Dr Woolhead , thank you for taking time out from your busy job to talk to us. First of all congratulations on recently becoming the head of the Department of Anaesthesia in OLOL Drogheda. Can you tell us anything about the upcoming 2016 ISMM scientific symposium in November?
The ISMM symposium will be held on the afternoon of Friday the 4th November next. We will present an exciting mixture of clinical scientific presentations together with accounts of military medical deployments in Sierra Leone and the Mediterranean. Military medicine of 100 years ago will get an airing and I hope there will be an opportunity to discuss the ethics of aspects of military medical practice.
How do you see the ISMM developing into the future?
I see the ISMM occupying a unique niche role in the future. Like all other medical specialties, Military Medicine should and does have a faculty or college to oversee training, exams and certification but also a social and academic society to promote and support the specialty. The ISMM is that organization. The ISMM has strong support from north of the border and ultimately I see the organization having a healthy membership or associate membership from the North. I see the ISMM as being inclusive of both traditions on the island of Ireland. As the military are invariably involved in many of the major conflicts of our age, it’s inevitable that military medics will have the spotlight of ethical medical practice firmly focused on them. I would like to see the ISMM provide a forum for discussion on these important issues. It is also to be hoped that through the activities of the ISMM, young doctors may experience a stirring of interest is this most noble tradition of service. It is also to be hoped that the social aspect of our mandate will promote friendship and camraderie between all our members, serving, retired, reservists or civilian.
Dr Woolhead, you spent a quite long time in the Defence forces. You are also on the faculty of Military Medicine as well as being the president of the ISMM. You clearly have a deep personal commitment to the Medical Corps. Could you explain to our readers what value you see in service in the Medical Corps?
I gave 23 years of service to the Defence Forces. I have no regrets. In many ways they were the best years of my life especially when serving overseas in Asia, Africa or Central America. Because of structural and systemic problems with the practice of medicine in the Defence Forces, I felt forced to retire in 2008. It was hardest decision of my life and I still look back with nostalgia and a profound grá for the Defence Forces and my time in the AMC. For a life of adventure and drama, laced with emotion and a modicum of danger, it would be hard to match. The young medical officer will quickly come to a refined understanding of the Oath and the Conventions as he learns to reconcile the role of the military and the values of the red cross. Truly a life less ordinary.
You had a long military career before you were appointed as consultant anaesthetist in Drogheda. Do you think that your experiences in the Defence Forces help you in your civilian career?
The army officer is first and foremost a soldier. But he is also a manager of men. He must inspire and lead his men. He must understand them, their dreams, their aspirations and their often humble backgrounds. He must be firm but fair. These attributes are especially important on overseas missions. At home the officer must learn to deal with bureaucracy, red tape and the civil service. He must learn to manipulate the system for the benefit of his unit, his corps or his hospital. He won’t always be successful. He will get to know the dead hand of the job for life. He will learn that there are a hundred ways to kill a project without actually saying no. He will see that for some, promotion depends on avoiding mistakes and that the best way to avoid making a mistake is to make no decisions whatever. Yes, all this and a refined sense of duty and responsibility. I do believe service as a commissioned officer does provide a useful platform from which to launch into the civilian world.
You also managed to raise a family while you were in the Medical Corps.How would you compare the work/life balance when you were in the medical corps with your current job?
For sure army life affords a better work life balance than civilian life. When in service I could leave my kids to school on my way to work. I could read story books to them in bed at night. Could I do that as an anaesthetic registrar or civilian consultant? Not likely! On the other hand overseas service brings all that to an abrupt end. In my time army Medical Officers did more overseas service than most line officers. It puts great strain on wives and girlfriends and we must acknowledge the great sacrifice they make looking after our kids and keeping the home and family intact till we return 6 months later.
Taking a short service commission as Medical Officer in the defence forces was once a very popular option for NCHDs before they regularly started to work in Australia/New Zealand for a year or two. Would you recommend taking a short service commission?
Army life for me was a most rewarding and fulfilling experience. I have absolutely no regrets. Nevertheless until such time as the DMB’s Military Medicine scheme comes on stream, young doctors would need to understand that time spent in the army may result in stagnation on the road to CCST (Certificate of Completion of Specialist Training). It’s expected this scheme will be activated in the next few months. Not that CCST is everything in life. Military life and especially overseas service is wonderful life experience sure to charm and amaze in all sorts of ways.
St.Bricin's Hospital is one of Dublin's lesser known institutions yet much beloved by those who worked in her. What was it like to work in St.Bricin's when you were in the Defence Forces?
Well, St. Bricins is on its knees and this a source of great sadness for me. Built in 1911, the hospital was overflowing during the Great War. Dr Bridget Lyons Thornton took the British handover in 1922 and soon after had her commission withdrawn. It took over 55 years before the next female was commissioned, our own Dr Peggy Flanagan. Till the 1960s’ or 70s’ St Bricins essentially functioned to the standard of a county hospital. Then somebody closed their eyes and when they opened them civilian medicine had moved on and St. Bricins was left wallowing in its isolation. It was a great place to work but isolation in medicine is deadly. The good times in Bricins or ‘Brigins’, as its long serving telephonist, Jimmy Gallagher , pronounced it, were tinged with foreboding, a portend of the sorry state the hospital has gotten to nowadays.
The medical corps of the Defence forces is often in the vanguard of the state's response to humanitarian need. The recent medical deployment to Sierra Leone to control Ebola springs to mind. There were other humanitarian missions over the years. Could you tell us about some of them?
There is invariably a humanitarian component to UN missions overseas and army medical officers invariably play a part. It’s always been a source of great pleasure to me to provide medical care to civilians in conflict zones. There is always a conflict of interest between the provision of that care and security. Wary commanding officers are always likely to restrict the movement of their medical officers. But I’ve always been lucky in that regard and especially so in Somalia. I worked every day in the civilian hospital in Baidoa. The conditions were that I had a soldier accompany me, that I had radio communications with the operations room and that I and the soldier with me were armed. Well, weapons were banned in the hospital so every day and out of sight, two Browning automatic pistols nestled at the bottom of the doctors bag well covered with medicines and other medical supplies. I became aware of the enormity of the suffering endured by the people in and after the famine. What do you say to a woman who has lost 9 of her 10 children in the famine? And her story was common. Others had taken to the ground around the hospital compound as death beckoned. Well, we fed them up on surplus ration packs, washed them and got them onto unwanted US Army camp beds. A humbling experience, for sure.
The Irish Army has run exclusively humanitarian missions also such as the Honduran support missions in the wake of Hurricane Mitch and the Goma mission in the wake of the Rwandan genocide. The second Honduran mission was the first deployment of a surgical facility overseas by the Irish Army since St. Lo in Normandy in 1945. I believe the Defence forces could play a bigger role in the government’s emergency response set up in the wake of the tsunami. All the necessary skills reside in the army – logisticians, engineers, medics, fitters, plumbers, carpenters and electricians etc.
Moving away from the Defence Forces for a moment, could you explain to our readers what a Forward Surgical Team is and why a deployable surgical capability is so important?
A Forward Surgical Unit can be quite a small unit but remains absolutely pivotal to the deployment of troops in an active service situation. The basic unit comprises a general surgeon, an orthopaedic surgeon, an anaesthetist, a general medical officer, a dentist, a theatre nurse, a laboratory technician, a radiographer and a small number of medical orderlies and nurses. The Irish army with a FSU in support can be deployed to any active service situation at short notice. Without its own surgical support it cannot be deployed safely and it should not be deployed with surgical support of uncertain standard from suspect UN contributing countries. The key personnel would need to be reservists and employed in the public health service in order to keep their skills maintained. The Department of Defence should be empowered to remove them from civilian service when the need arises and to reimburse the HSE hospitals for the provision of replacement locum cover. Simple!
Drogheda has a large catchment area and is just beside the M1. Do you manage much serious trauma in your current job and how does this compare to your time in the Medical Corps?
Drogheda is the second biggest trauma hospital in the Irish Republic. So, yes, I see a lot of serious trauma. Skills I would have loved to have brought back to the army. Sure I’ve attended to a lot of trauma in the army including GSWs’, RTAs’ and helicopter crashes but exposure needs to be ongoing and that’s a problem for a peacetime army. When it comes to trauma the Reserve is the only way for Ireland to supply the skillmix needed in this area. When it comes to primary care the DMB’s scheme ought to deliver. I believe, I have to believe the future is rosy.
Thank you for your time Dr Woolhead, we wish you every success in your new job and look forward to the meeting on November 4th!