As physicians and scientists there was no way of knowing the precise interventions needed at that point to control the pandemic, but we knew for certain that national and international responses were severely lacking. It was not a matter of “if” but “when”. We were headed into a storm the likes of which we had never experienced but the questions were “when” and “how bad”? This “quiet before the storm” had all of the foreboding but was far from quiet. Spurred by the tsunami of cases that overwhelmed New York City hospitals, the city was in overdrive to prepare for the possible scenario of caring for hundreds, possibly thousands, of ventilator-dependent patients per day. COVID-19 cases started to fill the emergency departments and with heartbreaking predictability the ICUs. I barely slept the night before my first tour of duty in our COVID ICU. I wondered if this was what it felt like before being deployed in a war: fear of an invisible enemy, fear for your patients, your family, friends, colleagues and your own wellbeing. As dawn broke over the deserted streets of Boston I thought about the decisions that had led me to this point. Like many, my training kicked in and the scale of the task at hand mostly distracted from the fear.
December 2006, Galway: I was faced with the decision of staying in Ireland for medical training, or leaving. I grew up in Galway for the most part. In secondary school, Medicine seemed a far reach but my closest friend and I committed to getting the leaving cert points necessary. With family and friends in Galway I barely considered other Irish universities. Fortunately, I found that I loved studying Medicine. Learning about things that I found fascinating was much more appealing than the alternative. The medical training was excellent and we were held to a high standard. By the final year of medical studies when most of the focus is on clinical medicine, that is understanding, diagnosing and treating disease, I felt in my element. We had many excellent instructors and I was particularly impressed by some of the newly appointed consultants who had recently returned from the U.S. including Dr. Donal Reddan, Dr. Anto O’Regan, and Prof. Tim O’Brien who had taken over as Dean of Medicine in 2001. I graduated in Medicine from the National University of Ireland, Galway in 2004. I decided to stay in Galway for internship and house officer training. As this initial phase of training neared its conclusion, I had a strong inclination to further my training abroad, for at least a time. Prof. O’Brien and Dr. Reddan encouraged me to consider a new collaboration between University Hospital Galway and the prestigious Mayo Clinic. The program was designed to give Irish trainees an opportunity to experience US medical training and I would be the first envoy from Galway. In June 2007, having completed my US medical exams, I arrived in Minnesota and joined their internal residency program. For the next year, I rotated through a different medical specialty every four weeks meeting new residents, fellows and attendings every time.