Dr Peter Keenan was Ireland’s first consultant in paediatric emergency medicine. Appointed in 1984,

at Temple Street Children’s Hospital in Dublin, he was immediately thrown in the deep end in an

emergency department that catered for around 50,000 attendances annually.

In this podcast episode, Peter recounts how he set about the management of the huge number of

patients, which he compares to dealing - afresh every day - with ‘a great military retreat’. He talks

about the crucial importance of reducing the number of ‘reflex’ admissions by managing as many

cases within the ED itself as possible. He cites the example of self-limiting febrile seizures, and in

response to the often stated “You can’t be too careful”, he says, “Yes, you can!”, pointing out that

unnecessary admissions to hospital are not only inconvenient, costly and associated with avoidable

and sometimes-distressing tests, but they are also a significant factor in overcrowding within a

paediatric ED. His antidote? ‘Sensible diagnostic thinking’ with this, as with every other presentation.

Beyond bringing some order to a perennially busy inner-city ED, Dr Keenan was also a major mover

in Ireland in the once-marginalised area of child abuse. He recalls here how the understanding and

management of childhood sexual abuse in Dublin was often based on the accounts of women who

attended the Rape Crisis Service at the Rotunda Hospital, just a few hundred metres from Temple

Street, as well as the aftermath of the notorious Cleveland Child Abuse Scandal in the UK, in 1987.

Sadly, Dr Keenan also reflects on the ‘multi-generational’ nature of such abuse, and how much of it is

driven by deprivation and intoxication.

In his own hospital and beyond, Dr Keenan is a much-loved and charismatic paediatrician, famous for

his energy, good humour and pride in his ‘Northside’ pedigree. However, he says he owes a great debt

to many of his colleagues in Temple Street for their willingness to help out, including Professors

Denis Gill, Niall O’Doherty, Niall O’Brien, Michael O’Keeffe and others. And in a particularly

moving reflection, Peter talks of how his ability to cope with a series of personal tragedies, including

the death of his son, Stephen, in a ‘free-diving’ accident in Egypt, was at least partially and

paradoxically eased by the amount of trauma and tragedy he had already faced in his place of work.

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Dr Diarmuid O’Shea is a Consultant Physician in Geriatric Medicine at St Vincent’s

University Hospital in Dublin, former President of the Irish Gerontological Society and

National Clinical Programme Lead for the Older Persons Programme of the HSE and RCPI

and, presently, the 143 rd President of the Royal College of Physicians of Ireland.

Dr O’Shea’s clinical and research interests include syncope, drug metabolism, and dementia,

and his organisational initiatives have been largely directed towards the enhancement of

patient care and of medical training in Ireland.

In this podcast episode, Dr O’Shea reflects on a very happy childhood in South Dublin, in a

family of high-achievers, including his father, Jerome, the famous footballer from

Caherciveen with three All Ireland medals for Kerry, and two ‘celebrity’ brothers,

(Endocrinologist, Professor) Donal and Conor (of international rugby fame), and he offers

some amusing insights into life-long sibling rivalry!

Diarmuid also recalls his enjoyable undergraduate years in UCD, and his training in the

Mater, St. Vincent’s, St Columcille’s, and Wexford Hospitals, before he moved to Nashville

in Tennessee, and then Newcastle, in Tyneside.

Since 2000, Dr O’Shea has worked at St Vincent’s University Hospital in Dublin, and he

observes that it was his exceptional good fortune to have worked with two giants of geriatric

medicine in Ireland, Dr Morgan Crowe and the late Dr Denis Keating, who gave him

invaluable guidance and career advice. We also hear why he is careful not to bump into his

brother, Donal, in a lift!

Diarmuid enthuses about his long-term passions, especially medical education, and he

touches on his work as a past-Chair of the Irish Committee of Higher Medical Training, and

Vice-President of Education and Professional Development at the College, along with the

successful RCPI Masterclass Series (which he established), and he offers a tour d’horizon in

terms of the College’s work to improve patient care, the quality of medical practice and the

health of the population as a whole.

In his role as the President of the RCPI, Dr O’Shea acknowledges and identifies many of the

current challenges across the Irish health and social care system, and he explains why he

firmly believes that ‘collaboration, recruitment and retention, as well as innovation and the

ability to adapt, will be central to improving the environments in which we (all) work and

train, and to delivering fit-for-purpose 21st Century training and medical care’.

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Professor Jean O’Sullivan is a Consultant in Emergency Medicine at Tallaght University

Hospital, in Dublin, Clinical Professor of Emergency Medicine at Trinity College Dublin, and

Chair of the Board and Founder of Global Emergency Care Skills (a.k.a. GECS),

a voluntary, non-profit charity organisation which she founded in 2008, and which provides

high quality emergency care training to healthcare professionals in Africa. To date, GECS has

provided training courses for over 600 doctors, nurses and clinical officers in six African

countries, where sepsis and trauma are the leading causes of death.

GECS training is provided through simulation-based courses in trauma care, resuscitation

skills and major incident management. All of the instructors are volunteers, who pay for their

own travel, and fund-raise for the organisation, and they’ve included paramedics from the

Dublin Fire Brigade, and many of the Ireland’s leading emergency physicians, like Drs Ger

O’Connor, Eoin Fogarty, Cian McDermott, and Rob Eager, as well as Jean herself.

Once the courses are completed, local trainers are empowered to continue the skills training

for other colleagues and to lead the regional development of emergency care, and both

teaching equipment and lifesaving medical equipment (like portable ultrasound machines) are

provided to their hospitals. GECS has partnered with the World Health Organisation, the

College of Surgeons of East, Central and Southern Africa, and the African Federation for

Emergency Medicine.

In 2021, GECS was the winner of the prestigious Royal College of Emergency Medicine

William Rutherford Humanitarian Award. And in June 2024, Professor O’Sullivan was

presented with the International Federation of Emergency Medicine Humanitarian Award in

Taiwan, for her ‘exemplary leadership ...(in the) development of safer emergency care in

areas of sub-Saharan Africa over the course of 16 years, through her vision, hard work and

the ability to inspire others’. It is no exaggeration to say that the announcement of the latter

award, in particular, was received with undiluted pride by the whole of the Irish emergency

medicine community.

In this podcast episode, Jean reflects on the origins of her humanitarian work and her growing

involvement in global online medical education with the United Nations, as well as the major

activities ‘at home’ with which she has been associated, from a ‘whistleblowing’ saga to her

role with the Injuries Resolution Board, as well as her therapeutic pastime of painting.

And in the process, the listener will hear how she left the podcast host very red-faced, indeed!

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