Dr Donald L Butler MBBS FRACP

Academic & Work History

Undergraduate: University of NSW, St Vincent’s Hospital Sydney
Intern/Residency: St Vincent’s Sydney
Paediatric Training: Prince of Wales Children’s Hospital and Royal Alexandra Hospital for Children Camperdown Sydney.
Senior Lecturer in Paediatrics: Westmead Center, Dept of Paediatrics.
Mt Druitt Hospital, initiated paediatric Department when the hospital first opened.
Visiting Paediatrician to: Sydney Adventist Hospital WAHROONGA, Hills Private Hospital then Norwest Private Hospital.
Present: Private rooms Mt Druitt Sydney.

Paediatric Health Education

Established the Paediatric Health Education Unit while at Westmead Centre. Organised public seminars for parents on common the paediatric conditions, especially Asthma.

Designed and wrote educational single page handouts for parents on the common paediatric conditions. While these educational handouts are now common this was innovative at that time. Eventually distributed/sold over one million to GPs to use in their private rooms.

While at Mt Druitt Hospital, wrote and distributed monthly newsletters to local GPs informing them of the current epidemics, gastro, RSV, croup etc. and recommended management strategies. 1988 to 1991

Educational “Newsletter”: Topical, interesting, and informative single page “Newsletters” discussing aspects of Behavioural Paediatrics. Included with patients’ letters to referring doctors, ongoing.


Analysis of the yearly admissions to Westmead Paediatric Ward. 1980 to 1982. This was undertaken to understand admissions patterns and so plan future workload for the unit. Booklets of the analysed monthly admissions for the common conditions as well as age, sex and length of stay for these conditions were printed.

Presently doing a clinical review of all patients, >150, that I have prescribed Intuniv to over the last 2 years. To measure its effectiveness, its side effects, the types of behavior most responsive to it and optimal dosage.


Worked for the ICRC, International Committee of the Red Cross, in Thailand in a refugee camp for Pol Pot survivors. Nov 1979 to Feb 1980.

Recently involved with Family planning in Papua and New Guinea.

Electronics: design and commercialization of a personnel device to better monitor and manage asthma/ respiratory conditions. Ongoing.

Present Interests

My present clinical interest is human behaviour, the neuroscience underlying it and optimal ways to intervene if needed. The human Pre-Frontal Cortex is probably the least understood area of the human body, but it is also the most complex and interesting. It is the area from where consciousness emerges, from where all the extraordinary achievements of civilization is imagined and then enacted. It is what makes us human. It is also where most psychiatric conditions arise. Understanding its functioning gives insight into who we are.  (It is more interesting than the heart, a pump, or the lungs, a gas exchange organ.)

Psychology is mostly the study of the outcomes of Prefrontal cortex function and the interventions to change outcomes. I however am intrigued by the building blocks that enable these outcomes. Chess illustrates the relationship of building blocks to outcome. The myriad outcomes possible in a chess game is the result of a small number of pieces interacting. Each chess piece’s individual abilities are limited but their interactions with other pieces creates the wonder of each game. Describing a particular chess game is similar to psychology when it describes human behaviour. Many chess games start out the same way, but as the game progresses any deviance from the usual results in a completely different trajectory for that game. No wonder so much psychological research is contradictory and confusing as each person’s unique environment impacts the interactions causing a multitude of different outcomes. By understanding how individual pieces interact with others gives a better understanding of why different trajectories occur. To better understand human behaviour rather than just describe human behaviour it is necessary to know about the building blocks and their interactions.

I have also found System Science and especially its insights into Complex Adaptive Systems enlightening. Not only does System Science help explain stock market crashes, weather events, or wars, it emphasizes and characterizes the phenomenon called Emergence.  Emergence is a higher-level outcome that arises from the micro level interactions in complex adaptive systems. System science gives a theoretical basis to many seemingly unexplainable occurrences. Consciousness is an example of strong emergence arising from the immeasurable number of interactions occurring in the prefrontal cortex while we are awake. Complementing these insights is the discipline of computational science as pioneered by Stephen Wolfram. This discipline explains how simple programs/interactions can create complex seemingly supernatural outcomes. Many outcomes from these interactions are random, thus making predictions theoretically impossible. Trying to predict the unpredictable is a trap seductively easy to fall into. Statistical methodology that assumes a normal distribution, for example using these methods to predict “100-year” floods, stock market crashes, climate change or human behaviour will give erroneous results.  Unfortunately, medical science craves certainty and medical statistics based on the normal distribution curve gives the illusion of providing that reassurance. I looked for an explanation when a recent Cochran review into methylphenidate’s effectiveness was inconclusive and it then received widespread negative publicity criticising, methylphenidate, Ritalin’s effectiveness for the treatment of ADHD. It became obvious that the measuring instrument that was used was invalid. This set me on the path to look outside the usual explanations and look to other disciplines to explain human behaviour and how best to describe and understand it.

  1. Hidden Order, how adaption builds complexity. John Holland Basic Books 1995
  2. A New Kind of Science, Stephen Wolfram 2002 Wolfram Media.
  3. Neuromodulation of prefrontal cortex cognitive function in primates: the powerful roles of monoamines and acetylcholine Roshan Cools and Amy F. T. Arnsten. Neuropsychopharmacology; https://doi.org/10.1038/s41386-021-01100-8

Associations & Memberships