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THE SMART NEWS SOURCE | Feb 10 2012 22:48 | LAST UPDATED Feb 10 2012 22:48 |
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She was in blue jeans and a red T-shirt when he brought her to Wilgers Hospital east of Pretoria. He was a psychiatrist and expert on suicide, but it was too late, she was succumbing to her final overdose. To outsiders he was the worldly Professor Abubaker Gangat, the 55-year-old head of the psychiatry department at the Medical University of South Africa (Medunsa). But to Veronika Cernochova, though she was his student and only 29, he was "Abinko", the man whose bed she shared. Within the confines of their furtive relationship lay anguish and strife, perhaps the trigger for this last overdose. Lurking there too was potential professional consequence for him, for ethical boundaries crossed. Gangat was an expert, and he knew about Cernochova's depression and earlier suicide attempts. If anyone could have saved her, it was he. On the available evidence, however, he waited for perhaps an hour after she lost consciousness in his flat. When he finally acted he took her to Wilgers, 48km away, rather than the hospital on his doorstep at Medunsa or the main academic hospital in Pretoria, not much over half the distance to Wilgers. Why? Gangat maintained this week that he had been unaware she had "taken any medication or attempted suicide". Credible evidence points to a possibly different explanation: that he was motivated by fear of exposure, which weighed more heavily on him than her health. This is how Gangat failed his young lover: Before the month is out, she files an application for promotion to registrar, a specialising junior doctor.  CONTINUES BELOW By now, Gangat has been at Medunsa for over a year, staying at a flat in the doctor's quarters at Ga-Rankuwa Hospital. His wife lives in kwaZulu-Natal with the kids. Cernochova "refused to discuss with me any of her problems except that she was very depressed and had 'no home'" -- remedied some weeks later when Cernochova finds lodging with one Beatrice Föck in Waverley, Pretoria. Later, Cernochova opens up a little, confessing that she "longed for a stable, lasting relationship ... However, she refrained from discussing whether she had relationships." Well past retirement age at 76, Van Hoepen was a strange choice of caregiver. Gangat had kept him on as pharmacist and personal assistant. Van Hoepen's name also appeared along with Gangat's on the letterhead of Dr OA Sabadia and Partners, a private psychiatry practice in Pretoria. If the first rule of psychiatry is to have an arm's length relationship between doctor and patient, Van Hoepen's role defeated it: he was Cernochova's colleague, and Gangat's confidant. Föck, also on affidavit, describes Cernochova's return home: "I was shocked to see her, she was blue in her little face ... [She] came that evening to sit on my bed and cried bitterly so that the bed shook, she was terribly upset ... She repeatedly said that she was scared, and eventually told me that Prof Gangat uses her as his wife, and that she fears him." Professor Michael Simpson, then a consultant psychiatrist to the department, describes in his affidavit how Van Hoepen brought Cernochova to his place looking for new accommodation, seemingly following the same incident. He understood her to have been discharged early to defeat an attempt by physicians at HF Verwoerd compulsorily to admit her to Weskoppies Psychiatric Hospital. Simpson: "During the strange time that she was with us, I happened to see her alone for a short while, and asked her why she had discharged herself ... She told me that 'they' [Gangat and Van Hoepen] had not wanted her to be admitted to Weskoppies or to come under the care of the doctors from 'Pretoria' ... 'in case I start talking to the doctors there about things that I know'." Gangat this week denied being party to her discharge from HF Verwoerd, pointing out that there already she was probably under the care of Pretoria University doctors, who also cared for patients at Weskoppies. His relationship with Cernochova, he said, was "a private matter". But he denied unethical or unprofessional conduct as, he said, Cernochova was "never my patient". Gangat did not answer a related question about the appropriateness of his love relationship with her as his student employee. While Van Hoepen was formally her psychiatrist, Föck's affidavit describes how Gangat may have crossed the line: On visits, Gangat checked whether she was taking her pills, but she was reluctant. Once she took some pills he gave her, but refused to take one in particular. He responded: "You do what I tell you to do or I will chuck you away." Gangat sent her to bed, where he joined her. Ismail, Gangat's friend, says on affidavit that he, too, received a call at this time from Gangat, who said Cernochova had "taken pills". Although he does not give a time in his own affidavit, Gangat confirms calling Van Hoepen after Cernochova "fainted". This followed her "screaming and shouting that I must help because she was going to die. She would not explain why." Van Hoepen, he says, "informed me to contact [Dr Barend Vorster, a former Medunsa doctor then practicing at Wilgers Hospital] and said he was on his way." Vorster, on his version, recommends that Cernochova be taken to HF Verwoerd Hospital in Pretoria -- a 28km drive -- "immediately", to which Gangat "answered that he was afraid that they would certify her" -- commit her to Weskoppies. Vorster then recommends Wilgers. Gangat and Van Hoepen, both confirm, transport Cernochova to Wilgers -- a 48km drive. There is no explanation why they do not take her to the Ga-Rankuwa casualty ward, where she was taken at least once before, virtually next door to his flat. Postscript Gangat declined this week to detail the circumstances of Cernokova's death, or to say why he had not taken her to the emergency ward at Ga-Rankuwa Hospital adjacent to his flat. In an apparent attempt to deflect criticism of the up to two hours it may have taken between when she collapsed and he got her to Wilgers, he claimed that "as I was not her physician I was not aware of what medication she was taking or, for that matter, that she had taken any medication or attempted suicide. I can confirm that she would not explain to me why she was not well." Gangat's version is contradicted by the affidavits of Van Hoepen, Vorster and Ismail, each of whom stated he had told them she had taken pills. Vorster has confirmed the essence of his affidavit to the Mail & Guardian. Van Hoepen, the man with the most intimate knowledge of the events that night bar Gangat, died about 11 weeks after Cernochova, apparently after falling and hitting his head against a desk at Medunsa. A police investigation into Gangat's culpability in Cernochova's death was closed after a medical opinion that although "theoretically ... an immediate stomach wash could have terminated exposure", there was no "dogmatic" answer to whether earlier intervention could have saved her. TOPICS IN THIS ARTICLE
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