margaret dublin

‘I’ve been a consultant at Mater Hospital since 2002. Before I worked in London and in the US, on a fellowship for 5 years.’

‘A consultant? I thought you were a doctor.’
‘All the doctors with contracts are called consultants. I’m a clinical microbiologist, to be precise, a doctor who specialises in infections, the management of patients with infections. I’m also an epidemiologist. And I’m a clinical lecturer, so I have a certain amount of academic duties. Primarily I work for the Health Service. I’m a head of my department but that’s a rotational thing. I don’t have any additional titles; I’m not a director of anything. Yet.’

She laughs.

‘But I do have some international titles, as I am specialised in transplantations of the heart and lung, I have been the chairman of the International Society of Heart and Lung Transplantation Infectious Diseases Council; I’m part of their executive committee.’

She mentions some other boards with very long names, also later during the interview (‘I’m in the National Health Committee’). Margaret is not bragging, she’s just good at what she does and very active and, as she says: ‘It comes with the job, as Ireland is small and I’m the only doctor who specialises in infections I have to be part of those international groups I do research with. Once you start working in international groups, you end up with titles…’

We meet at the Fitzwilliam Lawn Tennis Club, the oldest in the country, where past champions wielding wooden rackets look down on us from the wall. Margaret is a member (‘But just that. I’m not on boards or committees.’). ‘But through this collaboration you also develop some good friends and colleagues overseas. In fact it’s the best part of my job, it’s very stimulating to learn from your colleagues. And it’s nice to have a publication, every once in a while, it’s sort of a credibility for yourself.’

‘Only for yourself?’
‘Yes. In Ireland you might produce 10 or 12 papers a year and nobody even notices, whereas in the US you’d be automatically promoted every time you achieved so much in the academic world. A lot of consultants aren’t interested in research, because there is no clear promotion structure, no benefit. It would help if we would have merit awards, like in the UK, meaning that your public salary would increase. They have tried it in Ireland, but without the financial gain and therefore it didn’t work…’

‘Why didn’t government include the financial gain?’
‘Well, Ireland is broke. And it is really affecting the health system, the patients don’t get the service they deserve now. It makes working in Ireland frustrating. Fortunately I also work for a private hospital: Mater is both public and private – they are on the same site. The private system works, it is run by businessmen. Good at managing budgets, at adjusting to the new circumstances. Still making money, despite the crisis: the private hospital is a way to remain standard, because if we need equipment or programmes, we can sit down with these guys and discuss a business case, and if the plan is sound, we’ll have it brought into Ireland.’

Her phone rings, a colleague needs advice for medication and immediately her tone of voice changes. She’s a professional now, even if she’s wearing tennis shoes.

‘What does Europe mean to you?’
‘I work a lot with the Americans and a lot with French, Spanish, French, Dutch, Swedes. In general I think that Europeans are better doctors, because where Americans stick to the rules and protocols, and are law-abiding, Europeans are much better at tailoring the managing of patients, and tailoring the antibiotics. It’s a great combination though: together we can come up with very good guidelines.’

‘Apparently you see the Europeans as one group!’
‘I don’t collectively see us as Europeans. In fact, I don’t regard myself as a European; I’m Irish, even though my grandfather is from Dresden. I see Ireland and England as different, but the rest as a merged group, as a big state, like the United States. But I never knew people from Europe till I got to know some of my European colleagues more personally and now I find it easier to work with them than with Americans. I see how well we all get on, how we’re very similar, in how we think.’

‘Ireland might not be Europe, but your country is totally dependent on money from Brussels.’
In Dublin, like in Portugal, I could see a lot of EU signs, blue with the yellow stars, announcing that they had financed this road or bridge.

‘Yes, but that’s different. That’s just money. That’s nothing new either: we’ve always needed money, from the moment we joined the EU in ’73.’

‘A European state… what do you expect Europe will look like?’
‘It could all break up very soon. But I mean I think everyone all having different currencies is nonsense, it should all be one. The only way to move forward is as one big group, you have to connect to other countries. But we doctors don’t need the EU for that. We simply meet every year in Wengen, Switzerland. A very tough job. We discuss some difficult cases in the morning and then we ski.’