Interview: Dr Rhona Mahony

Dr Rhona Mahony, Master of National Maternity Hospital Holles St.

Dr Rhona MahonyDr Mahony, tell us about your background

I grew up in Raheny on the north side of Dublin; I started school when I was three, because I was always badgering my mother. I was the youngest of three and I’d be watching the others go out the door, so eventually in desperation my mother said ‘right off you go’, and I loved it, I really liked school.

I went to school in Clontarf, I started there when I was three and I stayed there until I was seventeen. And all of my friends from that period are still my close friends now, I’m very lucky to say that – it’s been a lovely constant throughout my life. I loved sports, I played a good bit of tennis, did a lot of running – I was a bit of a tom-boy actually so I think I was about twelve before I even wore a dress.

I was always up to something, we grew up on a road where there was a big gang of us so it was like a big family – we’d be out playing tennis, or skipping or rounders. We always make our childhood idyllic but it certainly does seem so, looking back.

Is there a history of medicine in the family?

No, not at all actually – I had a great uncle who was relatively famous on the rugby side and at St. Vincent’s. He was quite a pioneer in some ways. I didn’t know him terribly well; I suppose he seemed quite elderly when I was young, so no we’re not a medical family.

What motivated you to choose medicine as a career?

I always said I was going to be a doctor - right from the age of the first fisher-price doctor’s kit that I got for Christmas. Later on, certainly when I went to second level, I was very clear that I wanted to do medicine – I think I always knew.

I think I saw it as a career that would be very challenging but I also knew that it would be very useful. I came out of school in the late eighties; there was a recession, and it wasn’t an easy time. There was a part of me that wanted to be of some service and I suppose I thought that if I had skills and was reasonably bright, then they should be used with good purpose. I felt that medicine would be an ideal way to have a career that would be really interesting, full of interesting people – but one that would also allow me to be of some benefit.

Can you tell us a little bit about your career to date?

I studied medicine at UCD; I started aged seventeen and emerged in 1994. From there I did my internship in St Vincent’s Hospital and even at that stage, I was very clear that I wanted to do obstetrics and gynaecology. I started in the Coombe in 1995, as an Senior House Officer. That was a very formative period because I met up with a really great group of registrars, you couldn’t not love working with them.

Then, I went off to the Mater and met Malachy Coughlan and that really was it for me, there was no way I could have considered any other career. I moved from there to Holles St. I love the people I work with here, from midwives to obstetricians – they’re great fun, incredibly hard working and also very good friends.

What, in your experience are the kind of traits and characteristics that shape good doctors?

It sounds very clichéd but you do need to be very hard working, you’ve got such a volume of knowledge that you’ve got to somehow absorb. So, I think the first thing is you’ve got to be able to apply yourself. You need to be very conscientious and you’ve got to care.

Everything you do is very important, everything you say is very important. It’s not always about the major emergency, but often it’s about the off the cuff comment that you make to someone that can either be very positive or very negative.

You need a great deal of commitment and you also need to be quite robust; it’s not always an easy job. People don’t always appreciate your best efforts, or likewise you might have complications that you’ll feel very badly about and you have to be able to dust yourself down and move on to the next patient. You do need to be quite a strong person I think.

You also need to have huge empathy, you’ve got to have sympathy for people and you’ve got to look at the whole person. As a doctor you must never become desensitised.

Whenever I’m breaking bad news, I’m always conscious that at that moment, the world stops for that family and things change forever. So, I think it’s very important that you have a respect for what you do and you need huge and absolute respect for your patients.

Holles StCan you tell us about a stand-out memory from your time at medical school?

One of the biggest stand-out memories for me was doing psychiatry, with Ivor Browne (retired psychiatrist). There was a small group of us, we were actually the last group to cycle through St. Brendan’s and it was so just absolutely alternative and was so very different – I had never experienced anything like it. The teaching, the subject matter, it was like a different world. Somehow in the middle of that was this fantastic tolerance of human beings and the human spirit, and I suppose that that’s something I hope that I carried with me. I learned that things and people can be different and there is a great room for tolerance and that as a doctor it’s important that I can open my mind and that I must never judge.

A lot of these people had very serious psychiatric disorders but they’re human beings and they're people with a very valuable contribution to make. Tolerance is just such an important feature for doctors I think. A patient’s world might be very different to your own, and I think what we have to do as doctors is try to experience that world and not judge the manner in which other people live.

Tell us about some of the people that left an impression on you from your time at UCD

One of the great things about medicine, and one of the things that I can’t impart enough, is the people that you meet. You do meet incredible and brilliant people.

Muiris Fitzgerald, who was the Dean of Medicine, made a huge impression on me. His ward rounds were just fantastic, he taught me an awful lot but again, he looked after the patients with cystic fibrosis and he was very much a father figure. He was a very human being and he impressed me enormously; that combination of intellect and humanity that I think is so important.

I suppose in terms of teachers, I’d have to mention Professor Colm O’Herlihy and Professor Michael Foley, who was such a committed teacher and was so interested in students and teaching. Malachy Coughlan also left a deep impression on me, he was like a security blanket – he taught you and told you that you could do anything, he was brilliant for encouraging you and I don’t think I met anyone throughout my career that I liked as much – he was just a brilliant teacher. He was behind you the whole way, again quite fatherly – always there, bringing you on to the next stage. He’s retired now but I still meet him from time to time.

John Murphy, who is an amazing paediatrician, was also great. He was just great fun, but again was hugely supportive and had great insights when things got tough.

These people were and are at the top of their game, they’re brilliant doctors and amazing people. They all shared a great sense of humour as well. I think obstetricians must be the least pompous of all the specialties because you’d just have to be incredibly stupid to be pompous in obstetrics – you’re at the mercy of nature and you never know if it’s going to be a good day or a bad day.

One minute you’re brilliant, the next minute you’re not. The outcomes can be elating or incredibly devastating. That is very humbling, and so I think you have to get over yourself.

Tell us about the transition from pre-clinical education to bedside and clinical learning

I loved it. The early years in University were more difficult for me. I wasn’t always a brilliant science student; I took up chemistry from scratch which was quite challenging. I did struggle at times with the academic side but when I went to the hospital a light came on for me. I loved it, I loved being part of a team and meeting patients.

When I came into an internship, yes it was daunting meeting patients and beginning ward rounds but you have great help from your SHO and your registrar. I was very lucky with the people I started out with – they were lovely, talented people. We had great fun; I just thought it was fantastic. I absolutely adored it. The nights on call were a bit scary but as an intern, you’re pretty far down the pecking order and you have help.

You feel ten feet tall but terrified at the same time. You’re a typical medical student with pockets full of books, but you have each other, and you have a broader hospital system to tap into.

You are taking responsibility, but I think somehow people who go into medicine, I think innately, have that inner sense of responsibility and civic responsibility. As very young people, medical students do take on a great deal of responsibility – particularly once you progress through to SHO and Registrar level.

I was Registrar at age 25/26 and you have quite a lot of responsibility then and that is very difficult. You see very difficult things, it’s not easy and your world is very serious. Sometimes I did feel that quite acutely, I’d see my friends living in Barcelona for two years teaching English and I sometimes did worry if I was going to miss that part of my life.

I don’t regret it, and I’m learning to have more fun now. Even though I do have a very serious job now I do appreciate the need to laugh and I know that if you want to have fun, sometimes you have to make that happen yourself.

I try never to miss an opportunity to laugh. You are operating in a very serious and sometimes very difficult environment but you can’t get overwhelmed by that or swallowed by that. You need to have a balanced approach; I think I’m very privileged actually; largely because of the people I work with.

Dr Rhona MahonyIn terms of switching off, or leaving the day-job behind, is that difficult?

It can be yeah, you do get very involved with things and you can feel very responsible. I go running, exercise is really important, as is a really good peer group of friends – you’ve got to have a way of getting out of the environment.

The first thing for me, as my husband would say, is actually leaving the hospital. You do have to get out, and take control of your life and actually organise to do things. It’s too easy to get into a rut where you’re going in to work and then you’re sleeping and then you’re going back to work again. That’s not good for anyone. You must have a broader life than that; it would be a terrible waste if you didn’t.

All of those things are important to me, I do exercise, I do have very good friends, and I also have children. There’s nothing more grounding than when you go home and you’ve got to put a four-year old to bed and read to your kids and put the dishes in the dishwasher. It’s a great distraction.

You had very positive formative experiences throughout your career, does that shape the way that you interact with medical students?

Yeah, it does. I think years ago, when I was at the really tired registrar phase I remember telling one group to go off and do dentistry, because it’s much easier. Now, I find myself being really encouraging to medical students. You do go through a tired phase but you come out of that again and you step back and look at the whole picture.

You know the way they say youth is wasted on the young, well I was looking at a gang of students the other week and I was struck talking to them by what an amazing group of people they were; young, clever and caring people with this incredibly exciting life ahead of them. I don’t think that I always appreciated that as a medical student – the potential for twists and turns as your life develops and the choices you have about how your life will unfold. That is a really tremendous gift and a huge privilege.

I look at them and I can see it in them; their lives may unfold in a very exciting way – they might end up practicing medicine all over the world. They have such potential, and also they are at this point at which they’ve achieved so much already by just having gone through medical school. There’s so much more to come and that’s incredibly exciting. The students that I come across tend to be lovely people as well, very positive, lovely to teach, polite and they do tend to be extremely nice people - which makes it very exciting to work with them, actually.

You’ve been a prolific researcher throughout your career – is this an important aspect of what you do?

I don’t think it’s just important, I actually think it’s your duty. You must always be contributing and pushing the boundaries of what we know. It’s not good enough just to clock in, do a job, and clock back out again – you must be curious, you must always be learning and therefore you must always research.

You owe that to your patients and to your specialty. It takes a lot of effort and money to get us through medical school. There’s a lot of teaching and a lot of expertise, and a lot of contact with very great people. I think that you mustn’t break the chain of asking and answering questions and of driving your specialty forward. It’s a terrible waste to have a passenger in a specialty. It’s a great honour and a great privilege to practice.