Q. Assuming that things haven't changed since she ceased to be your patient is it your opinion that it would be in the interests of Mrs Klewer's health that her involvement in legal proceedings be kept to a minimum?
A. I think her physical condition deteriorates with - at high periods of stress which legal matters seems to cause her distress and I would - and my advice would be to reduce the legal matters as much as she possibly can."
29 As appears from the last answer in the passage just quoted, Dr Duguid expressed the view that Mrs Klewer's physical condition deteriorated at high periods of stress and that this was caused by legal matters. His advice was that, wherever possible, she should reduce her involvement in such matters.
30 I also note, as that passage will reveal, that as the result of the breakdown in the professional relationship between Dr Duguid and Mrs Klewer in March this year, he was of the view that he was not able to make a statement about what he described as her "current health status". Notwithstanding that statement, however, I would take it to be the position that any opinions that he expressed were at least referable to his knowledge of Mrs Klewer's condition as recently as March of this year.
31 Dr Duguid was cross-examined at some length by Mr Oliver. That cross-examination included, quite properly in my view, an approach by Mr Oliver based on information given to a Dr Gorman, upon which the plaintiff relied, which had not necessarily been available to Dr Duguid. For present purposes, this line of cross-examination commences approximately at page 62 of the transcript of 11 May 2009, and proceeds until page 66. Without descending to minute detail, the basis of the cross-examination was that Dr Gorman's opinion, to the effect that Mrs Klewer was fit and able to attend or to participate in legal proceedings, was based upon written material that emanated from her or which had been approved by her in long running and complicated proceedings in the Federal Court in which she is unfortunately involved. It was put to Dr Duguid that his opinion might have been different about Mrs Klewer's capacities if he had been aware of this material. He gave the following answer at page 62 of the transcript:
"A. I still would've been concerned that she would've suffered those other symptoms, chest pains, dizziness, fainting, shortness of breath, which at that stage hadn't been fully investigated, so I mean that's a hypothetical situation, but I think my advice still would've been not to partake in those legal proceedings until the problems, the next stage of that exclusion that we've talked about, the pathology."
32 As an aid to understanding, I note that the series of complaints and symptoms referred to in the course of that answer are redolent of the conditions referred to by Dr Duguid in his report of 19 September 2008.
33 Furthermore, it would seem that some at least of the exclusions to which Dr Duguid referred in that answer, in the nature of pathology tests and the like, have come to light since his September report. I take it to be an uncontested proposition at present in these proceedings that subject to any further or other material that may emerge, Mrs Klewer has not yet been diagnosed with any cardio-vascular or other physical pathology capable of objective assessment by chest X-ray, ECG, blood test or similar. That fact is not to derogate from the reality of her condition or conditions. This is referred to below.
34 As the balance of Dr Duguid's evidence in cross-examination reveals, he effectively changed his opinion from the one expressed in September 2008 to one that achieved more currency upon the basis of the hypothetical propositions put to him concerning the new material. For example, he agreed that Mrs Klewer could read and comprehend documents, as this further material would tend to suggest, but he retained some concern about her chest and abdominal pains and syncope, which she was getting a great deal of the time. He did however appear to concede that upon the basis of the further information put to him, Mrs Klewer would be able variously to understand submissions and questions (presumably in the context of a court case). Even though she may suffer from symptoms of the sort of which she regularly complains, Dr Duguid thought that Mrs Klewer would be able to attend court. As he said at transcript page 65, "[s]he would get symptoms but I think she would be capable of doing it."
35 Finally, for presently relevant purposes, at transcript page 60, Dr Duguid said:
"Owing further information I would say that the attendance before court will be that - cause her deleterious affects on her health but she should be capable of doing it."
36 This last answer was among the material to which Mrs Klewer specifically drew my attention in the course of her submissions.
37 Before leaving Dr Duguid's evidence I think it is important to observe that notwithstanding the fractured relationship that I have described then extant between him and Mrs Klewer, Dr Duguid struck me as a cautious and careful witness, who gave his evidence in a hesitating way and usually by reference to his clinical records, which he had with him in the witness box. The opinions that he expressed were in the first instance favourable to Mrs Klewer's assertions that she suffered from a stress related condition of a disabling nature and only when pressed by Mr Oliver, with the benefit of the further material, did he make concessions that in any way appeared to dilute the favourable views that he originally expressed. Dr Duguid struck me as a witness giving evidence in his professional capacity to the best of his ability and without any doubt truthfully.
38 The next person to give evidence was Dr Munro. Again perhaps unfortunately in the sense that it bespeaks a reoccurrence of Mrs Klewer's condition, but fortunately for the purposes of assessing the present application, Dr Munro was able to come to court almost literally from having treated Mrs Klewer within the previous 24 hours. His evidence is therefore very important.
39 At page 91 of the transcript on 12 May 2009, Dr Munro was shown Dr Spillane's report. Mr Oliver drew Dr Munro's attention to the fact that Dr Spillane's opinion, when he examined Mrs Klewer earlier in the day for presenting symptoms similar to those described by Dr Munro, was that she would be able to attend her court hearing later that day. Dr Munro was then asked the following questions:
"Q. When you discharged her from the hospital was she in the condition of a person who in your opinion, leaving aside the time, would have been able to participate in a court hearing?
A. It was - she was. I felt, in fact I was quite frank with Mrs Klewer, that the effective management of her symptoms would be obtained if she continued to proceed with the current court process and got through this time in her life".
40 I then asked Dr Munro the following question and he replied as follows:
"Q. Sorry, can I just understand that. She would be better to have these proceedings behind her, rather than continually confronting?
A. That would be paraphrasing it perfectly".
41 In the context of that evidence Dr Munro was further cross-examined by Mr Oliver. He gave the following evidence at transcript page 92:
"Q. At that time, would she in your opinion have been capable or incapable of reading and understanding a document?
A. She would be capable in my opinion, she'd be capable of reading and comprehending the content of a document.