The changing of the guard

The recent retirement of my wonderful mentor has caused me to think about the importance of resilience and other values.

There are many occasions that mark significant beginnings and endings in the seasons of life. These moments when they happen often give us a chance to pause, reflect and take stock. I had one such occasion recently when my mentor retired. Although not unexpected, it was sooner than anticipated and unlike I had hoped: She elected (as is her right!) to retire completely rather than stay on in part-time capacity as she had previously considered. I found myself feeling somewhat bereft and somewhat embarrassed at the impact her moving on to the next stage in her life was having on me. 

To better explain why, I’ll go back to the beginning of our mentor/mentee relationship. I was nearing the end of my radiology SpR scheme. I had already set up Fellowships in North America; two years of neuroradiology followed by two years of neuro-intervention, which would set me up for eligibility for a full licence and board examinations in that State. It was 2012, I was the generation of SpR who felt the 2012 pay cut to be a slap in the face by the Irish Government and I was keen to respond to it by taking myself elsewhere permanently. Cut in haste, repent at leisure was the message I hoped to convey, if you will. 

I was in the last group in my year to rotate to paediatrics. Before I started, I pleaded with my husband to reason with me if I decided to change my path from neuroradiology to paediatrics. 

“What would be wrong with that?,” he asked. 

“They do lots of call and it’s a way harder job. It would be a foolish move,” I responded. 

“Why would you change, so?” 

“Well one of the consultants there is really brilliant, she gives great lectures and she’s very funny. She clearly loves her job.” 

As I’d predicted, I was quickly won over. She was a wonderful teacher, delighted in sharing her knowledge. I ran after her to theatre where we injected botox into muscles that were too tight, on from there to the NICU in the Rotunda where she scanned the tiniest of babies with the greatest of care and back to Temple Street where she taught me the differentials of common brain tumours in children. In the ultrasound room, her warmth and patience with children and their parents really moved me. She taught me that when you look after a child, you care for the whole family. If you focus only on getting the diagnosis right, but you miss the opportunity to support the parents by listening to them and addressing their concerns, then you miss the chance to provide great care and a patient-centred experience to the whole family. Each day learning from her was a masterclass in professionalism and vocational care. 

As a result, at that late stage, I found myself rushing to change my Fellowships to paediatric radiology. I was really lucky to secure further training in Boston Children’s Hospital where I went soon after completion of the SpR scheme. She stayed in touch. Little emails from home reminded me of updates of the New Children’s Hospital; she was keen to impress on me that it was expected to open by 2017-18. She knew that I still planned to stay in the US, but she also knew that life has a way of changing the best laid plans. 

As it happened, my mother-in-law sadly became unwell while we were away and my husband was keen that we return home at the end of the Fellowship. I struggled with this as I was very happy in the US. I was working in a great hospital with brilliant staff, ample capacity, and protected research time each week with administrative support. I knew that any role I returned to in Ireland would be clinically busier, with much more on-call and less (or rather as it turned out, no) academic time. But the pull of family is strong and we made the decision to move home. 

For once, I was speechless. I was just too choked up to put words to what she meant to me and how she had shaped me as a professional 

Ego can make one want to amplify one’s achievements, but getting a consultant post was very easy for me due to ample vacancies in my specialty. I was one of two applicants for two available posts as a consultant paediatric radiologist and was duly appointed. The other candidate was also appointed, but ultimately decided to stay abroad. Ten years previously one would have seen at least five or six eligible excellent candidates. But most of my peers who followed the same training path in the US have elected to stay there. 

When I took up my post in Ireland, I approached my mentor and asked her would she be my mentor “officially”. I explained how the mentor/mentee relationship had worked in Boston and she was intrigued by the concept and took to it with gusto. Like many things in her career she managed to maintain the enthusiasm of the beginner, with the skill of the expert. We had regular meetings. She advised me on everything from filling in on-call forms, to continuing professional development, to filing tax returns. She was unwaveringly supportive and an absolute champion of me and everyone she trained. 

When she retired last October, the retirement party was somewhat muted due to Covid-19, social distancing, masks, and no food or beverages. But the hospital gave her a very warm send-off in spite of this, with wonderful speeches from many clinical colleagues who had benefitted from her skill and support over the years. For once, I was speechless. I was just too choked up to put words to what she meant to me and how she had shaped me as a professional. 

In her speech, she spoke of how, as she was cleaning out her office she found multiple letters that she had written over the years. They were to management, to fundraising, to various politicians, pleading for more staff and better infrastructure. She spoke with such passion about the frustration of having spent a career asking for adequate resources to provide care to the nation’s children and her disbelief that, even as she retired, we are still writing those same letters. What she was too modest to say was how many of those efforts made a difference to how we provide care to children in Ireland. An example is the funding secured for dedicated radiographer posts to support Ireland’s only paediatric MRI service on-call, and later CT on-call, which are essential to the timely provision of the neurosurgical service in Temple Street. She also was instrumental in the hospital acquiring replacement fluoroscopy, ultrasound, and gamma camera equipment. All of these were crucial investments in staffing and infrastructure, which enabled us to do our jobs better and provide the highest quality of care to our patients. 

As you drink your chosen beverage today, please raise a toast to this amazing woman, Dr Stephanie Ryan – Ní bheidh a leithéid ann arís. 

Many of you may have expected this column to be an update on the status of the consultant contract talks. In one rather glum respect, there is sadly nothing to report. Talks are stalled since mid-December 2021 and, as of yet, no new Independent Chair has been appointed to allow the process to resume. The Government decision to exclude consultants from the final round of FEMPI reversals has served only to damage relations further at a critical juncture for the health service. In another respect, thinking about Dr Ryan’s impact has given me cause to think about resilience, a quality those of us involved in the talks have had to call upon again and again, both individually and collectively. Ultimately, the strength to stay the course is what delivers enduring