Colles Q&A Mr Morgan McMonagle

When and where are you happiest? In a stadium, front of the pit at the foot of the stage of a classic rock concert. Just for the sheer tribal experience which cannot be equalled anywhere else in a stadium. Or 25m under the ocean, scuba diving in splendid isolation. So much beauty and danger juxtaposed. Makes you realise we’re all just visitors. What is your ideal evening? Concert at the Royal Albert Hall in London with friends or family, followed by tapas at Casa Brindisa in South Kensington. I should have frequent yer points! If you could research and write a book on any subject, what would it be?

Morgan McMonagle, MB, BCh, BAO (Hons), MD, FRCSI, FRCPSGlas

FACS is a consultant vascular and trauma surgeon at University Hospital Waterford; Director, Trauma MSc, Imperial College, London; Director, Trauma Training RCSEng; Mass Casualty Planning Training Team, World Health Organization. A er graduating from UCD in 1997, Mr McMonagle undertook basic surgical training at RCSI Hospital Group and gained further trauma surgery experience at Westmead Hospital, Sydney, Australia. Following this he gained extensive experience working in prehospital care and aeromedical retrieval with Care ight and Care ight International, Australia and with MAGPAS air ambulance in the UK. He completed higher surgical training with the West Midlands surgical training programme, UK followed by a Fellowship at the Royal Brisbane & Women’s Hospital, Brisbane, Australia and additional fellowship training in trauma, emergency surgery and surgical critical care at Penn-Trauma at the Hospital of the University of Pennsylvania and was awarded Fellowship of the American College of Surgeons (FACS). e rst trauma surgeon appointed at Imperial Healthcare as part of the new London Trauma Network, he was also a member of the steering group advising on A Trauma System for Ireland: Report of the Trauma Steering Group for the Department of Health, Ireland. A clinical lecturer in surgery at RCSI and an honorary lecturer in surgery at Imperial College, London, he is an Intercollegiate Examiner in vascular surgery, a published author and the national clinical lead for mass casualty planning for the HSE.

Route 66 and how it has weaved itself into modern American culture and music. What relaxes you most? Playing guitar, either acoustic or electric. I used to play in a group but haven’t been able to dedicate myself to that in a very long time. So now, it’s playing alone. Need to limit the decibels though! What is your greatest fear? at we, the human race, the most intelligent and progressive of our (or any) species that ever existed, as the current occupiers of this tiny speck of a rock called earth, suspended in the vast cosmic arena in a beam of sunlight, are slowly and deliberately destroying it. ere will be no planet to leave to our children. We are the worst tenants on a beautiful planet that we call home. Homo Sapiens will not be the rst species in history to become extinct, but we will be the rst species wholly responsible for our own extinction. Knowledge and wisdom are clearly not synonymous. When did you decide you wanted to become a surgeon? Probably about age 15. One of my very good friends had a kidney transplant. I went to visit him in Beaumont Hospital and met the team looking a er him who were incredibly nice I recall. Would you have any advice for your younger self? Ignore the begrudgers and the nay-sayers. Be yourself. Follow your own path. at’s about as polite as I can make it! How do you have fun? So many ways, as long as I’m moving forward! Working hard in the gym or pool. Going scuba diving (esp. South West Donegal), skiing in the winter. Going to any live music, then trying (with di culty) to re-play the guitar parts. Travel, restaurants, wine (amateur oenophile). Where would you be if you decided not to become a surgeon? Probably a helicopter pilot. Preferably o -shore ying. I’ve met a lot of pilots over the years from my days doing pre-hospital care in Australia and the UK and I’ve NEVER met an unhappy one. ey have the best o ce in the world and just love to y! In what way do surgeons struggle/ what issues do surgeons today face? I think the health service is becoming very consumer and target driven, which naturally leads to micromanagement at every level. e ‘purpose’ (ie: the reason why we all get out of bed in the mornings to come and do the best job that we can) is easily distorted and lost in such an atmosphere. ere is a certain existential deafness regarding this, which is less about hard work or long hours. It’s about the loss of self-pride in the pursuit of a productive day. As a result, people vote with their feet and leave. What has been your proudest moment? Professionally travelling deep into Ukraine on the day the Crimea Bridge was destroyed. Despite the massive bombing campaign that followed, the resolve of the Ukrainian doctors and nurses was humbling to experience and the spirit amongst our team was inspiring! Having said that, I was happy to cross back into Poland two weeks later (very sleep deprived). Who have you learned the most from in your life? Personally, my kids, who are the best teachers of humility. Professionally, probably Bill Schwab at PennTrauma on leadership and David Nott on making the absolute most of your professional life! How does a surgeon in 2023 cope with pressure? Live every day with intent. Intention equates with purpose. at includes professional and personal. Once the purpose goes, your inner vibe quickly follows. at’s covert self-sabotage. Always look to better yourself in every way, which is a form of reconditioning for the soul. Look positively towards change and be progressive. is keeps the spirit free from dry-rot. What is the best thing about the system of training young doctors in Ireland? It’s a small country, but punches way above its weight when it comes to surgical expertise internationally. ere is still a deep commitment to surgical training in Ireland, which includes embracing international travel and fellowships. is makes up for the smaller population. As a result, there is a very high concentration of skill and expertise on the island to learn from. is makes the ‘trainingdensity’ very rich indeed. What is your greatest extravagance?

Probably my 1959 Gibson Les Paul guitar. A soulful blend of handcra ed mahogany and Indian rosewood with a maple top. Beautiful tone unmatched by any other guitar. A small re-mortgage, but worth it! Do you have a mantra to live by? “Don’t say you don’t have enough time. You have exactly the same number of hours per day that were given to Helen Keller, Pasteur, Michaelangelo, Mother Teresa, Leonardo da Vinci, omas Je erson, and Albert Einstein”. - H. Jackson Brown Jr. What do you consider your greatest achievement? Personally, seeing my kids grow up with unique personalities and talents. Although it sounds trite, it is also a very grounding achievement. Professionally, getting nominated (twice) in the BMA Annual Book Awards. In your profession, a historical figure you admire?

Although not a surgeon, I admire what Henri Dunant (1828-1910) did to bring about the existence of the International Red Cross. A Swiss banker who happened to witness the devastation on the battle eld at Solferino in 1859 in the battle between the French – Italian allies and Austria. Not only did he use his in uence and leadership to convince the victorious to take care of all injured, regardless of their allegiances (tutti fratelli), but he also sparked numerous European leaders into action towards the concept of international humanitarianism. As a result, 16 nations signed the rst treaty to establish the International Red Cross. He established the concept of neutrality for healthcare workers in war (currently not respected in many con icts). He also used his banking credentials to raise funding necessary for such work. He was probably the rst logistician in humanitarian healthcare. Anyone who has been on such a mission will know that the most useful and important people are in the logistics department! What is your favourite memory? Holidaying in South West Donegal as a child with my parents, then later going back to scuba dive at the foot of Glencolmcille with friends, then again later re-visiting with my kids. Have you a hobby and if not, why not? If you do have a hobby, what do you enjoy about it? I do quite a lot in my (limited) spare time. I used to do competitive judo and was All-Ireland and University National Champion when in College. Nowadays, I swim (typically 2-3km every 2nd day) and use the gym, scuba dive in the summer and ski in the winter. I also own 16 guitars, a drum kit and a piano. Can’t play them all, at least at the same time though. Name your favourite writer. I typically only read non- ction. Favourite is probably AA Gill. Smart and intellectually funny. But there are many others I love to read like Joe Klein, Atul Gwande and Carl Sagan. e one book I’d love to get my hands on is Fly Fishing by J R Hartley. If you could invite any historical figure to dinner, who would it be? Jesus. I’d like to ask him about his life between the ages of 12 and 30 years old, as there’s no historical record! I might even get a book out of it. Which talent would you most like to have? A great singing voice. at way you bring your instrument everywhere. What is the wisest thing you have ever said? ere’s no such thing as an atheist at the end of a winch! is occurred a er winching an injured patient out of the Blue Mountains near Sydney, Australia from 200M into a helicopter. It works on so many levels when things take an ‘unexpected’ turn during surgery. Every surgeon has had that sinking feeling, where you pray quietly, act professionally and hope for the best! Name one virtue all surgeons ought to have. Progression and change. Name one vice no surgeon should have. Self-righteousness. Good luck excising that one! ■