12 minute read
A LIFE’S WORK
from 2024 RCSI Alumni Magazine
by RCSI
From Dublin to Baghdad to Chicago: Dr Yvonne M. Curran’s journey to becoming a vascular neurologist, and her work with underserved communities, began at RCSI.
Originally from Dublin, neurologist Dr Yvonne Curran MD graduated from RCSI in 1988. After her intern year in Beaumont, she worked for six months at Ibn al Bitar hospital in Baghdad before moving to Chicago. Initially she matched into psychiatry but then switched to neurology. At first she worked in private practice specialising in neurophysiology but now specialises in stroke medicine and is currently Assistant Professor of Vascular Neurology at Feinberg School of Medicine, Northwestern University, and Medical Director of the stroke programme, Saint Anthony Hospital, Chicago. Her non-clinical area of interest is physician wellness. Dr Curran gives an account of her life, before and after RCSI:
“I grew up in Dublin and lived in Raheny for the first seven years of my life. My dad, Gene Curran, was a GP there and my mum, Mary, was his practice nurse. We lived over the practice until we moved to Clontarf, where my parents still live. The practice stayed in Raheny. My father didn’t retire until he was well into his seventies.
“During secondary school, I worked as my dad’s secretary for his evening surgeries. The surgery was right beside the church, the Garda station and the bank and, in hindsight, it was more like a social services office. My dad loves to talk and tell stories of how he took care of three generations of families there. As the GP he was intimately involved in all the stresses of his patients’ lives, not just their medical problems.
“I used to go with my dad on house calls and I loved following him around. He had a lot of uncles in the bar trade in Dublin, and a lot of publicans were patients, so we often ended up in pubs. From as early as I can remember, the only career I ever thought about was medicine.
“After school at Manor House in Raheny, I went to the Institute of Education on Leeson Street for a year and I started in RCSI in 1982. In some ways I suppose I was better prepared than some of the other students, but in other ways I wasn’t. Many of my classmates had gone to more prestigious schools such as Blackrock and Gonzaga, and most of the Irish boys were into rugby so even if they hadn’t gone to the same school they knew each other before arriving at Surgeons. Coming from the northside, I went in there knowing nobody. In that sense, it was a culture shock. But on the first day I met girls who I knew of through my dad, as their fathers were also GPs. Two of them, Orla Donohoe and Helen Daly (both Class of 1988), are my closest friends to this day. I had a small circle of friends back then and was pretty shy and introverted – I’ve changed a lot since!
“Pre-med was the hardest year for me. I had never done physics before and we went from zero to A-Level standard over the course of a year. Chemistry wasn’t a strong point for me either. Once we progressed to our preclinical years, studying anatomy, physiology and biochemistry, I felt more comfortable and by the time I got to the clinical years I was flying.
“I have very fond memories of Professor David Bouchier-Hayes, sadly no longer with us, who was an amazing mentor and teacher, as were Professor Paddy Broe and Professor Alan Johnson. I was lucky because my uncle had given me a car so I used to pick up Helen Daly in Killester each morning and drive into St Stephen’s Green; Johnny Car Park always kept a spot for me. He was a real character.
“When I graduated in 1988, I hadn’t decided what specialty I wanted to pursue. I liked everything except obstetrics and gynaecology. I did my intern year in Beaumont. My SHO was Cathal Kelly [Professor Cathal Kelly, RCSI Vice Chancellor] who became a great mentor and friend. He used to make me laugh a lot. He was very perplexed about my wanting to go to America! I still remember him saying in his wonderful Donegal accent, “You know you haven’t made it until you make it in your own hometown!”
“I was coaxed into going to America by my now-husband Ken O’Riordan (Medicine, Class of 1988) who grew up in Foxrock. We met the first week of pre-med and dated on and off until final med when we became serious. I really hadn’t put much thought into my future; I tended to live day to day back then, but Ken was different. He had done electives in the US and had a career plan. Once we got engaged, I obviously had to go too. He wanted to go to Boston as he had connections there but I had family in Chicago and so we compromised.
“Ken matched to internal medicine in Chicago and started in July 1989. I didn’t go straight away because I hadn’t passed the United States Medical Licensing Examinations (USMLEs), so instead I went to Ibn al Bitar Hospital in Baghdad for six months. The hospital was run by an Irish management company and most of the physicians and nurses were Irish or European, who provided a very high standard of medical care including transplant and cardiac surgery to the local Iraqi population. We also had a lot of young patients from Kurdistan with aplastic anaemia believed to be from Saddam Hussein’s use of chemical weapons in that region. My time in Iraq provided me with an incredible education from a medical, cultural and global perspective. In hindsight, it helped lay the foundation for many of my future career interests. In Baghdad, I rotated through haematology and paediatrics, both of which I enjoyed. However, I decided that I would plan a career in psychiatry when I moved to Chicago.
“I matched into psychiatry at Rush-Presbyterian-St Luke’s Medical Center in Chicago in 1991. In the first year of residency, I rotated through medicine and, while most of the medicine residents hated their psychiatry stint, I enjoyed mine. I was a little bit concerned that this could be a bad omen for psychiatry. In the second year, I rotated through neurology. I had never been exposed to neurology in Dublin and I absolutely fell in love with it.
“I was very fortunate to have my first existential crisis in the presence of Dr Phil Gorelick with whom I worked in neurology. He took me aside on the last day of my rotation and said, “Please don’t take this the wrong way, but you don’t seem cut out to be a psychiatrist. Would you have any interest in doing neurology?” He literally read my mind. It was incredible.
“Gradually I came to accept that we were going to make our lives in the US. It took years. I used to be terribly homesick every time we’d go home. Ken was used to me being down in the dumps after each trip but I remember once returning to Chicago and saying to him, ‘I don’t mind being back’.
“Once we started having our family here, it changed things a lot. For the longest time I never felt fully Irish or fully American, just in the middle. I felt my identity had to lie with one country or the other, which it doesn’t. And now I’m very happy recognising both as home. When I am in Chicago I say I am going home to Dublin, and in Dublin I say I am going home to Chicago.
“The residency in neurology is three years. And then most people end up doing a fellowship, which I did too. I had my two older children, Enya and Gavin, during training. I wanted to work part-time while my children were small, and private practice was the only option for that so I did a fellowship in electromyography (EMG) or neurophysiology. Ironically, I didn’t really like it. It was just what made you marketable for private practice.
“I always loved stroke or vascular neurology, but it didn’t seem like there was a way for me to practise that at the time. Fellowships were just getting started, as it was a relatively new specialty. So I did five years in private practice in the suburbs of Chicago. And then I was approached by someone I trained with to see whether I’d be interested in coming to Northwestern Memorial Hospital. I moved there in 2001. I was able to take the vascular neurology boards and join the teaching faculty.
“Now I practise mainly stroke neurology, providing in-patient stroke service for between six and eight weeks a year and the rest in the out-patient setting or on our telestroke service.
“In partnership with Northwestern in 2016, I started going to St Anthony’s, a free-standing Catholic hospital on the west side of Chicago which services one of Chicago’s most underprivileged communities. The patient population is mostly Hispanic and Black. These populations have a disproportionately high incidence of stroke compared with the White population. St Anthony’s has since developed into a primary stroke centre. This allows ambulances to bring stroke patients there for acute therapy. If they need a thrombectomy then we arrange for a rapid transfer to Northwestern.
“I really enjoy my work there and I hope that in some small way I am giving back to my city. The contrast in the baseline health of the population there and at Northwestern is striking even though they are only a 15-minute drive from each other. It is unfortunately a typical example of the healthcare inequities that exist across the US.
“I also helped found the first free neurology clinic in Chicago, which is a separate not-for-profit clinic. I am one of the attending physicians, and I go there every couple of months to supervise the neurology residents. It serves patients with no insurance and is a very well run not-for-profit organisation.
“I feel the Irish are good at taking care of people less fortunate than ourselves – I certainly feel an obligation to give back. I used to do a lot of medical mission work in Haiti but it’s not safe to go there anymore. I find it very rewarding to be able to give back in my own community.
“My other non-clinical interest is in physician wellness and I completed a fellowship in this in 2018. Physician burnout produces a large strain on the healthcare systems, both in the US and Europe. This has been a recognised problem for several decades but became an even bigger issue during and since the pandemic. Over the years I have watched some of the most talented and caring physicians leave the profession early because of burnout issues that would be easily rectified if hospital administrators would implement relatively low-cost solutions.
“I feel fortunate that I am currently in a department where we have a focus on wellness and supporting each other during stressful times. This was not always the case and I get my own personal reward by paying this forward. We have a lot of support and trainees so my working hours are much more civilised than they used to be and we have excellent leadership which ensures people are treated equitably. I feel my quality of life is very good, better than when I had young children and at times was probably close to burnout myself.
“My children, Enya, Gavin and Maya, are now aged 30, 28 and 20. None of them have gone into medicine; they said their parents worked too hard when they were growing up. They are a different generation clearly, perhaps a smarter one with a better sense of work-life balance.
“I am fortunate to live close to my work so my commute is very short. We always resisted the urge to move to the suburbs and live just north of Chicago city centre near Wrigley Field, the baseball stadium. The children all went to the Lycée Français so they are fluent in French, which makes them a little more European. I also wanted them to be exposed to the diversity of growing up in a big city.
“I feel honoured to have received many rewards and much recognition for my work. I am most proud of the Martin Luther King Humanitarian Award at Northwestern for my work in Haiti. I was able to bring my husband and two older children there to volunteer and it left a lasting impact on us all. I am deeply saddened by what is going on there now and that fact that so many NGOs have had to leave because of safety concerns.
“I turn 60 this year and I have been thinking about how I want to spend the next decade or so of my career. I hope to continue spending as much time as possible working with Chicago’s underserved communities.
“I am also looking forward to spending more time in Dublin. I was honoured to be invited to give a talk on Physician Wellness at RCSI in August 2022 and I am going to be there again this year to co-chair a session on this important topic.” ■
