Where did you grow up and what was your childhood like?

I grew up in Raheny, on the northside of Dublin. My dad was a GP there, and the practice was in the house, at the end of a little shopping strip that had the supermarket, the butcher, everything really. We were right in the centre of the action. We lived there until I was seven, then we moved to Clontarf.

I was always at the front desk in my dad’s practice. My mother was a nurse and was essentially the practice manager. There wasn’t a name for it back then. I just loved it. I was intrigued by the whole thing. It wasn’t just the medical part of it. It was as if we had our own shop. But a different type of shop. I got to know all the patients, and all the daily stresses. I had an older brother and the patients used think I was a little boy because I had very little hair. They’d ask, “How are the two boys?” and I used to run off crying apparently when someone said that.

 

When did you decide to pursue a career in medicine?

There was no conscious decision. I followed my dad around as a child and I was intrigued by his daily routine.

I went on house calls with him, and I would listen intently to all the stories about the patients’ lives.

His practice had a lot of patients in what was a working-class neighbourhood at that time.

Looking back my father probably overshared information with a child. Nonetheless, it had a profound impact on me. I still remember how upset he was when he had to deal with situations of physical abuse in some of these homes. My dad would be horrified when he came across these situations.

He felt very strongly that a common theme in these situations was women who were being abused couldn’t leave their husbands because they had no education, and therefore no way to financially support themselves and their children. As a result, it was indoctrinated into me from when I was seven or eight that you have to be able to walk away from a bad situation and you must be financially independent. That was stuck in my mind from honestly as long as I can remember.

He also worked with the gardai (Irish police force) supplementing his income by doing medical evaluations on people who had been arrested (usually for intoxication driving etc.) Ironically, he would often hang out in pubs with the gardai, waiting for these “clients” to show up!

A lot of stuff was done in pubs, and he had a lot of publican patients. I particularly remember the Toby Jug bar which he used to on South King street. It was where my dad honed his drinking skills as a medical student. He ended up taking care of the Swifts who were the owners. There were a lovely couple and I have fond memories of hanging out there with him.

 

You were the fourth generation in your family to go to the same medical school (RCSI, Dublin) How was your time there?

No one pushed me. It wasn’t like they were saying you “must” go. Obviously, my parents were thrilled, but it was my decision.

I struggled in pre-med because I had very limited exposure to basic sciences in secondary school. I went to school in Manor House in Raheny. There were lots of very bright girls at the school here, but the nuns did very little to encourage them in academic pursuits. The highest goal typically set was to work in the bank or the civil service. When I started at the College of Surgeons, I realized most of the Irish students in my class had gone to schools that had much more prestigious academic records. I felt like a fish out of water that first year. Most of the other very competitive students insisted they were not studying at all. I also was not studying, but apparently, I was the only one telling the truth. Another life lesson learned!  So, I did horribly in pre-med. I had to repeat all my subjects in September. It was a terrible summer, but I survived.

Once I got through the first year I took off, and when I got to clinical years there was no longer any effort in learning. It became natural curiosity at that point. I had a great friend, one of my best friends to this day, Helen Daly, who lived down the road from me and we did everything together. We failed together and passed together. So that was a big help. Good friends were and still are so important for me. I don’t think I would have survived medical school without Helen and Orla Donahoe (my other bestie).

 

What made you leave Ireland for Chicago?

I graduated in 1988, and at that point, I’d been going out with Ken O’Riordan, my now husband, for at least a year consistently (we’d had an on and off courtship since premed). Ken was very organized. He came from a non-medical family and had gotten into RCSI on an academic scholarship. Because he had no medical connections, he planned his career over here [in the U.S.] and he had done electives in the states.

He took the American exams and came to the US while we were interns in Beaumont hospital in Dublin, to interview for medical residencies. He wanted to go to Boston, and the compromise was that I would go to the US if we went to Chicago, because I had family in Chicago.

But because I was disorganized, I hadn’t passed the exams to start a US residency. At that point I was 25 and I still lived in my parents’ house. That was not unusual then, but with Ken leaving the country I felt it was time for me to move also.

So, I decided to go to Baghdad. As strange as this sounds now, it was not that unusual back then. The hospital was called Ibin Al Bitar. It offered services such as kidney transplants and IVF and was the only hospital in the country to provide these services at the time. I went with two of my classmates for six months. It was an amazing, sometimes overwhelming, cultural experience. On our day off we would swim and eat in the Hotel El Rasid. This became the hotel where all the worlds’ journalists stayed and reported from during the American invasion of Iraq.

Baghdad was fascinating — a complete culture shock. Even in terms of the patients. A lot of them had were young men from the Kurdish regions who had been exposed to chemical weapons and were being treated for leukaemia. It was very sad. Many of them did not survive despite our best efforts to treat them.

 I took my American exams for residency (called ECFMG at that time now USMLE) in Baghdad University. I think I was the only woman there — and the Iraqis who were taking them with me had been studying in bunkers during the Iraq/Iran war.

 

How did you decide to become a neurologist?

When I came to Chicago, I thought I wanted to be a psychiatrist. I loved reading psychiatry, so it seemed like a good idea. I think in the back of my mind, I was also thinking it would be easier to get home to Ireland with it than many of the other medical specialities.

When I started psychiatry residency, I quickly realized that I was giving up most of the clinical skills I had learned in medical school. Luckily, in my second year, I rotated through Neurology as part of psychiatry, and I loved it. I had a Neurology attending who approached me while I was having this career crisis about what I was going to do, and he said, and I quote “Please don’t take this the wrong way, but you don’t seem cut out to be a psychiatrist. Have you any interest in switching to neurology?”  That’s how I became a neurologist basically. I was very fortunate to have a lot of serendipity along the way meeting the right people at the right time.

 I graduated Neurology residency in 1995. I’d had my oldest daughter, while I was in training, and then had my son two years later in fellowship. I did a fellowship in neuromuscular disease and then I went into private practice for five years in the suburbs, before again, a colleague I knew from training, approached me about joining him in practice at Northwestern University.

There was a new neurology chair there, Jack Kessler, another inspirational character along the way for me, and he convinced me to join the academic faculty there.

He was very open minded to anyone he felt had anything to contribute. He asked me to switch to academic practice three times, and I finally did in 2012.

I had done my stroke boards before that and was a certified vascular neurologist. In hindsight this is what I should have done after residency because it’s what I really love, but stroke fellowships were just being developed then. It is a very rewarding specialty to be in now as we have a have a lot of acute therapies (IV Tenecteplase and/or thrombectomies). Prior to these therapies, some stroke patients would be left with lifelong disabilities. The other part of vascular neurology that I really enjoy is preventative therapy.

I’m the medical director of the stroke program at a safety net hospital that cares for uninsured or underinsured patients. The patients there have very poor access to medical care. It is a predominantly Spanish speaking community. In addition to seeing patients there, we developed a telestroke program where we use a video platform to evaluate patients with acute strokes in their emergency room. If they need a thrombectomy we transfer them. It’s been shown if emergency room physicians have access to a telestroke system they are much more likely to give clot busting drugs than without it.

 

 You also did a fellowship in wellness and burnout among physicians?

I always had an interest in this topic. I think there was a period in my life when I was suffering from burnout, and I watched a lot of other good physicians leaving Northwestern prematurely who were clearly suffering from burnout.

Wellness has become a very important topic in the US. For a hospital system it costs approximately half a million dollars to recruit a new physician. The timing was ironic because I graduated this fellowship in 2020, and we went straight into the COVID crisis when physician burnout reached its peak. Burnout is an important topic in Ireland also where junior doctors are more affected than consultants.

 

What do you like to do in your downtime?

I just became a grandmother, so I am really enjoying that.

I love traveling. I believe I got the travel bug from my father. I’ve been trying to do more of this. Places we have visited recently include New Zealand, Jordan, Vietnam, and Cambodia Another place I love is Costa Rica. We typically go there in January to get a break from the Chicago winter.

We are very fortunate to have a big circle of friends in Chicago.

I am also very fortunate that both my parents are alive, living in Dublin and I try and visit them every 12 weeks.

 

What are you hopes and dreams for the future?

To quote Jane Fonda “I am now in my third act”.

This makes family time very important. My son lives in Chicago and is getting married next year. My daughter, her husband and my granddaughter live in Brooklyn, New York. I have a 21-year-old daughter who is back living in Chicago, working for Americorps (the U.S version of the Peace Corps).

 I also am really enjoying my work now more than ever. I’ve become involved in health equity research, and I do research projects in Kano, in Northern Nigeria. I want to do work that I find rewarding and that I hope can continue to make even a small difference in this field.