've offered surgery to, there's an

equal number of patients where I've said, look, you know, I just would not offer surgery.

I'm sorry.

It's just-

It's inoperable.

I don't think it's the right thing.

No, not inoperable.

I just don't think it's the right thing to do.

Yeah.

So that inoperable thing, I'm glad we actually cleared that because that's not a term that

should be used.

No, it really shouldn't be.

It's just about outcomes.

Yes.

And because, you know, when I, I don't want to, you know, it's like you're levitating,

but to me, in some respects, because you've got that sense about you, me sitting opposite

me.

That's what I feel.

And I'm not sort of, you know, here talking to you.

Yeah.

Yeah.

I'm not trying to blow smoke up your ass.

I mean, just that's, that's the sense.

Okay.

I got Charlie Teo in my podcast studio.

That's a big deal for me.

Okay.

Because of who you are.

Right.

And then I say to myself, if I was desperate or I knew someone was desperate, just like

all desperate people, they tend to collect around cultish environments because that's

what those evil bastards in cults feed off.

Yeah.

Desperation.

And there's a lot of cults that exist in the world today and have existed that weren't

as a result of desperate people with nowhere to go.

And these evil bastards fed off that.

And to some extent, I feel as though the media is doing that with you.

They're sort of saying you create a cult around you.

You know, you make yourself cultish.

Right.

And that's one way you can destroy someone's reputation by saying that.

Right.

But I can sort of see why media might think that fits in terms of the narrative.

Right.

Because Charlie does have a person, persona about him.

There is something about you that makes me feel as though I trust a dude.

If he tells me this is the way to go, I'm going to go that way.

Yes.

And on self-reflection, I mean, do you know that about yourself?

Yeah.

Okay.

I just told you that.

Okay.

So I gave a talk at the Sydney Children's Hospital once and, you know, I was basically

trying to say to them, listen, you guys, you should let me operate because my results are

so good.

Yeah.

Yeah.

And the pediatricians at the back stood up after everyone was shaking their head going,

this guy's a bloody, you know, he's just a show off and this and that.

They didn't believe me.

He goes, Charlie, do you think that maybe you have these great results because you're a

healer and people just trust in you and you heal people rather than your actual surgical

technique?

And he said it as a criticism, not as a, against my-

Not an observation.

Not an observation.

And I've, I've, I've always thought about that.

I mean, I can still remember it.

This was easy 25 years ago at the Children's Hospital.

And sometimes I have to do, I have to do that.

I have to think about that because maybe people are wanting me to operate, not because, you

know, I'm the world's best surgeon, but because of the persona and they really believe that,

you know, I've got healing hands and the ability to heal.

Here's how I justify that.

I mean, whether you believe in placebo or not, if it works, it works.

So in other words, if my patients are living longer because I've got Charlie Teo looking

after them, whether it's my surgical technique or whether it's the fact that I care for them

and I, I make them feel important and I give them autonomy, it doesn't really matter what

it is.

They're living longer.

So the way I look at it is, you know, if it works, it works.

If you're having surgery by me, because you think I'm some sort of God like figure, some

Messiah, then, you know, so be it.

Yeah.

Yeah.

But you're not trying to promote it.

It's probably my point.

But you accept it.

You acknowledge that this is a possibility.

Yeah.

Because, you know, I'm a, I see lots of people in my business over a long span, I'm a little

bit old and new, long span of my life.

And I've studied, part of my thing is I study people, their faces, how they look, how they

sit.

Right.

And you have a symmetry, the fact that you don't have much hair, you have, you know,

the Asian eyes.

You have a tone to your voice.

A certain timbre to your voice.

You have a, um, a shape, all of which are in the category that I'm talking about.

That is, I believe you.

Oh.

You have, probably wouldn't matter what you did, you'd have become believable.

Oh my God.

When I was in college, Mark, that my flatmate, my roommate, uh, his, uh, father met me and

goes, oh my God, Charlie Taylor.

You're the sort of person who would lead a thousand people.

You're the sort of person who would lead a thousand people into Jonestown.

Well, that's not so good.

Oh no, no.

It wasn't that funny.

But, but, but I.

But you're saying the same sort of thing, yeah.

I get it.

Okay.

Yeah.

But so happens that you are extraordinarily skilled, you're extraordinarily experienced,

and, uh, you got the results.

Yes.

As well.

So when you add those two things in, it's quite compelling if I'm now looking where

I sit on the risk profile.

Yes.

Of what decision I'm going to make.

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

Yeah.

And I can also see that others may not have articulated it, others, being your critics,

may not articulate it that way, but they have this sense of, um, I fear that because we

all fear people who are in that position.

Right.

Because they can abuse it.

Right.

So some people might jump.

I jumped to the, I didn't jump to the conclusion, I just made an observation and I articulated

the way I did.

But others who don't articulate it, make the observation and say he's therefore potentially

evil.

Yes.

to go after him because they feel as though they have a mission

to achieve because I'm here protecting the whole of society.

Yes, protecting society, yeah.

And, you know, whilst their objective may not be on the money,

their objective is nonetheless just as noble in their mind.

Yeah.

Therefore, they go after you as hard as they do.

Yeah, yeah.

And that might extend right out into the profession.

It might also extend out into, you know, the institution

that runs your, you know, the medical profession

and all the administrators, et cetera, et cetera, et cetera.

And ultimately then it becomes a waiting game.

Where is the most weight?

Is it in the outcomes or is it in the convictions of those people

who are trying to do this noble thing?

Yeah.

That has stopped Charlie from doing what he's doing.

Yeah.

It looks like, well, where do you think it's landed now?

Sitting here, say, 64 years of age, had a career trying to help people.

Yes.

Where do you think it's landed?

Yeah.

Well, it's landed on their side, unfortunately,

because I can no longer practice in Australia.

People are dying.

Can I just take it one step back?

Yeah.

If I acknowledge that I could convince people to have surgery

when they maybe shouldn't have surgery,

then the way to get around that is to be honest about your outcomes.

Yeah.

So it's incumbent on that person, i.e. myself, to reflect.

You know, oh, gee, maybe I…

I shouldn't have done the last 20 operations because the outcomes are bad.

So let's have a look at my results.

So it's really, really important to have audit.

There's two ways that I've made sure that I don't get caught up

with my own sort of importance.

The first is by having fellows.

So in other words, fellows and neurosurgeons from around the world

who want to come and learn my techniques.

I've had the great privilege of teaching some of the best neurosurgeons,

surgeons in the world from the best institutions in the world.

So I've taught fellows from Johns Hopkins, Harvard, Yale, Barrow, Stanford,

you name it, they've all come out to work with me.

And the beauty of that is that these people aren't fools.

So I say to them often, you know, what would you do?

And at the end of the fellowship, what do you think?

And, you know, let's publish.

There's a particular operation that I've done that maybe I shouldn't have done.

Let's look at the results.

So that's the first thing.

Surround yourself with people who aren't yes men,

who have their own idea of what is right and wrong,

and make sure they have the strength and permission to tell you

if you're doing the wrong thing.

So that's the first thing.

And the second thing is to publish your results.

And that's really important because at the end of the day,

you might be deceiving yourself.

And, you know, if, for example, more than 50% of the brainstem tumors

I did had bad outcomes.

And you'd want to know that.

So, you know, it's incumbent on someone like me

who potentially might be doing the wrong thing

to make sure that you're doing the right thing by reflection and audit.

Audit being peer-reviewed.

Peer-reviewed journal articles with multiple authors

so that you can't fudge the results.

Just so anyone listening, but it also compels you

to actually sit down and write this thing.

And it's not something you do overnight.

These are detailed announcements.

These are detailed announcements.

This is a statistical analysis of data significance of significance

and like detail and process, you know, how you did it,

what you went about, what the patient was,

what are the statistical analysis.

These are very detailed things which you can't fudge.

Exactly.

You might hear in there, but it might not be out of application,

but if you're continually publishing, you're going to get found out sooner or later.

Yeah, yeah.

So this is a balancing act that you put out there amongst the profession.

Yeah, of course.

That's what you're saying.

Yeah.

Okay.

But not only that, when you think about it,

I've been around for almost 40 years now doing brain tumours

that no one else will do.

You can't be bullshitting the whole time.

Exactly.

Mark, I mean, at the last tribunal I said to them, I said,

okay, okay, okay, let's stop right here.

I've done 11,000 brain tumours.

Can we please talk about some of the good results and the publications?

She goes, the judge at the time, she stops me and goes, stop.

We're not here to talk about the 11,000 cases.

We're here to talk about the two patients on the table.

And so, but that's so unfair because, you know, those, I'm the first to tell you those,

the outcomes of those patients was terrible.

But, but, you know, when there's 11,000 other cases out there of whom the majority have done well,

I think that should be put into the equation as well before you start sort of persecuting someone.

But that, doesn't this happen in like, just not just in brain,

but I'm sure it happens in urology as well.

I mean, they say, we'll take it out and the next thing you know,

someone dies three or four years later from prostate cancer.

Yeah.

Because it's probably burst through the prostate or something.

Yeah.

Or there's been, or there's some other issue, you know, they knocked off the nerves.

No.

And then you can't pitch yourself all the time.

Don't get the feeling this is a fair system and what I'm going through is fair.

It's got nothing to do with fairness and what's right or wrong.

It's all got to do with people's agendas.

And, you know, the agenda is to destroy Charlie Teo.

And in answer to your previous question, they have succeeded.

So what's Charlie do from here?

Well, I still have this urge to operate and save lives.

I mean, there's, you know, I don't know why a particular journalist,

a particular newspaper, a particular show, 14 particular neurosurgeons

have taken on this task of destroying me and my reputation and my ability.

But as long as I understand they have blood on their hands,

I really want them to know that.

I want them to know that, you know, you might not like me.

You might want to destroy me and you've succeeded.

But there's not a day that goes by,

that I don't see a case that's dying or is going to die that I could save.

I mean, it's terrible what's happening.

You can't practice as a neurosurgeon.

What can you do?

I cannot practice as a neurosurgeon in Australia unless I have a hospital

that will give me privileges and credentialing.

Right.

And that's what the problem.

Look, even with the last tribunal, they came up with level C restrictions,

which means that you can still practice.

I can be a fully independent neurosurgeon.

I just need to get permission from some other surgeon

before I do these difficult cases.

So double check.

Turns out that they put criteria on that person

and the criteria is so strict that no one can be that supervisor.

No one can take the risk.

Yeah, no one can take the risk.

So I've gone around to, you know, all these neurosurgeons saying,

well, you're 20 years out and you do brain tumors.

Would you mind being my supervisor?

Oh, Charlie, I'd love to.

Get a call the next day.

Sorry, I can't because my malpractice insurance company says.

I was going for insurance, yeah.

Yeah, it says I can't do it.

Yeah.

And or they just don't return my phone call when I ask them.

So they put restrictions on me that were meant to be the least onerous

and where I could still practice neurosurgery in Australia.

But in fact, I think they knew that no one was going to be my supervisor.

In other words, I can't operate.

Is there a right of appeal to this tribunal?

Yeah, so we went to them and said, listen,

Charlie has tried to get someone to be a supervisor.

He can't.

Can you please find a supervisor for him?

Because after all, you're the one that put this restriction on.

They said, no, it's up to you to find one.

So where to from here?

Do you have to leave Australia, go to Singapore or US or some other place?

No, because the media has been so influential that in Singapore, for example,

the Singapore Medical Council saw the 60 Minutes stuff

and they saw the Sydney Morning Herald stuff

and they said that we're going to put your license on hold

until we investigate further.

Same thing in America.

So how do you feel about that now?

64 and not doing what you love.

I know.

And doing a really good job.

I mean, really.

I know that I've got this skill.

I mean, I know it.

I mean, I take out tumors that no one else can take out.

And all the surgeons around the world that watch me just are absolutely amazed by it.

So when I operate in other countries, I get four or five or 10 or 20 neurosurgeons watching

and they just are just blown away by it.

So I know that I'm really good at taking out tumors.

And I know that I still have the passion, the desire and the skills to do it.

It's just I can't do it.

So yeah.

What are you going to do?

Like, how do you feel about that?

Like, it must be pissing you off.

I mean, I mean, like.

Well, I'm not going to say anything now because there are some countries in the world that want me.

But the trouble is that that particular journalist has gone to those countries.

As soon as she finds out that I'm operating in a particular country,

they go and try and destroy my reputation there as well.

And so I'm not going to say anything.

But at this stage, a few countries in the world have are trying to seduce me to operate there.

So I'm hopefully.

I'm probably going to be able to operate in some other countries.

Hopefully, you're going to be able to save some lives.

Yes.

Apart from operating.

Yeah.

Being what Charlie was saying.

Yeah, because, you know, quite frankly, I don't even know why I want to do it.

It's brought nothing but trouble for me.

It's made me all stressed out.

It's taken.

I mean, it's just, it's been terrible.

But the trouble is when I see a case, like I just saw one yesterday,

a seven-year-old girl from Japan.

And she sends.

The mother sends me the x-rays and I know I can take it out.

It's a benign brain stem tumor.

I've done lots of them.

And so I write back to her and say, look, I can take this out.

She goes, yes, yes.

But I can't operate in Australia.

So unfortunately, I just can't do it.

I can't do it.

So she had a biopsy by a Japanese neurosurgeon.

The kid will die.

And I know it's a sort of tumor that is benign, curable.

I can do it.

But I just can't do it.

No one's allowing me to do it.

And would you allow me just to meet once a year?

I mean, why wouldn't Charlie just get on an airplane, fly to Japan,

sit and stand alongside the neurosurgeon in Japan who's going to do the operation?

You don't do anything.

You just say, dude, just a little bit to the left there,

a little bit to the right.

Is it robotic?

Is it done through robotics?

No, no.

No, it's all.

Yeah, yeah, yeah.

And that's what I'm doing.

In Spain, that's what I do.

You cut them open sort of thing.

Yeah.

So in Spain, I've trained two of the neurosurgeons there.

They're fantastic neurosurgeons, but they haven't got my experience.

So, yeah, I've been sort of going flying.

Going over to Spain, in the operating room, guiding them through it as an observer.

So you can be a trainer, so to speak.

You can be an observer, a trainer.

You can't lay hands on the patient because you'll need malpractice insurance.

And my malpractice insurance now is just so high that, you know.

It doesn't work doing it.

Yeah, yeah.

So that sounds like not a bad solution though.

Yeah, no, it's good.

That's what I'm doing.

I'm going around the world.

So mentoring people.

Teaching and mentoring.

But there are some operations where, you know, even if they're a good neurosurgeon,

they just can't do what you can do.

Yeah, but it's like everything in mentoring.

Even though they're good operators, they're never going to be able to do what you think

they should be doing.

And there'll be a bit of frustration in it.

But at least you're passing on your knowledge.

Because the most important thing societally is that Charlie Teo passes on his knowledge.

Yes, yes.

And it doesn't just get locked.

Yeah.

And loaded inside of you.

And we never hear from you again.

You're going to live up in Byron Bay or top of the mountains.

Yeah, I know.

I know.

So what would be best?

I don't know.

It just seems to be a great outcome.

If you could just work yourself way around the world, obviously get paid for it, but

pass it, pay it forward and pass it on to those people and don't touch anybody.

Because maybe at the end of the day, he's probably better off not doing it.

Yeah.

Well, look, I mean, yeah, you're very insightful.

Look, there are neurosurgeons in Australia who have the skills to do what I do.

I can promise you that.

There's one in Brisbane.

There's one in, two in Sydney.

There's one in Melbourne.

These are skillful, excellent neurosurgeons.

Very competitive.

So in the last two years where I've been unable to operate, I've been sending them patients

and saying, you know, can you please do this?

They haven't been able to do them because their colleagues have bucked up and said,

you know, you shouldn't do that.

It's too risky.

And in defense to them, they've, just to see what's happened to me, well, I mean, why would

you?

Yeah.

So the worst thing about what's happened to me.

It's a bad precedent.

Exactly.

The worst thing that's happened to me is the precedent, is the message it's sent.

Yeah.

It's sent a message to all those good, young, aggressive neurosurgeons.

They've got the skills and says, if you try and do what Charlie Teo did, this is what's

going to happen to you.

And so they're not doing them.

Even though they've got the skills to do them, they're not doing them.

Well, that's a loss.

I mean, it's a huge loss because, you know, it's really set neurosurgery back several

decades, what's happened to me, the persecution of me, because really, I'm telling you, the

level of neurosurgery in Australia could be the best in the world if it wasn't for this

whole tall poppy syndrome.

It's maybe one of the reasons we don't become best.

And we'll in some areas, because once you get to the top of the tree, they're going

to cut your legs from under you.

Yeah.

Yeah.

In a bad way.

I mean, you know, where they get some journalist or some media outlet to just absolutely gun

you.

And it's just terrible.

It's absolutely terrible.

Charlie, we're out of time, but I want to thank you for your honesty.

And probably the most important word you use for me the whole way through is bravery.

Yeah.

You use that word bravery because to make, to do the surgery, it takes bravery.

To make the decision to have the surgery, it takes bravery.

Yes.

And that's the one factor that I think that media narratives, societal narratives, tall

poppy syndromes, et cetera, does, they create a fear that kills bravery.

Yes.

Yes.

Fear overlords bravery.

Very often.

Yeah.

And I appreciate all the bravery that you've shown the whole time long, particularly for

those people who you have cured.

Yeah.

Thank you.

Thank you very much.

The one thing I wanted to bring up is that, you know, Jordan Peterson?

Yep.

Did you listen to his interview with Joe Rogan?

Yeah, I did with Joe, yeah.

Yeah.

So there's a podcast of him and he's going through the same thing as what I'm going through.

The Canadian Psychologist Board are now persecuting.

Yeah.

And it's all about, you know, he goes, hang on, until I got a profile, no one made any

complaints about me, but now that I've got a profile and I'm this, you know, sort of

famous celebrity psychologist, suddenly all these complaints can start coming in.

You know, that's that whole tall poppy thing where, you know, it's not about if you're

a good psychologist or a bad psychologist or whether you're helping people or not.

It's all about, they just don't like the profile.

You're too popular and pull your head in.

Yeah.

Thanks, Charlie.

Thanks, Mark.

It's been a pleasure.

Same to you.

Thank you for listening to another episode of Straight Talk with Mark Boris.

Audio production by Jessica Smalley.

Production assistants, Jonathan Leondis and Simon McDermott.

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