Sydney neurosurgeon Charlie Teo has defended his decision to operate on a woman who was left in a "vegetative" state, during a fiery session of his disciplinary hearing.
Dr Teo is being cross examined on day four of the hearing brought by the Health Care Complaints Commission, on behalf of two deceased former brain tumour patients.
The Medical Council of New South Wales's Professional Standards Committee has heard Dr Teo believed he was right when he operated on one woman in her 40s who later died, despite two expert witnesses suggesting they would not have operated.
The committee previously heard from neurosurgeon Bryant Stokes, who described Dr Teo's rationale for operating on the woman in 2018 as "nonsense".
Dr Teo defended his decision as sound, but admitted he could improve his practices.
"When you judge a tumour as being surgically resectable and you get a bad outcome there is no-one to blame but yourself," he said.
"Of course you're going to reflect on your rationale."
Dr Teo grew increasingly frustrated during his evidence, often staring at the ceiling and talking over the health commission's barrister Kate Richardson SC.
Asked if he wanted a break, he responded: "No, I can operate for 26 hours at a time."
On Monday, the woman's husband gave evidence that Dr Teo told him his wife's chance of death from surgery was 5 per cent, and he considered that to be low.
Dr Teo, however, told the hearing he thought that was high, and that he also told the family there was a "100 per cent" chance of some degree of paralysis if he operated.
He said the woman had already made up her mind and wanted surgery with him "as soon as she entered my room".
Dr Teo was also questioned about whether he breached the privacy of another patient in his waiting room, by introducing her to the prospective patient as someone who had a successful outcome.
"You agree you did not have her consent?" Ms Richardson asked.
"I didn't have her written consent," Dr Teo said. "I had her implied consent.
"She's a friend, she's on social media, she's done interviews.
"She's given a talk at a high school down in Melbourne as a brain tumour survivor."
Before the hearing, Dr Teo was approached by a couple who'd driven from Melbourne to Sydney to greet him with a sign of support.
Samantha Halmoukos said Dr Teo operated on her "inoperable" cranial tumour three years ago.
She said he has operated on her four times, and three of the surgeries were done for free.
"They said six months. It's [been] three years, and I know it's going to be a lot longer," Ms Halmoukos said.
She believed Dr Teo was subject to unfair personal attacks by the medical fraternity.
"Every appointment I sat in with a neurosurgeon, Charlie Teo was put down," she said.
After the hearing Dr Teo thanked his former patients for coming from across Australia to support him.
"Do you really think they'd do that to support a callous, cold, money hungry, reckless surgeon? I just don't think so," he said.
"You start self-doubting after a while.
"You know, am I that person? Am I really that terrible person?
"And when you see all these people supporting you, it gives you strength that maybe I did do the right thing."
The hearing continues on Monday.
