In a letter published in Fairfax Media newspapers Dr Sallie offered his expertise to help the Cardinal get home. Reached in Western Australia, Dr Sallie admitted he was something of a veteran newspaper letter writer – his own mother even receives death threats, presumably meant for him, from time to time. Of what spurred him to prose, Dr Sallie said: "I'm just a physician, I have nothing to do with this story, but I've had a lot of patients who have, for one reason or another, [such as] sexual abuse, or abuse within the church. "You read what's gone on in Ballarat, you read the litany of destruction that's occurred as a consequence of these people, and you get outraged at it."

Dr Sallie is an atheist, and says he would not know the Cardinal "from a bar of soap". But he – and several other doctors he has spoken to – feel a keen sense of injustice at the Cardinal's decision not to attend the hearing. "It seems to me if he's able to carry out his job as senior financial controller of the Catholic Church then he's probably fit enough to travel," Dr Sallie said. "He's clearly evading coming back and speaking to the Commission, and that shows absolute contempt for the people whose lives have been trashed as a consequence of what's been done." "It seems to me if the US can transport troops from Iraq with their legs blown off back to Germany for treatment, it would be no problem transporting Cardinal Pell." If his offer was declined by the Vatican, Dr Sallie suggested the PM's private jet could also be made available "to bring him back in extreme comfort".

Cardinal Pell was excused from appearing in person after his medical records were tendered to the Commission's chair. "I have always expressed my willingness to assist the Royal Commission in its work," the Cardinal said in a statement at the time. "I have appeared on two previous occasions and many months ago made it clear I was willing to appear again. "While my plans were always to make the journey home to appear in person, my doctors have made it very clear that at the present time my health prevents me from undertaking long-haul travel. "I wished things were different, however I am pleased after receiving the latest medical reports last week, the Commission has now decided to agree to hear my evidence via video link from a professional conference facility in Rome."

A hearing held in Sydney on Monday was told that Cardinal Pell suffered from heart problems. Part of a medical report from an Italian specialist was read out, saying that Cardinal Pell suffered from hypertension, ischemic heart disease complicated by a previous myocardial infarction, and cardiac dysfunction related to the arterial hypertension.



A cardiologist who did not want to be named said Cardinal Pell's doctor would be most worried about his cardiac dysfunction - a condition that causes "heart failure". The symptoms of this failure often include breathlessness, especially with physical exertion. While there is a spectrum of severity with cardiac dysfunction, and some people with the condition do fly, the cardiologist said most people with it are advised not to fly because of the risk it will worsen their condition. Cardinal Pell's doctor probably factored in the emotional stress of the journey, too, he said. Loading "These are people who struggle to get travel insurance," the cardiologist told The Age. The doctor said when flying on long haul flights, the oxygen tension is the equivalent of about 3000 metres (the top of Mount Kosciuszko is 2280 metres), causing the amount of oxygen in your blood to reduce. This can affect somebody's heart function, especially if it is already weak.

