Medical Alumni Newsletter 2010

Medical Alumni Newsletter 8

May 2010 Contents P1 Diary in Pictures Diary in Pictures

P2 Introduction UCC Medical Alumni Scientific Conference 2009 P3 Two Outstanding Medical Graduates Honoured by UCC

P4 UCC Medical Alumni Meeting St John’s Newfoundland

P6 A medical delegate on assignment with the Dr Mike Henry, Dr John Coulter Prof Paul Finucane, Prof Brendan Buckley International Committee of the Red Cross

P8 What’s New State Side?

P10 “The best way to predict the future is to invent it”

Dr John Casey, Dr Brian O’Mahony, Dr Eamonn Shanahan Dr Pat Sullivan, Prof Noel Caplice, Dr Dan O’Mahony, Dr P12 Memories of an Applied Paula O’Leary, Dr Liz Kenny Physiologist

P14 Change is on the way for the Health Service in Cork and Kerry

P16 Interview with Dr Con Murphy

P17 Professor Fergus Shanahan Dr Paddy Ryan, Dr Sheila O’Neill, Prof David Kerins Prof Noel Caplice, Dr Mary Cahill awarded “David Sun” Lecture

P 18 North Infirmary Revisited

P 19 Book Review

P 20 Fire & Ice - A Photographic Journey of Antarctica

Dr Denise Deasy, Dr Pat Cogan, Dr Hilda Fennell, Dr Dr Margaret Lynch-Nyhan, Dr Donal Nyhan P 21 Appreciations Helen McGrath, Prof Gerry O’Sullivan, Dr Pat Devlin

1 Dr Will Fennell

Introduction Welcome to the eighth Newsletter. We are grateful to our many contributors who have shared their experiences with us. We also should acknowledge the outstanding presentations at the Annual Scientific Conference last year – one could not ask for a more interesting programme and we hope as many as possible will gather again in September (16 and 17) for this year’s get together, which also marks the Inaugural Joe O’Donnell Memorial Lecture.

You will also see the continuing efforts Fergus Moylan brings us up to date processors, PubMed, interuniversity done on the international scene by from the US and down to earth with library loans, etc and with his busy Prof Eamon Quigley and Prof Fergus his insightful piece on bipolar workload one can only marvel at this Shanahan recognised by their peers in depression and its potential role in achievement of a remarkable man, the award of the David Sun Lecture. suicide in the young, an ever whose example led to an extraordinary Eamon was the recipient of the increasing problem in our student number of UCC graduates following a Medical School Medal and population. A better insight will surgical career in Ireland and Distinguished Alumnus Award for hopefully lead to improved recognition overseas. 2009. of the problem and lead to better preventive strategy. We also include obituaries on recently Dr Con Murphy was recognised for his deceased and much loved and outstanding voluntary contributions to John Good recounts his experience as respected colleagues, Pat Beausang, UCC and Irish sport in general. You a delegate in the International Red Cal Condon, Derek McCoy and Fred will enjoy the interview with Con and Cross (and as our silent ambassador). Moore. Paddy Crowley. It is a long way from academic centres of excellence and private practice but We will also welcome contributions Katy Keohane recounts for all the one cannot but stand back and admire from Alumni or friends of UCC for memorable reunion for the Class of 74 the work done by so many under future editions and will look forward to held in St John, Newfoundland and difficult circumstances and follow the welcoming as many as possible to hosted by Benvon and Pat Parfrey and ideals of Albert Schweitzer for the Class Reunions in UCC in September their colleagues who have left their betterment of mankind. (to coincide with our Annual Scientific indelible mark on the Canadian scene Conference on September 16 and 17) and as our ambassadors we have Carol Dundon has revisited the North or at any other time of year. basked in the reflected glory. infirmary ("North Cha") and will bring back happy memories to many. The College and Faculty is grateful for Frank Golden recounts the memories the very generous response to the of an Applied Physiologist where new Michael Hanna has outlined the recent Ainsworth appeal. To date frontier research has led to benefits daunting task of reconfiguring services €9,000 has been raised. for humanity in improving survival within our acute teaching hospitals in after cold water immersion. I don't Cork and Kerry to better cope with the I will shortly contact all Alumni to think John Sheehan could have asked challenges of today and hopefully appeal for your support to our Alma for more from one of his outstanding provide a better service to our patients Mater in whatever way you can students. in the future, I personally hope we can contribute now or in the future to have a united university hospital on nurture further development of our Gerry O’Sullivan has detailed for us, three sites bringing the best of the old proud heritage in these difficult times with typical understatement, the and new together, under the banner, and repay our debt to our teachers and remarkable ten year journey of the United Colleagues of Cork. those who sacrificed so much to give Cork Cancer Research Centre. It is an us such an outstanding preparation outstanding story of innovation and Pat Gaffney and classmates have and opportunity. hard work inspired by one man with combined to "rereview" the Textbook of vision and determination, of whom all Surgery of Prof Patrick Kiely, first in UCC can be justly proud. released 50 years ago, and reached a second edition. In the absense of word

2 Two Outstanding Medical Graduates Honoured by UCC

Last December, two outstanding medical graduates were honoured by UCC and the College of Medicine & Health at the annual Alumni Awards Evening.

Professor Eamonn Quigley was recognised with an Alumnus Achievement Award, as a leading international expert in the field of gastroenterology. On the night, Professor Fergus Shanahan, Head of UCC’s Alimentary Pharmabiotic Centre (APC) delivered the encomium for his friend and colleague.

UCC President, Dr Michael Murphy presented Dr Con Murphy with the inaugural Alumnus Award for Voluntary Services to UCC for his outstanding voluntary contribution to UCC GAA and to Cork GAA over the past forty years.

PROF EAMONN QUIGLEY is Professor of Medicine and DR CON MURPHY combines his busy general practice in Human Physiology at UCC and is Principal Investigator at Cork City with his commitments to UCC GAA and his deep the Alimentary Pharmabiotic Centre (APC), UCC. He serves involvement with the Cork County Board GAA Inter-County as President of the World Gastroenterology Organisation Teams. He has been Doctor to Cork Senior Football and & (WGO-OMGE) and is the immediate past President of the Hurling Teams since 1976. He has a national reputation American College of Gastroenterology. His major research for excellence as a volunteer in Sports and his commitment interests include motility, functional gastrointestinal to County teams is unequalled throughout the country. He disease, eurogastroenterology, gastroesophageal reflux is currently President of the UCC Gaelic Football Club and disease and probiotics in health and disease. He has has been involved with the Club either as a selector or published over 550 original papers, reviews, editorials and medical officer since the early 1970’s. Highlights with book chapters, and has received numerous awards and the Club include being team selector in 1973 and 1999 accolades for his work. The Alumnus Achievement Award when UCC won the County Championships. The 2009 from the College of Medicine and Health was sponsored by Alumnus Award for Voluntary Service to UCC was sponsored Boston Scientific. by Henry Ford & Son Ireland Limited.

3 Dr. Catherine Keohane

UCC Medical Alumni Meeting St John’s Newfoundland Aug 26th 2009 (Combined with class of 1974 reunion) A group from the class of 1974 celebrated their 35th reunion combined with a Medical Alumni Scientific meeting in St. John’s, Newfoundland, Canada. Our hosts were Pat and Benvon Parfrey who organised what can only be described as an outstanding and memorable trip, with the strong support of their UCC colleagues in St John’s, Brendan Barrett, John Harnett and Eilish Walsh. The meeting started officially on Wednesday August 26th with the Scientific Session at St. John’s Hospital, where the Hospital and Medical School of Memorial University are combined. Coming from the cramped conditions in CUH, the layout of the hospital with loads of car parking and plenty room for expansion, one was jealous of the feeling of space. The meeting included local and Irish speakers on a variety of topics. We started with a talk by Adrian Honan on the organisation and running of a Primary Care Centre by the Primary Care Team in Portarlington. The role of the Multidisciplinary team with Doctors, Gary Lee, Pat Parfrey. Dan Burke, Barry Oliver, Kathy Honan, Adrian Honan, Benvon Parfrey, Practice Nurses, Physiotherapist, Katy Keohane, Judy Burke, Mary Lee, Donna Oliver, Charlie Mc Carthy, Marie Rabette. Pharmacist and Dietician and the collection, of scenes depicting life in malignant glioma. need for frequent team meetings for the region, where many people lived in good communication were stressed. In small settlements clustered along the The difficult management of an Portarlington, this has resulted in a coast. Their livelihoods depended unusual case of recurrent successful venture for both those largely on the sea, including sealing, hypercalcaemia due to parathyroid providing and receiving the service. whaling and cod fishing, now largely carcinoma was described by John diminished. Harnett with a relatively successful The next talk by Pat Parfrey described outcome in the patient. Benvon the multidisciplinary approach which Brendan Barrett then gave the results Parfrey then discussed the provision of had been taken to study a number of of a very large regional Canadian study teleradiology services to a vast area of diseases affecting the populations of to assess the significance of outlying centres in Newfoundland and Newfoundland and Labrador. This biochemical markers of early renal Labrador, with examples of cases from relatively stable population is capable failure in apparently well individuals in her own specialty of Paediatric of being traced back to a small the community. The focus was to Radiology. This latter talk included number of founders, so that the assess the need or not to refer to a impressive information on the kindreds affected by a number of nephrology service. commitment and enormous economic genetic disorders can be accurately investment of the Canadian Health screened both clinically and My own contribution was next on an Service to a single electronic patient genetically. This has led to Update on Brain Tumours with record. identification of certain target genes, emphasis on the still very bad clinicopathological correlation of prognosis in High Grade Malignant As usual with UCC Alumni Scientific genotype and phenotype and Gliomas which are increasing in Meetings, it was the exposure to topics monitoring of treatment and incidence as the population ages, and and specialties outside one’s own intervention. Pat used a familial the role of molecular markers in which was so interesting as well as the cardiomyopathy to illustrate the type targeting chemo and radiotherapy. talks themselves, and they generated of approach taken by the research There was a very timely interruption by vigorous discussion. The contrasts teams in Newfoundland, and Gary Lee, who told the group that his between the Canadian Health System illustrated his talk with beautiful internet phone had just informed him and the HSE were striking. paintings, many from his own that Ted Kennedy had just died of a After the science there followed a

4 wonderful lunch downtown and the The icing on the cake was Saturday first of a series of trips around the when the sun came out strongly and Avalon peninsula of Newfoundland, we toured around Bull’s Bay in taking in Signal Hill with its O’Briens boat. We not only breathtaking views over the bay and experienced the coastline from the the adjoining hills. One was reminded sea, but followed a rare Minke whale of the Kerry coastline, but with the which dived and surfaced close to the distinctive wooden brightly coloured boat, to our great delight. We also painted houses of St John’s and circled around Gull island, where perhaps a more “savage” landscape. colonies of puffin, gulls, kittiwake, and The steep cliffs resembled the other seabirds nested. Unlike the Judy Burke, Adrian Honan, Harry Comber, Marie Rabette, Gary Lee, Dan Burke, Donna Norwegian fjords. We were blessed Skelligs, gannet were not in evidence. Oliver, Mary Lee, Katy Keohane, Pat Parfrey, with good weather although strong Barry Oliver, Charlie McCarthy, winds persisted, the tail end of Most of the group went on to other Benvon Parfrey at Cape Spear. Hurricane Bill which had blown locations or returned to Ireland on through the previous Sunday, when the Saturday. The general consensus was airport was closed. No ice floes in the that the trip was a wonderful success. harbour, they had gone, along with the My own view is that none of us would humpback whales before we arrived. have gone to St John’s if it had not been for the generous offer by the Over the next few days we took trips UCC Alumni there to host a meeting around the region visiting the most combined with our class reunion. easterly point in N. America, Cape Thanks to the exceptional hospitality Spear (see photos), “The Rooms” of the Parfreys and their colleagues, museum located where the cod and we not only had an excellent Scientific seal fishermen stayed, and learned meeting and caught up with other Adrian Honan, Pat Parfrey, Benvon Parfrey. about the medical services to the Alumni activities, both professional, “outposts” distant stations where life family and social, but we got to visit a was very hard and a living from the beautiful part of the world with a sea was eked out under the dictat of history of hard survival of its people, climatic conditions, contending with many of whom trace their origins to ice and storms. Ireland. For those who travelled, it was a fantastic and enjoyable trip, for We were royally entertained chez those who did not, you really missed Parfrey, where the combined interests out! of medicine and rugby were evident. The most recent early pensioner Gary Lee delighted us with an after dinner Brendan Barrett, Pat Parfrey. talk which recalled the wilder and funnier episodes of our UCC days with just the right mixture of fondness and irreverence for our teachers. Modesty forbids me retelling some of the accompanying jokes, besides I can’t compete with Gary’s talents as a mimic.

On Thursday evening we took a bus to the Bay of Conception and watched the sunset as we had a tasting menu Katy Keohane Judy Burke, Barry Oliver, Katy Keohane. with accompanying wines in restaurant “Atlantica”, worthy of at least 2 Michelin stars and most unexpected in such a location.

On Friday there was golf in the inland course of Clovelly for the hardy surviviors of the night before, hosted by John Harnett. The strong winds against us provided the perfect excuse for any stray shots. Friday evening saw Marie Rabette, Kathy Honan. Joe Curtis, Gary Lee. us dining again in great style at a Japanese inspired “Mashu”, a triumph of presentation and taste with wines to match.

5 Dr. John Good

A medical delegate on assignment with the International Committee of the Red Cross ‘Until he extends his compassion to include all living things, man will not himself find peace’. Albert Schweitzer, Nobel Laureate. Expect the unexpected. This may well have been the mantra with which all delegates set forth to distant conflict areas, when accepting a mission with the Swiss humanitarian organisation, founded by the Geneva based business man Henri Dunant in the mid nineteenth century. Doctors who volunteer their services to the International Community of the Red Cross (ICRC) do so as part of a specific remit to work within a multi- disciplinary team, either as surgeons or anaesthetists at a field hospital near to a battle zone, or as medical delegates coordinating urgent health action into the field where civilians need health protection, shelter and basic primary care. In other actions, under the auspices of the Geneva Conventions and their Protocols, medical delegates accompany Protection Teams to visit political prisoners across the Globe. The Geneva Conventions, of which the ICRC are the guardians, permit (under Dr John Good international humanitarian law) the right of access to persons detained by a State on grounds of national mystery to this day how such a and parting company with a cherished security. ICRC delegates are privileged seemingly bizarre idea led to a Waterman fountain pen, ‘borrowed’ by to visit these persons without any frightening detachment from the an immigration control officer. First witness or guard being present, and to reality of the ‘here and now’ to pursue lesson. Travel light and carry nothing take details of their circumstances and tropical medicine studies in Dublin of value! Then on to the Turkana conditions of incarceration, and ultimately be assigned as a desert base with its airstrip and a field endeavouring wherever possible to medical coordinator with the Red hospital with a capacity of some 350 ameliorate suffering. The same Cross to South Sudan, where civil war beds during emergencies. A team of privileges are extended to the ICRC to and internecine strife had raged for six primary care nurses with public visit prisoners of war and ensure their almost twenty years. health and midwifery training, safety and health under the terms of principally from Europe and the Geneva Conventions. I flew to Geneva and had what may be Australasia, provided an incredible described as an intensive, if short service with the minimum of It all began with a book, lying on the briefing over a few days on the equipment to isolated villages dotted hall table at my parents’ home. The ‘situation on the ground’, the logistics, over South Sudan, when fighting had biography of Albert Schweitzer, the health care and self care and the receded and the area was deemed philosopher, theologian, musician and scope of my responsibilities. This temporarily free of hostilities. For the doctor who founded a leprosarium in would entail arranging the evacuation next two years home was a stone Lamberene, Gabon, on the West coast of wounded combatants, almost always floored, whitewashed mud and of Africa, had riveted my attention. I by air in small aircraft capable of short thatched tukul in the Turkana Desert, was happily doing my GMS thing in Co landing and takeoff, from the battle in a sheltered compound surrounded Kildare, married to a wonderful lady zones to a safe location across border by local native Turkana people. Some and rearing a family of five sons. where a field hospital had a team of were employed as local staff for Suddenly I was beginning to think surgeons on standby. Initially I flew to domestic work but otherwise there was long and hard, what would it be like to Khartoum for more intense briefing, no direct contact with the local undertake such work? It remains a passing through Cairo airport en route people, since the team was mandated

6 to work in the conflict area across the fire in the field itself, considerable compassionate healthcare, much of border or in the diplomatically attention was given to expatriate the work was fraught with elements of protected zone of the hospital. healthcare and psychological frustration and helplessness in the monitoring. Malaria was a constant face of real war situations (bombing But we were afforded the luxury of health hazard in the rainy season but and rocket fire, bicycle bombs in running water and cold showers, with accidents were fortunately rare. crowded markets, checkpoints with an excellent canteen and the armed militia etc) and the attendant wonderful company (for the most part) The missions spent with the Protection natural fear reactions such situations of a multinational work force of teams in the ensuing seven or eight evoked. One had always to realise that doctors, engineers, nurses, logisticians years, visiting political prisoners in whether it was to rescue casualties of and an agronomy and fisheries expert. Asia, the Caucasus and the Middle war or bring some outside contact to Days went quickly, busy on medevac East were of a totally different nature, prisoners, there was no realistic runs when security clearance was demanding some knowledge of public likelihood that these actions would given, ferrying severely injured to the health and skin diseases, especially change the minds of those having the hospital, many with tetanus and early with recognition of conditions such as authority to proscribe war or indeed gangrene and wound infection. At beri-beri, scabies, tuberculosis and take it upon themselves to extract other times there was planning with nutritional deficiencies. Sadly too was information, from those in their water and sanitation engineers to the evidence of ill treatment and custody, by whatever means and in restore damaged wells or rig up India torture, matters which needed to be contravention of international pumps for a supply of safe water, handled with extreme diplomacy and humanitarian law. since many of the nomadic tribes discretion. The efforts to engage in people of the Dinka and Nuer clans meaningful dialogue with prison The concept of privilege in being able depended on herds of cattle and goats doctors, without appearing judgmental to work with the International Red for their survival. Every six or eight and being aware of their own difficult Cross, the experience of living and weeks time off was given for rest and position, presented more challenge. working among many different cultures recuperation, flying to Nairobi across Later on other members of the and the safe return to my family and the Equator and perhaps on to Kenya’s delegation were assigned to raise family medicine in Ireland, almost Masai Mara, Zanzibar or Mombasa for issues at both State and diplomatic physically and psychologically in one a few days. Because of the stress of level based on reported findings of the piece, has provoked the persistent field work, in the presence of much Protection teams. While there was search and yet to be attained goal, visible injury and death and certainly personal satisfaction in being recognised by Schweitzer as sometimes bombing threats or rocket able to conduct an amount of ‘peace’.

(1) Documentary Film - Covering the history of the society, annual fund raising activities & events, the actual placement experience, the different sites/locations to which the students travel to, the stories behind the locations & beneficiaries, etc.

(2) Exhibition (in association with The Jennings Gallery in Brookfield/UCC) and Book - Compromising photographs & reflective pieces written by previous Surgeon Noonan participants.

They would be grateful to receive any materials/information that former UCC graduates/Surgeon Noonan participants may have.

The projects outlined above would hopefully serve to (a) raise Surgeon Noonan's profile, and (b) generate some welcome funds for the placement sites/locations. There is currently a search for any Surgeon Noonan archive material (newspaper features/clippings, Any help/input would be gratefully appreciated. Please contact Alex photographs, written accounts of placement Kelleher on Mob: (087)9619382 / Email: [email protected] experiences, whatever is out there, etc) with a view with any relevant details or queries. to the following:

7 Dr. Fergus Moylan

What’s New State Side? Back in the 1980s when I was working at Tufts Medical Center in Boston it was part of my duties to attend the Pharmacy Committee meetings. The chairperson was a very prominent physician, department chief and editor of the New England Journal of Medicine. One particular meeting was singularly discomfiting since the chair’s son had committed suicide three weeks previously. After we had muddled through the meeting I had a second meeting with my own department chief. When I related to him what had just transpired he commented: “I once had lunch at the Harvard Club vicissitude of everyday life. he was moody: “I go from being really with the other three chiefs of happy to really angry with no in Pediatrics in Boston and I was the How can such loss of life occur within between”. Another complained that only one who had not lost a child to plain view of the medical profession? she “was really happy and then the suicide.” A perusal of the medical literature least little thing pisses me off”. would suggest that these final fatal In general, bipolar children are One would have thought that being the acts are a function of unpredictable, extremely irritable, difficult, unhappy Chief of Pediatrics in a major medical impulsive behaviour and as such not children who are impossible to please. center such as Boston would inure one preventable. Why then do children Unpredictable emotional “meltdowns” from the ravages of such personal loss. commit suicide and can they be are common. They rarely exhibit mania But they were, despite their medical prevented? I don’t profess to know the and when they do it usually goes advantages, just as incapable as answer but I do know that Bipolar unrecognized, often being dismissed everyone else to protect their families Disorder, which was the explanation in as just an extreme version of their from the fatal consequence of mental most of my patients, is a diagnosable hyperactivity. They tend to be illness. and treatable condition. excessively talkative, argumentative and beyond the reach of reasoning. Suicides are not what the practicing Sixteen years ago I gave a talk to There are times when they are silly, physician deals with since by their Neurology Grand Rounds at UCC on goofy, over the top, happy go lucky. very nature they are fait accompli and ADD or as it is now known ADHD Since most of them have ADHD this is as such are relegated to the (Attention Deficit Hyperactive usually the explanation given for their responsibility of total strangers, Disorder). I still remember the look of behaviour. When they are put on ambulance personnel, police, recognition on the faces of some of stimulants (which is the standard pathologists and undertakers; lost to the audience. I also remember some treatment for ADHD) their initial all in the medical profession except of my slides which contributed to that response, if you are lucky, is short for the medical statistician. Rarely, look of recognition (“When they are lived or as is sometimes the case they however, do the unfortunate victims good they are very, very good and become unbelievably irritable, since lack medical care. In fact, when one when they are bad they are horrid”). the stimulants may activate their BPD. considers the above, they may have Little did I realise at the time that an How common is BPD? It used to be shared their short lives with the article was in preparation for thought to be 1% of the overall medical profession’s finest. publication by the Pediatric population. However, since nearly half Psychiatric Department at the of depression in children, which is In the 25 years I have been in general Massachusetts General Hospital which 10%, is in retrospect found to be pediatric practice suicide has been by would refute that particular statement. BPD, the incidence is probably closer far the most common cause of death What the authors of that article to 4%. That means that in any in my patients. All but one had been discovered from a review of nearly classroom of 25 kids there is probably at one time under psychiatric care for nine hundred patients referred to them one potential case of BPD. You may Bipolar Disorder. Some had died by was that many children who present say: “This is just a figment of an their own hand e.g. drank “anti- with ADHD also have bipolar disorder overheated American imagination? freeze”; others had died as a (BPD) and that nearly all children with None of this was there in my day”. consequence of suicidal behaviour e.g. BPD have ADHD. Well, it was there in my day. In doing motorbike “wheelies” in the elementary school I had a classmate middle of the highway. Yes, some had Further reports suggest that two thirds who ended up in residential care. And been drunk or on drugs. One hanged of those with BPD can date the onset in boarding school I had a classmate himself in jail. All had left behind of their symptoms to when they were who committed suicide. Both were shocked, confused and deeply children and in one in six as early as bipolar. wounded families. They also left preschool. In addition, in contrast to behind a shocked and confused adults who go through weeks or Earlier this year I had a fourteen year medical profession, deeply at a loss as months in a manic, hypo manic or old transfer to my practice because his to what part it had or had not played depressed mood, children can have mother liked my office staff (my in a family’s greatest tragedy. The rapid cycling between these moods secretary is from Connemara). I had a general practitioner says “Well, I sent within the same day. quick look at his chart, enough to the patient to the psychiatrist” while realize that I had my work cut out for the psychiatrist says: “He had not What constitutes mood swings? These me. He sat across from me angry, been keeping his appointments.” The are inappropriate responses to hostile and unfriendly. According to families search for answers and they something that might be funny or his mother and the record he had are told there are no answers. The irritating. They result in been seen repeatedly for the previous newspapers report that the victim had disproportional responses, either fits of seven years in Boston for encopresis been despondent recently over the loss laughing or crying. Or as a patient of (fecal soiling). He had been of a job, a relationship, or some such mine described it when I asked him if hospitalised twice to clean him out,

8 once for an intestinal biopsy and for the treatment of adults. this was the first time in human manometric measurements. In fact, he Two weeks later he returned and history when the younger generation had never been continent. He had looked like the cat that had swallowed was teaching the older generation. He already missed fifteen days of school the canary. Did he like the effect? Yes. was referring, of course, to the age of that year as a consequence of his Did he want to continue to take the computers. But it is not just in fecal accidents and having to keep medication? Yes. But, as his mother computers that they are running rings appointments with the explained, he was still struggling with around us but in the area of common gastroenterologist in Boston. his ADHD and wanted to be treated for behaviour problems. Their everyday Eventually, since many of these visits it. I put him on a two week trial of language reflects a comfortable became heated exchanges either with increasing doses of a standard familiarity with OCD (Obsessive the doctor or his mother it was stimulant used in the treatment of Compulsive Defiant Disorder), ADD concluded that there was a ADHD. Again, to my surprise, he and Bipolar Disorder. Time and again psychological underpinning to this returned. It worked. And he wanted to when I ask a patient what they think intractable problem. He was referred continue to take it. But, as his mother their diagnosis is or what their friends to a very good child psychologist who explained, he now wanted to be think of them or when I suggest to diagnosed him as ADHD and treated for his encopresis so he could them that they may be bipolar their recommended that he be started on attend school. response is often confirmation of what stimulants. This he adamantly refused they and their friends have suspected in another heated exchange and the Eighty percent of children with for some time. “He’s so bipolar!” is a psychologist asked him not to return. encopresis still have the problem six comment in common usage in the Well it was clear to me at first blush months after the initiation of medical schools and in my estimation it is that this was a very angry kid with a intervention. For a sizeable proportion frequently used correctly. lot of family pathology (one brother of children the toilets in American was in jail). When I asked if he was public schools are a refuge of last Fifteen years ago I began to prescribe ever a “happy camper” and learned resort. Bearing this in mind, I put him a lot of inhaled steroids for respiratory that yes he could at times be happy go on a daily laxative which was tasteless, problems. Frequently the parent would lucky I pushed a little harder. Could effective and could be added to ask whether this meant their child was he be goofy, silly, over the top happy? orange juice etc. He was to take this asthmatic. I would and still do hide Oh yes! This line of questioning, I when he got home from school, thus behind such diagnoses as “Reactive could see, seemed to them not only avoiding the need to use the school Airway Disease,” “Respiratory puzzling but irrelevant. They had come toilets. Allergies” or “Exercise Induced to have his encopresis and his ADHD Bronchospasm.” And when these fail treated. They were definitely not Four months later he was attending to satisfy the parent I say: “Let’s not prepared for what followed. I explained High School, getting average grades worry about what it is called,” that I believed he was having mood and though he was still having fecal preferring to focus more on the relief swings; in fact he could be bipolar accidents they were infrequent and of symptoms and less on the and as such not a good candidate for not at school. All the tension in his semantics of diagnosis. This approach stimulant treatment. At this he got up face which had up to this defined him must have some validity since I cannot and left in disgust. His mother looked was gone. He was a different person, a remember when I last hospitalised a totally deflated. It was as if he had happy person. I asked him: “Have I patient for asthma. sucked all the oxygen out of the room. been able to correct all that was When she had recovered a bit I bothering you?” His conceded: “Pretty It is debatable whether all the patients explained to her again why I thought much.” I treat are bipolar. Certainly most he was bipolar and why it was psychiatrists are reluctant to relax inadvisable to treat him for his ADHD On a daily basis I see patients whose their criteria, feeling that the patient without addressing this first. I then parents struggle to make their children must be by definition manic, a state suggested that she return when he had happy. No matter what they do it is less likely to occur in children. The calmed down, since I was familiar with never enough. And yet there are times psychiatrists are only seeing the tip of bipolar patients storming out of my when everything seems to be as it the iceberg, the 1% versus the office. should. But it never seems to last. estimated 4% thought to be the real They work on the basic premise of all incidence. Could it be that, as in the However, having said that I had to accepted good parenting: the more I case of asthma, a willingness to admit to being surprised, considering do for my child the happier my child recognize that mood swings may be how angry he was, when he showed up will be. And the more difficult the more frequent than previously believed a few days later with his mother. I child the harder they try, for it is a and a readiness to prescribe the explained to him why I wanted to commonly held belief in United States newer, safer and more effective second stabilize his moods before I addressed that failure is a function of inadequate generation antipsychotics, might result his ADHD and that I was not even sure effort. So they try harder. Mothers in fewer hospitalisations, less that his ADHD needed to be treated. blame themselves and the entire world suicides? He agreed to a trial of a small dose of is willing to let them. The sad fact in one of the new second generation my experience is that no matter how Recently I asked a noncompliant atypical antipsychotics. Of course, I outrageous the child’s behavior the patient of mine what would happen if did not put it exactly like that. No medical or the mental health he stopped taking his medication. His parent, not to mention an extremely professional consulted is unlikely to answer was clear: “I wouldn’t last angry adolescent, is going to embrace diagnose their condition as a mood long.” the concept of taking an atypical disorder. They will blame the antipsychotic no matter how small the behaviour on ADHD or ODD And so it goes, another profound dose. So I told them that it was a (Oppositional Defiant Disorder, a observation by a child seeking medical mood stabilizer (which, of course, it common feature of BPD) but they intervention in his every day struggle is). Sure! That sounds harmless resist labeling it bipolar. And so it to be seen, recognised, treated and enough, especially since these goes undiagnosed and untreated. healed. medications are currently being heavily advertised in the United States My son once pointed out to me that

9 Prof. Gerry O’Sullivan

“The best way to predict the future is to invent it” Predicting the future in cancer research is difficult but there is cause for optimism. We have come along way in the last ten years and the pace of discovery is accelerating so we should anticipate significant progress over the next decade. While the disease burden will remain significant in the community several of the cancer types that are today incurable will be controllable within the next ten years. But the demands are also going to be greater. The life expectancy of the population will increase. With increasing age there is an increased incidence of cancer and here current therapies are either less successful or less tolerated because of their invasiveness, toxicities or because of a lack of patient fitness from co-existing diseases. Thus a continued goal is the development of treatments which are more effective, safer and applicable to patients compromised by infirmity or advanced disease. Progress is more likely to come in small increments in many separate areas rather than in a single major breakthrough.

Developments arising from the human genome project and from the widespread application of high throughput gene based analytical technologies are already having a significant impact in the clinic. For some patients the risk of developing specific cancers can be predicted making the selective application of surveillance tests or preventive therapies both efficient and effective Staff of Cork Cancer Research Centre strategies. There will be a greater emphasis on personalised treatment. mechanisms, with advantage, and CCRC we have developed a vaccine for Many patients will be treated based on without collateral injury to normal prostate cancer that could achieve a predicted responsiveness of the tissues has been proven for some clinical application. Successful gene cancer derived from its molecular cancers. However most tumours do not therapy of cancer is now a realistic profile. Thus while there will be a depend on a single mechanism or goal. Already we have established that more rational usage of toxic or invasive metabolic pathway and much work gene therapy may be used to induce therapies there will also be the remains to be done to bring designer production of immune molecules by immediate recognition that many type drugs into multi - agent treatment the growing cancer cells and thus cancers are resistant to current protocols. establish immune control over the treatments. Recent developments in cancers. This is particularly effective Cork Cancer Research Centre (CCRC) Pursuant to the understanding of the in the control of secondary spread and give hope that new approaches will biological processes involved in should eventually have a central role shortly be available for some of these tumour growth, spread and host as an adjunct to surgery or other recalcitrant cancers. From the cancer responses thereto, several new types of treatments. Viral based therapies of cell death studies, mechanisms of biological treatments are under cancer have now achieved clinical trial drug resistance have been defined and development and some are already at status. The viruses are modified to already there is the promise that the stage of clinical application. become non pathogenic, to enable within the next few months a clinical Immune, gene, cell and viral therapies gene therapy and to selectively trial will commence on a new have now been developed for specific replicate in the cancer cell thus killing treatment approach. biological targeting. There is the tumour cell after modifying its compelling evidence that many tumour immune function. It is likely that Rational drug design for cancer types can be forestalled by the these will be clinically applicable treatment is a field of great promise. immune system and vaccines are within the next few years. The stroma The concept that molecules may be reaching trial particularly for is the non cancer component of the designed to specifically interrupt melanoma and prostate cancer. In the growing tumour and is derived from cancer dependant pathways or

10 Profile: The Cork Cancer Research Centre (CCRC) is a multidisciplinary organisation that provides a research partnership between the University and the Cork Hospitals. Its mission is to investigate major issues that concern the genesis, progression or treatment of cancer. Its purpose is to provide discovery and innovations that may be applied to the prevention of the cancer in the first place or to the development of more effective treatment strategies. Its foundation is based on the unshakeable belief that the cancer questions can be resolved and that in Cork we can create the capability to make significant contributions. cells that migrate there from the bone clinical trial. We have now developed marrow. These cells differentiate to new technologies and systems that will Cancer research is a continuum from become blood vessels, collagen allow endoscopic delivery of drugs and basic investigation through to clinical producing cells etc thus providing a genes to internal cancers. This form of application. In our Centre we foster scaffold and blood supply that enables treatment is highly effective, has a low such an environment: Where there is three dimensional growth and spread toxicity and invasiveness and should an interactive atmosphere conducive of the cancer. The growth of these include patients that heretofore were to collaboration between investigators stromal components may be targeted not treatable. of differing skills and profession; for treatment – particularly the new where we have the human and blood vessels and is the basis of the Prof Albert Deisseroth in a recent technological resources to provide high anti angiogenic therapies which are interview said “There is a revolution standard penetrating research; where now used in treatment. There is a happening in cancer research and inquiry and innovation are relevant to continued exchange of cells between Cork is at the centre of that knowledge creation and clinical the bone marrow and the tumour and revolution” a generous appraisal by application. In addition our Centre and these cells are amenable to the eminent internationally acclaimed programmes benefit from modification to transport toxic American scientist. Indeed we can be collaborations and shared studies with molecules and viruses into the tumour. at the centre – we now have a solid investigators in Cancer centres in In our laboratory non pathogenic platform on which we can build. We Europe, United Kingdom and USA. microbes have also been modified to have the conviction, the scientific selectively propagate in the tumour capability, the high standard of Since its inception in 1999 the Centre suggesting the possibility that an off clinical cancer care in the region and has been a leading force in developing the shelf cell therapy. the public support to realise our new treatments. Current research at objectives. Over the next few years we the Centre is mainly directed towards In the treatment of solid tumour will expand our laboratory to more the critical challenge of secondary cancers surgery remains the most than twice its present capacity, we will cancer and is directed at three successful modality of therapy whether increase our academic staff research themes: Cell Death and used alone or combined with radiation complement, we will engage further Survival Mechanisms, Novel and chemotherapy. Major surgery with the cancer prevention clinic to Therapeutics including gene therapy, however can be debilitating and is not enable development of rational clinical delivery, in addition there is a applicable to many patients because preventive approaches for at risk significant and expanding programme of fitness or disease stage. The power people, we will expand further with the on cancer prevention and of procedure based treatments can be clinical research centre the conduct of education. expanded by development of clinical cancer trials which will not minimally invasive methods to ablate only evaluate new therapeutics but will tumours and to regionally deliver inform our research. The cancer appropriate therapeutics. Electrical question will only be resolved by the drug (Electrochemotherapy) and gene scientific method and in Cork we have delivery has been introduced to the capability. We can make a Ireland by the CCRC and brought difference through conviction, through preclinical evaluation and collaboration and inventiveness.

11 Dr. Frank Golden

Memories of an Applied Physiologist ‘My God it’s cold. How the bloody hell did I get myself involved in this torture?’ All the scientific thoughts that my poor brain may have contained before I jumped into the water were quickly replaced by questions like: ‘Why would any sane person, voluntarily throw themselves into 10°C water just to find out more about the effects of cold water on the body?’ ‘How much longer must I endure this agony?’ Once the initial shock had declined - as the skin thermal receptors habituated to this horrible environment, leaving just the more tolerable deep cold pain and the discomfort of uncontrollable shivering - I began thinking of those unfortunates who have had to endure these conditions without the comfort of knowing that they could get out and have a warm bath anytime they wished. I also developed a better understanding of those frightened individuals we rescued from the sea and how ignorant I had been about the stress they had undergone and were still enduring when we got to them. Even after rescue some of these poor individuals died despite my best interventions. My associated guilt was the catalyst that started me thinking of the physiological changes that were occurring during cold-water immersion and after rescue. In my case, as a first year medical testing of protective immersion suits the Admiralty on matters relating to student in 1955, and even later on for aircrew. At last, rather naively, I the physiology of survival at sea. This graduation in 1960, if anyone saw a chance to put some ideas to the topic was a matter of some concern at suggested to me that I would wind up test! the time given the enormous loss of practicing Applied Human Physiology, life in the North Atlantic convoys. It I’d have laughed at their poor It was while undergoing one of those was through his encouragement that I judgement and even offered them auto experiments, enduring the began a long journey as a part-time odds of a thousand to one that they suffering described above, that one student, under the supervision of couldn’t be further from the truth. day the ‘laboratory’ door opened and Professor GR Hervey at Leeds How wrong could I have been? Of an elderly, diminutive, shaven headed University, towards attaining a PhD in course I never envisaged a ‘Road to character, wearing rather dilapidated Applied Physiology. Damascus’ life changing experience clothing and looking as if he had just would come into the reckoning along been released from ‘Belsen’, appeared Initially I spent three invaluable the way. with my then Boss at the pool side. He months in Professor Ron Linden’s wouldn’t tell me his name at first but well-known cardiovascular physiology As a young impecunious doctor said he just wanted to see what was department, learning ‘experimental working in London, on the advice of going on and ask me some questions. method’. Thereafter, my seven-year my Bank Manager, I took a short-term I tried as best I could to explain what study time was interspersed between commission with the Royal Navy Crew I was doing, and why, but some infrequent laboratory work and with the promise of a financially unfortunately my replies were rather Naval duties. These included: some rewarding tax-free gratuity after 3 unintelligible due to the intense general practice; teaching & training; years. In one of my early postings, shivering of my jaw. working on a variety of practical while working as a G.P. in the Naval questions relating to everyday military Air Station in Cornwall, I was involved After a warm bath, and still unaware ‘medical’ problems and assisting with intermittently in Air-Sea rescues - who he was, we resumed the air and marine accident investigations, including the ‘Torrey Canyon’ super conversation over a cup of tea. He etc. At that time I was also providing tanker in 1967. Apart from some ‘nail- clearly had an enormous depth of advise to the UK Government on biting’, ‘sphincter-testing’ moments, knowledge on the subject of cold- Merchant Marine safety matters – co some of these rescues proved both water survival, most of which, writing the syllabus for the Merchant interesting and challenging from a embarrassingly, was new to me but his Navy sea survival training, that is now medical viewpoint. But it was the main interest concerned the also in use in Ireland and several other helplessness of not knowing what to background to my interest. After about countries - as well as advising the do with some of those who died, either an hour we were formally introduced; North Sea Oil industry, which was in while being winched up to the it transpired he was the famous its early days of deep sea oil helicopter, or shortly after arriving in Professor RA McCance, Professor of exploration, on thermal related issues the back of the aircraft, that proved to Experimental Medicine in Cambridge. be the cathartic experience that led to Although world renowned in the area In many situations, knowledge gained my interest in physiology. Neither of nutrition; during the war years, in from literature surveys, or medical textbooks nor calls to various conjunction with his equally famous straightforward data gathering – local medical consultants proved colleague Elsie Widdowson, they did including interviewing many survivors enlightening as regard possible the underpinning research to provide of ‘helicopter ditchings’, sailing, mechanisms other than ‘hypothermia’. advice to the British Government on fishing, or shipping incidents – was That conundrum led to my interest in the dietary requirements for the sufficient to answer the questions. physiology. besieged population of Britain in Many others, however, required some WWII. (A diet that most specialists in applied research in order to devise a In a subsequent posting to the RN Air preventative medicine would like to practical solution, e.g. the cause of Medical School in Hampshire, I see reintroduced). His interest in some injuries in aircrew; working in discovered a refrigerated pool under thermal physiology dated from the war flooded compartments of ships; the floorboards of an out-building, that years when as Chairman of a cooling in divers; crew fatigue in long had been used in the immediate post subcommittee of the MRC, the RN duration helicopter flights; etc. WWII years for the development and Medical Survival Committee, advised However, of more direct interest to me 12 were matters related to sea survival, rescue collapse and death provided by retirement from the Navy in the mid especially in cold environments. This Nazi experimenters at Dachau was ‘90’s, I was fortunate to be invited by was not only limited to simply gaining rejected. In addition, some data taken Professor Tipton, to work with him at a better understanding of the to ensure that the animals remained in Portsmouth University. At one time he physiological changes occurring but good physiological state throughout was my PhD student – who did some also to applying that knowledge in their immersion, serendipitously, brilliant work on helicopter underwater devising potential lifesaving strategies provided a major clue to discovering escape in our laboratory. Subsequently and protective equipment. Such the answer to post rescue problems, he became a very close colleague in problems varied between: hypothermia viz. hypotension following hydrostatic much of the later work on immersion and drowning (both through research decompression. A very welcome matters. Obtaining funding for and treatment of patients in the local secondary benefit was the discovery experimental work in physiology has Naval Hospital); cold water swim that all traces of anaesthetic evaporate always been difficult but with the failure; liferaft, lifejacket and survival from an anaesthetised pig during growing interest in genetics in recent suit development & testing; ‘non roasting and did not in the least years, even the microbiologists are freezing cold injuries’; dehydration detract from the succulent taste of complaining. Currently, support for during arduous exercise in extreme young, meal-fed, animals. This finding whole body physiology is well nigh cold environments; etc. All of this won me an enormous number of impossible other than from the work combined a mixture of laboratory friends in the physiology department, military or industry. We were lucky to experiments and field studies, many of whom I was only briefly get some funding to support work on sometimes in fairly arduous conditions acquainted with, nor have seen since! cold injury. Sadly the hunt for an - including a week at sea in a drifting Regrettably, human experimentation appropriate animal model has been liferaft living only on survival rations, has no such secondary benefits fraught with problems from the outset, and living in the field in Northern although in a scientific sense can be but at least it has led to it some Norway in winter for a short time. equally rewarding. promising collaborative work with the Regrettably, the military nature of pharmacologists. much of this work impeded the The results from the pig experiments freedom to publish in the open subsequently led us to the As the dusk of life approaches with literature – the ‘Cold War’ was still in development of a practical rescue incremental speed and with it a full swing – nevertheless, at the end of method of lifting the victim tendency to reflect from time to time - the day, there was great satisfaction horizontally from the water. This particularly with a glass of fine wine in from finding the right answers and device is currently used by many Air hand - on how one’s career has seeing the lifesaving advice and Sea rescue organisations, worldwide. evolved over the years. I often regret measures working. that I didn’t pursue a career more Not long after finally completing my directly involved with hands-on My PhD work on the physiological PhD, my time was almost totally healing, but then if I did I would never changes in immersion hypothermia devoted to the subject of ‘Non had such an exciting, interesting, and involved: both laboratory and field Freezing Cold Injury’ (NFCI). I had generally enjoyable life as it has human experimentation; the creating a previously encountered a few cases of turned out to be. In the course of my mechanical model and subsequently – NFCI after one liferaft trial, and a few lifetime I’ve had the great privilege of with considerable help from a in some Royal Marines returning from attending many international scientific Cambridge mathematician – a winter training in Norway, but nothing meetings, assemblies and dinners, computer model, leading finally to an compared the hundreds that occurred conferring with many historical animal model to convince some of the in the Falklands War. My immediate notables in my field along with ‘grandees’ of the Physiological Society task was to devise a practical explorers and humble brave fishermen. who were somewhat sceptical about diagnostic screening technique to The more I reflect the more I wonder the modelling results. This work classify the degree of residual clinical at my luck in becoming involved in a proved to be most rewarding as the injury in returning troops and to career in applied physiology. variability between “subjects” was formulate a management policy. much more controllable than with Regrettably the literature relating to humans! ‘Cold Injury’ was not a great deal of help as it centred predominately on The animal research involved a ‘Freezing Cold Injury’ (“Frostbite”). reasonable number of experiments on Sadly, while the physiological testing anaesthetised pigs (40kg) at the of a large number of Falkland veterans ‘University Farm’, situated between provided a better understanding of the Leeds and York, where I set up a mechanisms of the clinical laboratory containing cold and hot complications of NFCI, we were water tanks. This proved to be a major unable to identify the precise logistical exercise that would never underlying pathophysiology and thus have been achieved without the provide a definitive treatment. The assistance of a very able Lab hunt is still on. technician. How I wished at times to be based in a convivial academic In a hierarchical organisation such as department with a fully equipped the Navy, with progressing seniority laboratory at hand, rather than a and the associated slow, but ‘shed’ in a distant rural pig farm. inevitable, decline in cerebral Despite this inconvenience the results capability, I became more involved in proved rewarding. The modelling administrative matters, including the hypothesis was supported while the management of the Navy’s Haslar long accepted explanation for post Hospital. However, following my

13 Mr. Michael Hanna

Change is on the way for the Health Service in Cork and Kerry During the past year, a major change project has been underway to reconfigure the way health services are managed, organised and delivered in Cork and Kerry. It falls within the wider transformation programme of the HSE that includes similar reconfiguration projects in the North East, the Mid West and the South East. These projects are essentially following not quite so modern in other parts, age demographics at a meeting through on reviews of acute hospital like the curate’s egg. We have the recently. The presenter pointed to the services undertaken by consultancy Mercy University Hospital in a cluster left hand side of a steadily increasing firms Horwath and Teamwork in 2006 of buildings a stone’s throw from the stack of histograms and commented and 2007. The principles are simple: River Lee which catastrophically broke memorably “This is where we are now, • put the patient at the centre of the its banks last November just outside working” and then to the right hand health service; the entrance to the A&E department. side “and this is where we’re going, • concentrate complex care; We have the South Infirmary and sick”. Each year the screw turns • deliver as much non complex care as Victoria University Hospital sharing tighter and each year the distance it close to the patient as possible; different histories of an older Cork. turns is a little more. The HSE is • bring consultants together into Then there are Mallow and Bantry, keenly aware of this as it presses regional specialty teams; small but dearly loved, providing vital ahead with an ambitious • build an alliance with higher service to their communities and transformation programme and its new education and research. excellent care for many patients. In Directorate of Quality and Clinical Tralee we have Kerry General, a Care seeks to make real the role of The difficulty lies in changing hearts smaller version of CUH, the only clinical director as envisaged in the and minds to make this happen with general hospital in Kerry, an icon for new Consultant Contract 2008. no extra resources. In Cork and Kerry the Kingdom but a long way from the Secondly, HIQA is developing its we have a fragmented service in which cities of Cork or Limerick. So we have credentials as a quality watchdog with hospital loyalties take precedence over problems of geography, problems with some teeth. (Nobody who has been the patient needs. This means the larger facilities, problems with custom and subject of a HIQA inquiry will want to hospitals grow at the expense of the practice. repeat the experience.) Thirdly, there smaller ones and the bigger centres of are no more resources – and everyone population suck in disproportionate Within Cork city, there was a major knows it. In fact, there are less resources from rural communities. We attempt to integrate hospital services resources so we simply have to use are used to complaining about Dublin in 2002. The Acute Hospital Planning them better. So the context has taking a disproportionate share of the Forum carried out a major planning changed and the imperative for reform cake but Tralee can say the same exercise that made detailed is stronger. about Cork. recommendations on how the three hospitals might work together more UCC’s Professor of Obstetrics and Nobody would quibble with the effectively in relation to development Gynaecology, John Higgins, was principles listed above: they are of staff and services. Hospital appointed Director of Reconfiguration evidence based, they are international management and clinicians agreed to in March 2009 and charged with best practice and above all, they are work more closely together. Some turning the Horwath and Teamwork person centred. The problems start resources flowed – Cork University Review into an implementation plan when you try to balance them. Start by Maternity Hospital was built, CUH and for Cork and Kerry. He was given some putting the patient at the centre of the MUH got new A&E departments, and a funding to put together a small team health service. That means the patient new Cardiac Renal tower is due to of health professionals and who lives in Glasheen and the patient open at CUH later this year - but administrators and told to publish the who lives in Allihies or Rockchapel; nothing fundamentally changed in how Horwath and Teamwork review and that means the elderly patient with services were organised or delivered. take it from there. mysterious aches and pains and the Formalised structures for cooperation patient with a rare form of cancer; that promised in the report were stillborn. What has happened in the intervening means getting consultants to develop months? John began by setting up a their subspecialties and operate a How do we make it different this time? broadly based Reconfiguration Forum general medical rota; if you are a First, our population is getting older consisting of all the key decision consultant it means working in the and our health status is under makers in the region. The Forum tertiary centre and providing regional continuous threat from unhealthy meets every second Monday from outreach. Or take our present lifestyle behaviour, so the pressure on 7.15am to 9.00am and debates and buildings: we have a modern hospital our health services is increasing discusses regional issues that bear on at Wilton, modern in parts and maybe inexorably. We had a presentation of reconfiguration. Along the way it has

14 found itself drawn into problem have the necessary skills and training have been discussing its main solving some major current issues to carry through implementation of the recommendations with key partners so because it is the only forum that plan - without extra pay, please note. there won’t be too many shocks. We brings together senior clinicians and are already commencing managers from Cork and Kerry in the Another novel aspect of the exercise implementation planning for a number same room consistently and regularly. has been engagement with public of strands so that planning will move From the workings of the Forum, one representatives and members of the seamlessly into implementation. We can see what a regional health service public. Last autumn, we introduced a hope the plan will become a once off could be like. There has been wit and pod of six Advanced Paramedics into reorganisation of what we do, where wisdom, persistence and passion and West Cork as an outcome of the we do it and how we do it. If we through it all a growing awareness that Emergency Services Review carried succeed, resources will be better apparently intractable problems can out last summer. This team is concentrated, services will relate be solved by thinking and acting providing a 24/7 emergency service together in a more rational way, together. In addition to the Forum, out of Bantry with their own vehicle facilities will be used more efficiently, John has put together a non executive and an impressive range of equipment. and we will build a mood for change advisory board that brings together Before the team “went live” they in the years ahead. One of our expertise and experience from a mix of conducted a roadshow throughout outcome measures is to deliver 2008 senior figures in the public and private West Cork, attending schools, marts, levels of service with 2011’s budget. sectors. The advisory board meets agricultural shows, ICA events, That is an achievable target. every six weeks and gives of its time explaining what they would bring to free gratis. It has been fascinating to emergency care. People told us this What will this mean for the training of see business men becoming hooked was the first time the HSE had ever our doctors, nurses and therapists? We on health service reform and to realise explained what it was doing before it want to change not just the how business approaches can help did it. It was helpful to us too in a organisation of our health services but solve complex health service problems. number of ways: it bonded the APs to also the culture. We want to create a the people of West Cork; it gave us culture that is forward looking, On the clinical side, over 40 time to think through issues raised innovative and solution focused rather subgroups were set up to address each before the service began; it gave us than problem focused, a culture where medical and surgical specialty and a time to liaise with the GPs in the area we learn from our mistakes and move number of functional subgroups were and with the staff of Bantry Hospital. on to internalise those lessons in our established to look at such things as Now the APs work in the hospital as practice and our teaching. A colleague education and training, GP referral, a they await calls. Currently we are told me a good story yesterday about single patient chart and number, working in the same way to introduce teaching students patient safety in UK communications and theatre Acute Medical Units (AMU’s) into medical schools. One school utilisation. These groups had each hospital in the region. This introduced a module for final year consultants, nurses, therapists, patient project is being led by Dr Jennifer medical students covering clinical advocates, GPs and university Carroll, a UCC alumni who has governance, risk management and representatives. Their deliberations transformed the emergency medical patient safety. At a meeting of medical will feed into the final reconfiguration service in St. Lucks Hospital, schools last year it was suggested that plan. Resources were also put into Kilkenny. “We teach them so well”! other medical schools might want to (Toyota) Lean training to support do something similar, to which certain bottom up change in processes and The reconfiguration plan is currently in Deans asked why they would need to into project management training to preparation and we expect it to be teach patient safety to their students provide a cadre of managers who will published in July. Prior to that we as they won’t make mistakes.

Call for Submissions For the next Newsletter and “one liners” recalling expressions or sayings of patients, staff, colleagues and land ladies from old times at UCC. I expect they will bring back happy memories and a smile to many.

15 Dr Paddy Crowley (Plain country doctor)

Interview with Dr Con Murphy, Family Doctor, Chief Medical Officer to the Cork County Board and Cork Senior Hurling doctor since 1976 and football team doctor since 1977.

P.C. Con, you were born on 7 June P.C. Was it a sign of things to come Seanie and Christy Ring (who was a 1949 to Anna and PA Murphy (known that you spent most if not all of your selector). Christy had one look at as Weesh) and you are the first born of time that time in the dug-out? Seanie and said “you won’t be the family. I presume the story is needing your nose for playing hurling apocryphal that your father – then the C.M. Yes, and at that time I was a Seanie! Go back out on the field!”. Cork Senior football full back and selector with both the hurling and He went back out and Seanie then winner of an All Ireland football medal football club. We won a number of played on. Tomas O’Leary, the current four years previously in 1945 – picked Fitzgibbons and one year I was a Irish scrum half is Seanie O’Leary’s you up by the ankles – noted the selector. son. distinct lack of musculature – and said to Anna no more of these and P.C. Exactly how and when did you Also concerning that game, Cork would four daughters were born become the Cork team doctor? not have won except for the fact that subsequently. your brother Tim had an outstanding C.M. It happened in 1976. I was game at midfield for Cork. During that C.M. Yes Paddy, you have always said doing a years medicine down in Tralee period I was fortunate as I sat beside that was true. before general practice. I came up Christy Ring for three years. I think from Tralee to Cork to Pairc Ui others might not have wanted to sit P.C. When was your first All Ireland? Chaoimh one Saturday night before beside him but he liked to sit beside Cork played Tipperary in the first me as he considered me a good luck C.M. First All Ireland was in 1956 and round of the Munster Hurling omen. It was fascinating to hear him. my father was a selector. We lost that Championship. Jimmy Barry Murphy It was like sitting beside Pele for a day against Galway and it was the first was there and I went along with him World Cup Final. day I saw grown men cry. My second as he was a sub the following day and was the following year in 1957 when Denis Conroy, Cork County Board, P.C. Con, in 1983 you married Joan my father was also a selector and that asked me if I was going to the match Nagle. year, famously, Paddy Harrington was as they had no doctor. So I went and wing back (he would be Padraig did the doctor work. The following C.M. In 1983, I married my long term Harrington’s father). Another loss – to week when Cork were playing football, girlfriend and love of my life from my Louth this time. Billy Morgan said you did the hurlers, UCC days, Joan Nagle. We have three why don’t you do the footballers. The boys. Colm is a Doctor in Australia, P.C. You went to Farranferris in 1962 rest is history. Brian is an Engineer in Vancouver and where your family either wanted to Cian is in UCC. make a priest or a hurler out of you to I was with Cork for nine All Ireland maintain the GAA playing dynasty. Football Finals. We won two of these P.C. The old saying that athletic ability Neither of the above happened. You – in 1989 and 1990. I was with Cork can skip a generation rang true with were present for the golden era of the for thirteen hurling finals and we won your boys! commencement of Farranferris nine of these. I was also the team winning Harty Cup and All Ireland doctor for three series of Aussie rules C.M. Yes Patrick. Thank you again for Colleges teams and you subsequently games both here and in Australia. reminding me that I was so went to UCC in 1967. uncoordinated! I was lucky to be able P.C. Remind us of the drama before to walk not to mind walk and chew C.M. Yes, while in UCC, UCC won the middle of the three in a row All gum simultaneously! three Sigersons plus two Cork County Ireland Championship winning teams Senior Football championships in before the All Ireland Final in 1977. P.C. In the modern era, what were the 1969 and 1973. Those teams highlights in your sporting career? included Brendan Lynch, Paudie C.M. Before the 1977 All Ireland Final Lynch, Moss Keane, Dan Kavanagh, in the puck around in Croke Park, C.M. Probably Jimmy Barry Murphy’s Seamus Looney, Ray Cummins, Denis Seanie O’Leary was pucking around team that won the All Ireland Hurling Coffey, Denis Cotter. I was normally before the match and one of the Final in 1999. We were rank confused with Ray Cummins until it players hit him on the nose with a outsiders against Brian Cody’s came to kicking a ball! sliotar and made bits of his nose. I Kilkenny and we were very lucky to went in to the dressing room with win on a score of 13 points to 12.

16 During those years, I roomed all of the C.M. Jimmy Barry Murphy without Secondly, during my time, we time with Jimmy Barry Murphy as we doubt in hurling and the best player in introduced the blood sub rule allowing were great friends. medicine was Professor Denis a player to be treated while a O’Sullivan. temporary substitution was being P.C. And in football Con? made rather than a full substitution. P.C. You were chairman of the GAA This came about interestingly at a C.M. The best football win was in Medical Advisory Committee in Croke Cork match when Fergal McCormack 1990 versus Meath under our great Park in the past ten years. What did accidentally got split by Alan Browne friend Billy Morgan of UCC days. This you achieve? in 2000. He was bleeding profusely gave us the double All Ireland in during the first half. He did not leave hurling and football. Winning a Cork C.M. I was chairman during Sean the field at that particular time. A County Championship in senior Kelly’s presidency (2002 – 2005). reporter quite rightly pointed out that football in 1999 also stands out. We introduced the gradual this was very poor for the image of the implementation of compulsory helmets GAA so the blood rule was researched P.C. And the biggest disappointment? which is now mandatory for all hurlers. and designed and introduced into both I know yes that I famously stated hurling and football in 2004. C.M. The big disappointment was “Urbi et Orbi” in the early 1980s drawing against Meath in 1988. when helmets were being researched P.C. Your hopes for the future Con. There was a Kerryman as referee – we and designed by a much more won’t mention his name – but it was competent and research orientated C.M. It would be that Cork would win barefaced robbery. colleague that “they would never take the double again and Cork hurling to off”! resume it’s rightful place at the top of P.C. Who would you rate as the best the hurling world and reclaim the title player you have seen? of the home of hurling.

Professor Fergus Shanahan awarded “David Sun” Lecture

UCC’s Professor Fergus Shanahan, MD, FACG, was awarded the prestigious “David Sun” Lecture at the American College of Gastroenterology annual Postgraduate course in San Diego in October 2009.

Some 2,500-3,000 people attended his lecture titled “Gut Microbes: From Bugs to Drugs”. The David Sun Lectureship in Postgraduate Education was established by Mrs Sun in memory of her husband, Dr David Sun, an outstanding gastroenterologist and investigator. The Lecturer, with a distinguished background in gastroenterology or an allied field, is chosen in recognition of his/her contribution to science and clinical medicine.

Fergus Shanahan is Professor and Chair of the Department of Medicine at UCC and Director of the Alimentary Pharmabiotic Centre (APC), a UCC/Teagasc Research Centre funded by Science Foundation Ireland and industry, focusing on gastrointestinal health and development of therapies Picture shows: American College of Gastroenterology for debilitating disorders such as President, Professor Eamonn Quigley, presenting a plaque to Crohn’s disease, colitis, irritable bowel Professor Fergus Shanahan on the occasion of his delivering syndrome (IBS) and food poisoning the "David Sun" lecture. (http://apc.ucc.ie).

17 Dr. Carol Dundon

North Infirmary Revisited Last July I revisited the North Infirmary. I had been a medical student and an intern there many moons ago, but this revistitation was very different! In 1917, the North Infirmary was wanted me to write her in as well. I asked by the Military Authorities to was pleased by her keen initiative and designate a surgical ward for soldiers promptly inserted a little girl called Photo of actress playing role of Mother returning from the Frontline of World “Veronica” into the play. This was not Josephine wearing the traditional Daughters of War I to Cork. The Infirmary did this as difficult to do as it sounds. Writing Charity headgear. (Actress Aileen O’Leary) to such good effect, that Rev Mother to order, complying with a directive Josephine was awarded the Royal Red from a ten year old is, in fact, abundance. I had written in a bowl of Cross Decoration for the outstanding infinitely easier that toying with a apples and oranges in the script, care the soldiers received. These blank sheet of paper on which no which were at least contemporary – so patients were struggling to adjust from characters have yet appeared! that was easy! life in the Trenches, to life in the “Veronica” loved being part of it all. North Infirmary. No easy task! On the Opening Night, we all gathered There were two plays, “Paper in an upstairs room in the Infirmary. I went to the Cork City Archives and Lanterns” and “Back from the Everyone was in high spirits. I did not set off on the trail of this particular Trenches”. They were separate think anyone was unduly nervous. period. It was totally and utterly entities but were linked by a common There was great last minute reading of fascinating. The only problem was the underlying theme – the guild to scripts, and we gave the Nun’s enormity of the eye catching and survivorship. One of the plays headgear one last good spray of starch thought provoking material. It was featured the ghost of a fallen comrade. for luck. Excitement was mounting as hard to know where to begin. Anyhow, This was a disembodied voice off the time drew nearer. I went after many enjoyable days in the stage. It worked well. We also made downstairs, curious to see who had Archives, I emerged with two One Act a recording of the omnipresent turned up. I knew it was an unusual plays. They are based on real life Shandon Bells. These were essential venue and in some ways experimental characters who once inhabited the Old to both plays. The patients made in nature. To my delight I recognised Infirmary nearly a hundred years ago. constant reference to the bells, some most of the audience gathering. It I wanted the plays to be site specific, loving them, others grumbling about was great to see familiar faces. There in other words to put them on in the being kept awake at night by them, seemed to be a very good buzz around Infirmary, now the Maldron Hotel. we also used the Bells to punctuate the place as they all greeted each the Scenes and Acts. I loved the other. The seats filled up quickly and This was not a problem. The Hotel recordings and found they bought a before I could take it all in, the show liked the idea and said we could use strong atmosphere into the room. I began! It was a very thrilling moment the “Jack Lynch Room”. This has a felt we are starting to get very close in for me. seating capacity for fifty people. our bid to recreate the Infirmary of Together with some friends we 1917. I felt I had done exactly what I set out founded the “Goldfish Players”, and to do. Thanks to our excellent booked the venue for four nights in One spot of bother was the “Coronet”. Director and marvellous cast we July. Things were going well. This is the larger swanlike headgear managed, I feel, to bring back the worn by the Daughters of Charity in spirit, mood and atmosphere of the Casting had not been a problem either. those days. I could not locate a North Infirmary in 1917. Many of the The actors and actresses seemed to coronet in Cork or Dublin. We ended audience told me afterwards that they intrigued by the whole concept, which up having to send to London for one found it a very emotional evening, was, by any standards, a rather as they appear in “Phantom of the especially those people who had a unusual one. Rehearsals began in Opera”. It duly arrived in a big direct link with the old place. March. They took place in three cardboard box to our wild excitement. Afterwards the cast were heady with different venues all of which I liked. Now the show could go on! We delight – it had gone very well for Firstly we met in the Pavilion of the bought endless cans of spray on starch them all. Their excited chatter bore Cork Cricket Club on a beautiful and sprayed the Coronet at least twice this out. evening. This was the first reading of a day during the production. The the plays. It was a tremendously actress playing Mother Josephine We did the plays for four nights in all. exciting time for me to hear my plays looked very elegant in it. She used to We were feeling decidedly sad on the being read by the group for the first get a spontaneous clap when she last night. The boy who played the time. I was taken aback by how well appeared on stage. She was also Ghost was going to America, which they were reading the lines. Already clapped when she was coming down made it even sadder. When the they seemed to be inhabiting their the main staircase. Her evanescence audience were gone we stayed on in parts in a highly promising way. Other every evening lent an air of mystery to the Jack Lynch Room until the early rehearsals took place in the old the proceedings. Props of that vintage hours of the morning. Eventually we Sunbeam Wolsley Factory and the Cork mounted at an alarming rate, thanks said goodbye to each other, as the real Arts Theatre. But the thrill of that to our hardworking stage manager. Bells of Shandon chimed. It was a first reading in the Cricket Club will Packets of Woodbine cigarettes were moment of sadness, but we all felt we never leave me! bought in – one of the packs got had pulled off our site-specific plays smoked by an outsider during one of to our deep satisfaction. It would be A sudden phone call from a ten year the rehearsals. Old fashioned sweets, nice to do it again! old girl caught me by surprise. Her bottles of lavender water, handmade elder brother was in the play and she Christmas decorations were all in

18 Dr. Patrick Gaffney

Book Review: Text-book of Surgery. By Patrick Kiely BSc., MD, MCh, FRCS (Eng.) Second edition (Pp 1158, illustrated, 63s.) London HK Lewis & Co Ltd 1958 Last year was the fiftieth anniversary were a small class and perhaps not facts of surgery within a reasonable of the publication of this book and typical. My copy was purchased in compass.” He notes “a tendency to although it is not used now it is Hudson’s Bookshop in Birmingham in cling to the older outlook ... A perhaps useful to look back at the 1964 so it was still on the shelves of generation ago tuberculous arthritis book and its author. medical bookshops at that time. One and the gummatous lesions of syphilis problem with it is the lack of clarity of were common but today the one is Patrick Kiely, or P. Kay as he was headings. These are bold typed but in rapidly diminishing, the other seldom widely known, was Professor of a fairly undifferentiated way so that seen. Perhaps textbooks cannot Surgery in UCC 1942-67. The first headings for subsections are in the change so rapidly because some edition of his book was published in same type as main ones. If he was examiners are conservative in January 1958 the second in 1959. At writing the book today P. Kay would outlook”. the time of writing as well as his probably be advised by his students teaching and administrative work he how to configure it; (how much easier In his preface P. Kay quotes Professor had a clinical commitment in both the it is to do that today than then). More Geoffrey Jefferson of Manchester “the public and private sectors. problematic is the profusion of causes branches must not become separated for every condition, for it is not readily from the tree in general surgery”. P. It is a long book, all the work of P. Kay apparent what is important and what Kay goes on to say “In other words it except the chapters on the Eye and is not. He acknowledges his debt to is essential for the student and junior Ear, Nose and Throat by Professor V. other authors particularly to Walter postgraduate that the pieces into O’Hea Cussen. Two chapters, on Mercer in orthopaedic surgery, he which general surgery is being split up Anaesthetics and Gynaecology, were sometimes uses WM’s classifications, should be suitably integrated. For this omitted from the second edition. It is but he does not plagiarise him. the general surgeon is still the most detailed, too detailed. For instance it suitable teacher and there are a takes sixteen pages to cover injuries of In a review of the book in Journal of number of excellent textbooks of the ankle and foot making it difficult Irish Medical Association at the time, surgery available to students written to discern the more important ones. Harold Browne notes some of the mainly by general surgeons”. Its style is simple and unadorned, as changes in the second edition; were his lectures. In description of annotations about antibiotics, blood His book has its place on the shelf conditions it is fluent and in chemistry, etc, the chapters on the beside them. summaries concise. When he uses blood vessels and surgical conditions long sentences, for instance in the of the lungs and oesophagus have examination of the patient with low been revised, a summary of cardiac back pain his exposition of what to and other intrathoracic congenital look for is memorable and clear. abnormalities added. An unsigned review in the British Journal of Surgery His students did not have to show is critical of the quality of the familiarity with his textbook and he illustrations some of which were said would have expected them to use not to represent the clinical condition whatever book they preferred. He did of the legend. Sir Zachary Cope in a not often refer aloud to his own book. review in the British Medical Journal The experience of the writer who did notes that “All (this book) …is from not use it himself was not that it was the pen of Professor Kiely... (he) has widely used by fellow students but we succeeded in presenting the main

19 Mr Michael Hanna

Fire & Ice - A Photographic Journey of Antarctica “This exhibition is compiled from my collection of photographs taken throughout the 1980’s and 1990’s while on fieldwork in Antarctica. It includes images of volcanoes, life in the field, shots of wildlife and a visit to the historic huts of Scott and Shackleton on Ross Island, that were the staging posts for historic exploration of the continent at the beginning of the 20th century”. The Jennings Gallery recently held this exhibition of photographs taken by Professor John Gamble over many years of field work in Antarctica where he studies deep earth Olivine-bearing ultramafic xenoliths. These objects are thrown up by Antarctica's volcanoes that tap into deep veins of magma 60 km below the surface of the earth. Thus he uses natures own boreholes to retrieve fragments of the upper layers of the earth's mantle. The show however is more concerned with surface features, - the huts of Shackleton and Scott, the lonely profiles of his colleagues against the vast backdrop of Antarctica's frozen landscape where there are no markers of distance, no indicators of scale, where the eye is deceived and the spirit awed by enormous formations of ice and rock. And then there are the penguins, comic birds to look at, but That career is widely respected and as John told us, if you try to lift one highly distinguished. He carries his up, it is like picking up a brick! erudition lightly, but it is not all of us that can claim to have a volcano and a The exhibition was opened by Dr. Clare glacier named after us. O'Leary who had to drive over from South Tipperary General Hospital There are about 30 images in the where she had an afternoon endoscopy exhibition and we put some maps and list. Clare has climbed Everest and the some items of his kit into the other six highest continental peaks; exhibition "bunkers" in the gallery. she has also treked to the South Pole These include an old ice axe that he and back. In doing so she followed in found in Antarctica. Whose? We will the footsteps of Scott himself and never know. travelled over the routes travelled by Crean and Shackelton. UCC's Medical School is deeply privileged to have Clare not only as one of its Alumni but also as a clinical teacher and a role model for its medical students.

We had over 120 people at the launch. John's wife and daughter and many of his friends and colleagues shared his pleasure with the occasion. A number of people from the Tom Crean Society attended. Before the launch, he gave us an entertaining illustrated talk of some of his experiences and insights about this strange laboratory in which he has chosen to build his academic career.

20 Appreciations Dr Pat Beausang He completed his training in 2000 Mr KC Condon and commenced in post as a Consultant in Geriatric Medicine, Consultant Physician in Geriatric Cal Condon who died on the 1st June Stirling Royal Infirmary (b 1966; q Medicine at Stirling Royal Infirmary. 2009 was born on the 21st University College Cork, 1991, BSc , His main areas of interest were in September 1927, the youngest in a MB BCh, BAO, MRCP (I)), died from movement disorder and orthogeriatrics family of seven, to Justin C. and Annie Acute Leukaemia on 16th August but the Day Hospital at Stirling, with Condon. His father (“The Boss”) was 2009. its multiplicity of challenges and an auctioneer and rent collector for rewards was an area of particular the town of Youghal, Co. Cork. He Pat, a twin to James and one of six focus. He was modest and unassuming was educated at Christian Brothers children, was born on the 9th of July but had a dry and at times wicked School, Youghal, Castleknock College 1966 and brought up in Ballincollig, sense of humour. However at all times and University College Cork, Co. Cork, Ireland. He was from a he was dedicated to the care of his graduating in 1950. It was at UCC he medical family, his father (Dr John patients. met Dr Margaret (Peg) O’Donoghue Beausang) having been a general whom he married in November 1956. practioner. He won an academic Outside of Medicine, Pat was a keen His Post Graduate training continued scholarship to the Christian Brothers athlete and had previously participated at St Mary’s Hospital Portsmouth, Bury College in Cork City prior attending in 10 km races. He was also a keen General Hospital and St Catherine’s University College Cork. Pat excelled follower of football and Liverpool Hospital Tralee. Plastic Surgery was at University and won a Health Football Club was the focus of this his chosen speciality and he spent two Research Board scholarship for his interest. In addition to football he had years as SHO at Rookstown House, intercalated BSc in Physiology which a very broad and detailed knowledge Basingstoke, Hampshire, under tuition was subsequently awarded with 1st of sporting facts in general. by Sir Harold Gillies and Charles class honours. McCash. While there he gained extra His family however was his abiding credit as he tied fishing flies for Pat qualified as a doctor from UCC in love. He met and married Cat in 1999 Gillies who was a keen angler and had 1991 and commenced his and had renewed his wedding vows in success with the “Condon Specials”. postgraduate training at Cork July 2009 just prior to his sudden Subsequently he worked as Registrar University Hospital. He was a illness. He is survived by Cat and his with Emlyn Lewis at St Lawrence’s notoriously hard working SHO and two children, Orla and Louie, whom he Hospital, Chepstow and as Registrar at worked as a registrar within the adored. He had taken up swimming Rookstown House. Department of Geriatric Medicine at lessons very recently to keep up with the Cork University Hospital. He had a Orla and Louie. He completed his training in Plastic particular gift for teaching basic, bite Surgery spending two years (1958- size principles of Medicine to students The ceremony to celebrate his life in 1960) working as Senior Registrar at and his teaching sessions were hugely Stirling was attended by all the Queen Elizabeth Hospital, popular. differing and varied occupations from Bermingham. within a hospital due to his inclusive He decided to pursue a career in nature and excellent wit as well as Following the death of his brother-in- Geriatric Medicine and was noted by many friends and family. law, Michael Kelleher, Cal took up the his contemporaries at the time to be post of General Surgeon at the Bon meticulous, yet immensely practical. As one of his friends from University Secours Hospital, Tralee, where he They described his common sense stated, “I've always thought that you spent the next ten years. There were approach to complex medical issues are lucky to meet a handful of real no vacant posts in Plastic Surgery in as “The Beausang Method”. friends throughout your life. To those Ireland at the time. Pat moved to the West of Scotland in of us who knew him, Pat will be 1995 to take up a Specialist Registrar remembered as a true friend, During the latter years in Tralee the Training in Geriatric Medicine. He regardless of time or distance, and we late St John O’Connell, Consultant rotated through various hospitals are better for having known him.” Orthopaedic Surgeon, arranged for Cal including Stonehouse Hospital, the to travel to St Finbarr’s Hospital and Southern General Hospital, the Dr Diarmuid Quinlan and St Mary’s Orthopaedic Hospital one Western Infirmary and Gartnavel Dr Mike O’Connor day a week to attend and Out Patient General Hospital. Clinic to do inpatient consultations

21 and to operate on a long list of Dr Derek McCoy hospital, a feat unthinkable in the seriously injured or burned patients. modern medical era. Many of these lists continued late into The appointment of Dr Derek McCoy the night. as county physician to Bantry His dedication to this post knew no General Hospital in 1971 was a bounds, with an around the clock, In 1970 Cal was appointed Consultant catalyst for the modernisation and permanent on-call commitment for 28 Plastic Surgeon and Director of the advancement of medicine in west years. Despite this onerous Accident and Emergency Department Cork. His contribution still impacts responsibility and the financial at St Finbarr’s Hospital. He moved to positively on healthcare in the region straitjacket of dark recessionary times the Cork Regional Hospital, now Cork and further afield. in the 1970s and 1980s, he was not University Hospital when it opened in satisfied with merely maintaining the November 1978. He established what Born in Belfast, he was the only child status quo. He set about introducing is now a major Trauma Centre with five of William and Veronica McCoy. After new services and modernising A&E Consultants and introduced graduating from Queen’s University practices. Plastic Surgery to Cork. There are now Belfast in 1957, he interned at four Consultants in the specialty. Musgrave Park and Antrim Hospitals. He oversaw the establishment of the A further two years were spent as a laboratory services at Bantry General Cal enjoyed teaching and was held in senior house officer at Belfast City and Hospital. He attracted a technician high esteem by all who were trained Musgrave Park Hospitals before he back from Australia knowing if he by him and with affection by his heard the Franciscan missionaries could hoodwink the Health Board into colleagues and staff. He was in great were looking for a doctor in western paying her for the first month it would demand as a medico legal witness. Kenya. be well-nigh impossible to get rid of His opinion was much appreciated her. The Health Board obliged. during his time on the Irish On April Fools’ Day in 1960, Derek, Postgraduate Training Committee, the his wife Breda and their 12-week baby The closure of St Finbarr’s Hospital Specialist Advisory Committee in daughter Deirdre undertook the three- and the transfer of services to Cork Plastic Surgery, and the Irish week trek to Nyabondo in the middle Regional (now University) Hospital in Association of Plastic Surgeons of of the African bush. For 2 years, he 1979 offered a unique opportunity to which he became Chairman. was the only doctor for hundreds of recycle equipment regarded as too square miles, providing medical care dated for a new flagship hospital. Outside of work Cal was a keen in all specialities. He used this Witnesses reported seeing cars sportsman; fishing, shooting, golf and experience to equip himself with a returning from St Finbarr’s at various sailing were his passions. He was remarkable range of practical skills intervals full of equipment which Captain of Tralee Golf Club in 1968 and knowledge in diverse Medical subsequently served the population of and involved with John Kelleher in areas. He also demonstrated the first West Cork very well. Blood pressure putting together the land package that signs of his pioneering approach to and heart monitors used at Bantry ultimately became Barrow Golf Club. Medicine by establishing the first General Hospital for over a decade He was a competent sailor being a laboratory service in Nyabondo. were saved from the rubbish skip at member of Tralee Sailing Club and the South Infirmary/Victoria Hospital. subsequently Royal Cork Yacht Club He returned to Ireland in 1962 and The problem of retrieving information where he competed successfully. He worked for three months in the South from these monitors, which were prone had a memorable and “hair raising” Infirmary Hospital before assuming the to overheating, was solved by placing experience sailing across the Atlantic. post of Medical Registrar at St them in his refrigerator for an hour Finbarrs Hospital, Cork, under the after use. Cal was a great family man and tutelage of the iconic Prof Denis particularly enjoyed the annual family O’Sullivan. In this role, he continued He established the Intensive Care Unit holiday in his beloved Dooks. He is his pioneering approach to Medicine at Bantry General Hospital which sadly missed by his wife Peg, sister by being central to the establishment today enjoys an excellent reputation Peg Finn, three sons Justin, Michael of the first Renal Dialysis Unit for and personally fundraised for the heart and Cal and his seven grandchildren Munster, St Gerard’s, named after his monitoring equipment that helped to Justin, Derry, Richard, Luke, Karl, son who died aged 10 months. save many lives. In addition, he put Sebastian and Hope. himself at considerable discomfort by May he rest in peace. His defining appointment, however, sacrificing a Medical Registrar’s post was as County Physician to Bantry for a six-month period to purchase the Dr TPF O’Connor. General Hospital in 1971, succeeding first endoscopy equipment for the Dr Tim O’Connell. Although appointed hospital in the 1990s. He described as a Consultant Physician, such was this time as probably the most the range of his skills he actually difficult of his working life but it performed as Physician, Obstetrician, allowed him to establish an endoscopy Anaesthetist and Paediatrician at the service admired by many much larger

22 hospitals today. inspiring aviator and, two days before take up a new Consultant post in his death, made his last flight over his Orthopaedics in Cork later that year. He enjoyed the academic side of beloved west Cork. He was commodore medicine and lectured in of the local sailing club and was very Orthopaedics was in it’s infancy in Pharmacology at University College widely read, consuming manuals, Cork at the time and was extremely Cork. As a teacher, however, he almanacs and history books busy due to an outbreak of Polio in seemed most at home at the bedside, voraciously. As a result, he proved an 1956. Fred took a keen interest in inspiring literally hundreds of doctors invaluable reference point on the the musculo-skeletal problems of polio now practising in Ireland and abroad. minutiae of anything from astronomy and paediatrics. He set up a highly There, he taught his bewildering array to battlefield tactics. successful screening programme for of practical skills honed in Africa and the early detection and treatment of was a true exponent of the philosophy He is survived by his wife, Breda, sons Congenital Dislocation of the hip and that one can reach any body cavity Eamon, Diarmuid and Bryan, clubfeet. with a long needle and strong will. daughters Deirdre, Claire, Bríd and Katherine and 18 grandchildren. He was appointed as part-time lecturer He was probably two decades ahead of in Surgery in UCC Medical School. He his time in appreciating the Dr Brian Carey was also involved in the National importance of adjusting drug doses in reproduced with permission of the Training programme in Orthopaedic the face of declining renal and hepatic Irish Times Surgery. His real interest was in function and in recognising the Paediatric Orthopaedics. Fred had a negative impact of sedative Dr Frederick Moore remarkable ability to relate to children medication on older people. and their parents. Frederick Hugh Moore was born on He was the physician on duty the January 22nd, 1922 in Bray, Co. He was a man of immense common night of the Betelgeuse disaster in Wicklow, and grew up in Dublin. He sense who had an outstanding Bantry Bay 30 years ago, an event that attended St. Columbas College and aptitude for choosing the correct affected him deeply. then undertook his medical education management of the individual patient at Trinity College graduating in 1946. even if it meant advising against A man of action rather than words, he After various house jobs in Dublin he surgical treatment. had a healthy suspicion of health moved to Liverpool to train in Surgery. service managers. This suspicion was Prior to leaving Scotland Fred had fuelled further when the Health Board While in Trinity he excelled at rugby taken up golf. He became a member removed maternity services from the and captained the senior team. He of Cork Golf Club and represented his hospital in the 1980s. He recounted continued his interest while in club in various competitions. His the dark irony that the maternity Liverpool and played for Lancashire. most glorious memory in golf must be delivery room was subsequently a ‘hole in one’ at New Delhi Golf Club converted into a storeroom with the He went to work as a ship’s doctor for at the age of 80. notice “Deliveries between 9am and six months and on his return from that 12pm only”. went to work at the Bridge of Earn He was an active member of the Hospital in Scotland. It was there that British Orthopaedics Travelling Club He was a powerful patient advocate he decided to pursue a career in and he and Elma enjoyed many trips and viewed the current penchant for Orthopaedics. He was elected as a with this club. He was also President clinicians in management with Fellow of the Royal College of of the Irish Orthopaedic Club, a suspicion. His feared that any dilution Surgeons in Edinburgh. He continued council member of the British of the advocacy role of Consultants on to play rugby as a prop forward for Orthopaedic Association, Chairman of behalf of their patients could Perthshire Academicals and lined out the Cork branch of the Trinity College ultimately compromise patient care. for the north of Scotland against the Association, Chairman of Blackrock All Blacks in 1953. Tennis Club and a member of St. He officially retired in 1999 but Michaels Church Choir. continued full-time until 2002 He moved to Dundee Royal Infirmary performing locum work. He was greatly in 1955 where he met his future wife Above all, he was a great family man. honoured to be asked to officially Elma Rankine who was a resident in He died in June after a brief illness unveil the new CT scanner at Anaesthetics. They married in 1960 at and will be sadly missed by his wife Bantry General Hospital in 2007. St. Andrews where Elma had attended Elma, son Donald, daughters Caroline University. and Linda. In later life, he learned to fly light aircraft, obtaining his pilot’s licence. It was a chance meeting in Dr John Curtin As part of the Leeside Flying Group, Washington at an Orthopaedic he relished soaring in a four- Conference with the late St. John seater Cessna 172. He was an O’Connell in 1960 that led him to

23 The UCC Graduates’ Association offers UCC Annual Scientific Conference 2010 members the following September 16 and 17 benefits and services:

Contributors Include: Dr Danny Costello Dr Orla Crosbie Mr Carl Davis Prof Barry Keane Prof Gerard O’Donoghue • Access to a global network of graduates Prof Ivan Perry • Invitation to graduate events and Dr Liam Plant gatherings in Ireland and around the globe Dr Columba Quigley • Mailing of UCC Alumni News and Prof Cillian Twomey the annual UCC Graduate magazine Dr Fionnuala Quigley • Readership rights to the Boole Dr Eamonn Shanahan Library, UCC. Members will need to register directly with the Library. Dr Paul Whelton • Exclusive membership rates to the Mardyke Arena Leisure Centre, UCC The Conference will also host the inaugural • Expert assistance on organising class reunions Mr Joe O’Donnell Memorial Lecture on September 16, • A choice of UCC affinity credit at 4.30pm which will be followed by the launch of an cards with AIB and Bank of Ireland exhibition Joe O’Donnell’s artwork at the • Special graduate membership rate Jennings Gallery. to the Lewis Glucksman Gallery

• Email for Life Service allowing Registration for the Conference is Free of Charge. recent graduates to activate their The dinner at the Aula Maxima on the evening of September 16 at 7.30 student email account will be €70 per person. • Substantial discounts on goods and services with over 150 traders – e.g. 10% Nangle’s Garden Please register for the Conference and/or Dinner at: Centre, 10% Griffins Garden http://conferencing.ucc.ie/conference Centre, 10% Maher Sports, 10% or contact Rachel Hyland – 021 4901587 / [email protected] for details. Matthews Ltd, 15% Black Tie, 10% Blarney Irish Woollen Mills, 10% L’Occitaine and 10% Contact Details: Keane’s Jewellers, 20% Cork Ms. Rachel Hyland, University Press, 10% Medical Alumni Association, Oak Tree Press, and Brookfield Health Sciences Complex, College Road, Cork 10% Cremins Dry Cleaners etc. Tel: +353 (0)21 4901587 € Membership costs 100 for five year Email: [email protected] membership. To join, please forward http://www.ucc.ie/en/DepartmentsCentresandUnits/SchoolofMedicine/MedicalAlumni/ payment (debit or credit card or cheques accepted) with your Please send us your e-mail address to update our files. graduation details and current address to the UCC Graduates’ Association, University College Cork UCC Medical Alumni News is intended for circulation among UCC Medical Alumni. The opinions and views in the publication are those of the contributors and are not necessarily shared by the UCC Medical Alumni Association.

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