Chris O'Brien AO 1952-2009

Professor Chris O’Brien. Photo courtesy of the Sydney Cancer Centre

When Professor Chris O'Brien was told he had a malignant brain tumour in November 2006, the renowned Sydney head and neck cancer surgeon refused to bow to his poor prognosis. No one who knew him was surprised. Over the years he had helped thousands of cancer sufferers fight off their own sense of powerlessness, loneliness and fear, and believed passionately in the power of being positive.

Honesty is an important medical ethic - but the one thing you never do is destroy a patient's sense of hope, he would stress to medical staff when he was director of the Sydney Cancer Centre at Royal Prince Alfred Hospital.

Becoming a cancer patient himself, the ultimate role reversal, was a huge challenge - and he never pretended it was easy. But he remained a vital, alert figure, only bemoaning the fact that as a result of his illness, he had lost his taste for good red wine. "And I've got a cellar full of the French stuff," he moaned to friends over lunch the day before his third craniotomy (which involves removing a piece of bone from the skull to reach the brain), in August 2007.

It was O'Brien's choice to go for a third craniotomy. That spirit of his, as well as his decency and compassion, made him a well known figure on Channel Nine's long-running hospital reality show, RPA - so much so that when the news got out about his cancer diagnosis, the network was flooded with emails and messages of support.

Christopher John O'Brien, who died on Thursday night aged 57, was born in Regents Park, the son of Kevin, a clerk, and his wife Maureen Healey, a teacher. O'Brien enjoyed telling people that he didn't come from a privileged background and was subsequently overwhelmed by the "fan mail" that came his way.

It was typical of the surgeon's absurdist sense of humour that after a while he started to joke that the goodwill messages were beginning to ease off and the bills were outnumbering them again.

He went to Parramatta Marist Brothers then studied medicine at Sydney University. He graduated in 1976 and married Gail Bamford, a physiotherapy graduate, in 1980.

Head and neck surgery attracted him because serious cancers in that area need careful treatment for appearance and quality of life as well as removal. Colleagues and patients were stunned that O'Brien, of all people, should get cancer but the surgeon pointed out that 33,000 people in NSW are diagnosed with the disease every year. The fact that he had become one of them was not exceptional, he stressed.

As well as running the cancer centre, O'Brien was also director of the Sydney Head and Neck Cancer Institute (which he founded) and clinical director of cancer services of Sydney South West Area Health Service, making him responsible for the needs of 1.3 million people. Before he took over as director of the cancer centre, he was head of the Department of Head and Neck Surgery at RPA.

O'Brien knew what he was facing. His type of cancer, a grade-four glioma, also known as a glioblastoma multiforme (GBM), is the most aggressive of the primary brain tumours, and the one with the poorest prognosis. "It has a very, very capricious reputation for being, you know, relentlessly lethal - not absolutely 100 per cent inevitable, but statistically, the odds are weighted strongly against me," he said in 2007. "You don't accept the statistics. You say, 'Well, within the statistics there's hope,' and you seek every treatment that will be of benefit."

Gail O'Brien was sitting by her husband's side in hospital after his first craniotomy, when Frank Sartor, the then minister assisting the health minister (cancer), telephoned, asking how surgery had gone.

Gail thought her husband was asleep. He wasn't. He opened his eyes and said: "Tell Frank I'm going into politics. I'm perfect for it now I've got only half a brain."

During his first round of radiotherapy, in December 2006, O'Brien had treatment at the same time as one of his patients, a man in his 60s. His heart went out to his former patient, who lived alone and had to catch two buses to get to RPA. On Christmas Day, the surgeon brought his former patient home to spend with the O'Brien family.

His big dream was to see a comprehensive cancer centre built in Sydney, modelled on those in the United States. O'Brien worked in a cancer centre in Alabama during the 1980s and, even after he became ill, continued to lobby for a similar set-up here, concentrating world-class research, diagnosis, clinical trials, cutting edge treatment and cancer support services under one roof instead of fragmenting them through numerous hospitals and facilities.

In April this year, the Prime Minister, Kevin Rudd, committed $100 million to an integrated cancer treatment and research facility, Lifehouse, adjoining RPA.

O'Brien's work in the management of head and neck melanoma, salivary gland tumours, mouth cancer and metastatic cancer in the neck had brought him as much recognition overseas as it had here.

In 2005, he was made a member in the Order of Australia; on Monday he will be appointed an officer in the order. In 2007, the American Head and Neck Society announced it was establishing the Christopher O'Brien International Lecture.

The surgeon was a warm, wickedly funny man, a keen reader who loved talking about books and writers, and whose literary tastes ranged from meditations of the Roman emperor Marcus Aurelius to Cormac McCarthy's The Road.

But most of all he loved being with his family. The most important part of the day, he used to say, was coming home in the evening and "de-briefing" with Gail, and whoever else happened to be at home, over a glass of red wine.

He told the Herald on Wednesday that his work had prepared him for the disease and for death: "I think inevitably I'll die of this and I'm not frightened of dying. I'm at peace with my situation, I'm not willing it to come quick but it will come soon enough."

Chris O'Brien is survived by Gail and their children, Adam, Juliette and James.

Nikki Barrowclough
By permission of the Sydney Morning Herald