Irish Medical Lives

Dr Fergal Hickey, emeritus consultant in emergency medicine in Sligo University Hospital, where he was first appointed in 1995, is someone’s whose voice is familiar to every radio listener and TV viewer who is concerned with the functioning and state of Ireland’s emergency departments.At a national level, as well as being the official spokesman for his speciality, Fergal has long been primus inter pares, as it were, or the most prominent Irish emergency physician of his generation: in short, he has been President of the Irish Association for Emergency Medicine on no fewer than three periods between 2005 and 2022. Dr Hickey was a founding member of the working party for the national Emergency Medicine Programme and a Board Member of the International Federation for Emergency Medicine, and he has been the national director for the Advanced Trauma Life Support Programme in Ireland since 2006. In 2012, Fergal was awarded the Fellowship of the International Federation for Emergency Medicine in recognition of his contribution to international emergency medicine, and he received the Gautam Bodiwala Lifetime Achievement Award from the IFEM in 2023.In Autumn 2022, Dr Hickey memorably told the Irish media that the coming Winter would be “hell on earth” for both patients and hospital staff, if official projections for hospital and ICU admissions were correct. Hospital emergency departments had become “warehouses for admitted patients”, he said, and to make matters worse, staff didn’t want to work in a broken system, and as a result, the health service was “haemorrhaging” healthcare professionals.This podcast is genuinely essential listening for anyone hoping for a better emergency healthcare ecosystem in this country. 

Professor Niall O’Higgins, Professor of Surgery Emeritus at University College Dublin, he was Professor of Surgery at UCD and St Vincent’s University Hospital in Dublin between 1977 and 2007, President of the Royal College of Surgeons in Ireland between 2004 and 2006, and Professor of Surgery at the Royal College of Surgeons in Ireland, Bahrain, between 2008 and 2011.Since his ‘retirement’ from St Vincent’s, Professor O’Higgins has been the chairman of the University of Limerick Hospitals Group and the National Screening Advisory Committee, Co-Chair of the Interact-Europe Project, and a consultant to the National Cancer Screening Service. He has received many awards, including Honorary Fellowships of the Royal College of Surgeons of England, the American College of Surgeons, and other Royal and National Colleges of Surgeons in Glasgow, Greece, Singapore, South Africa, and Bangladesh, along with the European Society of Surgical Oncology, the Academie Francaise de Chirurgie and the President’s Medal of the RCSEd.He is - or has been - a visiting professor all over the globe, from the Europe to the USA, Australasia, and the Far East and has published over 300 articles and 20 book chapters, mainly on surgical oncology, thyroid disease and specialist training.Among his many achievements in surgical practice, those he cites with particular pride are the introduction of the first breast cancer clinic in Ireland, the Breast Check programme, the Advanced Trauma Life Support or ATLS course, the liver transplant programme, various clinical guidelines by the Royal College of Surgeons of Ireland including breast cancer management and trauma care, the European Board of Surgery Examination in Surgical Oncology, the Accreditation Council for Oncology in Europe and the Interact-Europe programme to develop interdisciplinary training for cancer specialists.In this episode of Irish Medical Lives, Niall recalls a happy childhood and school days, he talks of the importance of working in a county hospital as well as a world-famous London teaching hospital, he outlines the development of Ireland’s first dedicated breast cancer service (and his appreciation for the pioneering specialist nurses associated with the initiative), he reflects on the problems with ‘managerialism’ and explains why professors should be particularly concerned with the welfare of both patients and medical students (the future carers).

Professor Trevor Duffy, Consultant Rheumatologist at Connolly Hospital Blanchardstown in Dublin, is one of the best known ‘medical politicians’ of his generation, having started his political career as an NCHD during the health service disputes of the late 1990s and risen through the ranks to become President of the Irish Medical Organisation, in 2014. In this episode, the remarkably self-deprecating physician recalls his early years in Kilmacud and a small rural town in Iran, his time as the first Chief Resident in St Vincent’s University Hospital in Dublin and then Chef de Clinique in Geneva’s University Hospital, and his serendipitous route through an MBA to becoming Director of Healthcare Leadership at the Royal College of Physicians in Ireland. En route, we hear about the importance of mentors and good professional relationships, the vital role of teamwork, and the necessity of ‘dust-gathering reports’. Describing himself as a bit of a contrarian, he offers a case for following ‘the road less travelled’ (to Europe) and remembers how a ‘can-do’ attitude led to his transforming a hospital bathroom into an elegant office, with a little help from family and friends.

Professor Geraldine McCarthy is a Consultant Rheumatologist at the Mater Misericordiae University Hospital in Dublin and Professor of Medicine at University College Dublin. Geraldine undertook her Fellowship in Rheumatology at the Medical College of Wisconsin in the United States, where she developed her interest in calcium crystal deposition disease. Since then, she’s led studies into the biological effects of calcium-containing crystals in degenerative joint disease, atherosclerosis and breast cancer and has received research with funding from institutions on both sides of the Atlantic.She continues to have a busy clinical practice at the Mater and Cappagh National Orthopaedic Hospitals in Dublin, and is involved in ongoing international collaborative research with colleagues all over the globe. In addition to her extraordinarily prolific output of publications, editorial, review, committee and mentoring work, Geraldine was President of the Irish Society for Rheumatology for four years until 2023, and has won many awards, including the RCPI Institute of Medicine Bryan Alton Medal. Most recently, Professor McCarthy received the designation of ‘ACR Master’ at the American College of Rheumatology Annual Scientific Meeting, the highest honour that the College (ACR) can bestow. Geraldine was one of only three people from Europe to receive the award at this year’s ceremony in San Diego and the only woman.  In this podcast, Professor McCarthy pays tribute to several mentors, including her dad, Dr Donal McCarthy, former County Physician in Laois, Dr Daniel J McCarty, ‘a giant of rheumatology’ in Wisconsin, and her husband, Dr Dermot Kenny, who taught her ‘how to deal with men’! She also waxes lyrical about a particularly important comrade, Ms Anne Madigan, one of Ireland’s first research nurses, she offers crucial advice to young medical women about strategic career planning, and she recalls some chastening advice she once received about the high price that doctors’ children may unexpectedly pay for their parents’ ‘greedy jobs’. There’s also some hot-off-the-press guidance about the practical management of gout, ‘the most common form of inflammatory arthritis in adult men’.

Dr Philip Crowley is the National Director of Strategy and Research at the Health Service Executiveor HSE in Ireland. Originally a ‘public health trained’ general practitioner, he is also adjunct associateprofessor at the School of Health Sciences in University College Dublin, and adjunct faculty at theInstitute of Leadership in the Royal College of Surgeons of Ireland. His career path has beengenuinely remarkable, taking him from Nicaragua to Newcastle, Edinburgh and Dublin’s North InnerCity, by way of specialist training, multiple diplomas (including most recently in lifestyle medicineand positive psychology), and an extraordinarily broad range of public health medicine, generalpractice, journalism, advocacy and NCHD and other leadership roles.In this podcast, Philip pays tribute to his parents, and his wife, Emma, and to the hugely ‘therapeuticnature’ of West Cork, and he recounts how he - almost serendipitously - ‘wandered through a series ofjobs’ from leadership of Ireland’s NCHDs in the turbulent mid-1980’s to Deputy Chief MedicalOfficer, all the while recognizing that communities of patients and professionals are ‘great assets’ andthat, while significant progress is constantly being achieved (for instance, in Irish cancer andcardiovascular care), there will always be further advances to be made. Dr Crowley also touches onmany initiatives of historic and practical importance with which he has been closely involved, like theMadden Report, the National Office of Clinical Audit, the national public health response to therecent pandemic, the clinical services for the homeless and addicted at Merchants Quay Ireland, thereconfiguration of the emergency service in Roscommon and the work of Irish Aid in Africa. And,based on his own truly exceptional exercise regime and cultural calendar, Philip offers listeners one(distinctly challenging but apparently effective) approach to staving off boredom, burnout andpremature ageing: “Let all keep fit!”

Dr Aisling Loy, Consultant in Genitourinary Medicine (GUM) at St James’s Hospital in Dublin, is the national specialty director for GUM training, medical director of Himerus Health (a highly rated private STD clinic in Dublin’s Portobello), a lecturer in Trinity College Dublin and Medical Director for women’s health service and anti-human trafficking HSE clinic. In addition to being an articulate and charismatic advocate for her specialty, Aisling provides an in-reach service to the Coombe Hospital for pregnant women with HIV/STDs, she is Secretary to the Society for Sexually Transmitted Diseases, Ireland and director of the STI Foundation courses in Dublin.In this podcast, Aisling describes the ostensibly short but surprisingly challenging journey from a Convent Grammar School in Newry to Trinity College in Dublin, she offers powerful advice to young women in medicine (to think ahead and talk about having a family, and what that means in practice), she explains why she is so grateful to the ‘amazing, beautiful, energetic and enigmatic’ woman who is her own primary mentor, she provides a succinct but reassuring review of the epidemiology and management of sexually transmitted disease in Ireland, and she describes the remarkable SH:24 home-testing scheme in Ireland, which has proven so useful in terms of screening and ‘telemedical care’, while simultaneously addressing that age-old obstacle to GUM care – patient embarrassment. 

Professor Jonathan Hourihane, one of the world’s leading paediatric allergists, is Head and Professor of Paediatrics in the Royal College of Surgeons in Ireland University of Medicine and Health Sciences and consultant paediatrician at the Children’s Hospital Ireland in Temple St, in Dublin. He was previously Professor of Paediatrics and Child Health in University College Cork.Professor Hourihane graduated from Trinity College Dublin, in 1987, and he obtained his Doctorate in Medicine from the University of Southampton, in 1996, for his thesis entitled “Clinical and immunological features of peanut allergy”.In this extended podcast, Jonathan recalls his somewhat faltering start in medicine, following which ‘hard work’ and ‘deep study’ led to a joint first place in Final Med; he talks of the need to recognise when a ‘door of opportunity’ opens, often unexpectedly, and he reflects on a career that took him from Dublin to London, Southampton to Cork, and then back to Dublin. He doesn’t shirk controversy but offers pragmatic views on issues like Sláintecare, the new consultant contract and generous salary, the obstacles to efficiency so often embedded in consultants’ workplaces, and the vexed topics of medical recruitment and retention. And, for specialist and general listener alike, he provides a handy review of the practical management of peanut allergy, anaphylaxis, hay fever and rhinitis, while highlighting the important distinction between food intolerance and allergy.

Interviewees at the Irish Hospital Consultants Association (IHCA) Annual Conference in Dublin on Saturday, September 30th 2023: Professor Garry Courtney, Consultant Physician at St Luke’s Hospital in Kilkenny and the HSE National Clinical Lead for Acute Medicine Dr Rob Hendry, Medical Director, Medical Protection SocietyMs Eleanor Faul, Consultant General and Colorectal Surgeon Beaumont Hospital in Dublin, and Our Lady of Lourdes Hospital, in Drogheda Mr Greg Fulton, Consultant Vascular Surgeon, Cork University Hospital, and the Bon Secours Health System