Hospital's prized operator

HEROES OF THE HEALTH SERVICE:In the second of a fortnightly series highlighting the contribution of individuals working in the health service, we feature Dr David Hickey, director of transplantation at Beaumont Hospital and consultant urologist

“Everything I learned in life in terms of social obligation and commitment, I learned on the football field.”

DR DAVID Hickey, director of transplantation at Beaumont Hospital in Dublin, and three times all-Ireland winner with the Dublin Gaelic football team in the 1970s, borrows the quote above from another well-known footballer, Albert Camus. It describes what he has learned during four decades as one of Ireland’s leading transplant surgeons.

Last year Hickey, who has carried out more than 1,500 kidney transplants to date, won the Lifetime Achievement Award at the Irish Healthcare Awards.

He says it was an accolade he accepted “on behalf of the whole transplant programme in Beaumont Hospital, [and] the donor families who donate organs in times of great stress”.

According to Hickey, the team spirit that was behind the success of the Dublin football team in the 1970s continues to be central to the team he works with today in Beaumont.

Kidney and pancreas transplantation in Ireland is carried out at Beaumont Hospital, heart and lung at the Mater, and liver at St Vincent’s hospital in Dublin. Hickey and his team also carry out paediatric kidney transplants for the State at the Children’s University Hospital, Temple Street in Dublin.

Hickey explains that in the early 1970s Ireland was carrying out 20-30 kidney transplants a year. Last year, Beaumont did 192.

Hickey says there are currently 600 adults on the waiting list for kidney transplantation and, much like the demand, waiting times are also increasing.

“Ten years ago it was six months, now it is three years. There is a worldwide increase in renal failure.

“It is bankrupting health services because it is incredibly expensive to dialyse patients. So we need to double the number of transplants we are doing to keep up with what is happening.”

According to Hickey, transplantation is one of the few areas of medicine where “the more you spend, the more you save”.

However, he says somehow that message isn’t getting through.

He explains that one successful kidney transplant which typically lasts 15 years, can save the taxpayer almost €700,000 over that period, in the direct cost of dialysis alone.

Apart from the economic cost of dialysis, there is also a human cost. Patients on dialysis typically spend four hours a day, three days a week hooked up to a machine.

Hickey says it is particularly difficult for children as it consumes the lives of the entire family.

Speaking earlier this year, Minister for Health James Reilly said: “Transplantation is financially, ethically and morally the right thing to do.”

He added: “Not alone can this save lives but can improve the quality of life hugely and also is financially viable given the cost of a transplant against the cost of maintaining a patient on dialysis for a year.”

Ireland has a world-class transplantation programme, which Hickey says has been sustained by “very dedicated people, donating their time beyond and above the call of duty”, as opposed to an investment of much-needed resources and infrastructure.

However, he warns that the volunteerism within the service could get “eroded to a tipping point, where one person says ‘I just can’t keep doing this any more’, and then the whole stack of cards will fall down.”

Asked how he copes in a health service that is constantly under pressure, he says: “The patients are fantastic, the interchange between the donor families . . . It is almost like professional football, that a cheque arrives at the end of the month is almost a surprise.

“Because you nearly would expect to pay to do this job.”

Although he would be loathe to admit it, Hickey continues to go above and beyond the call of duty every day.

In the past two years, he has travelled twice to Sudan to carry out kidney transplants on children there. He also trains Sudanese surgeons in Beaumont.

Six years ago, at the age of 55, Hickey was diagnosed with cancer. Following surgery in Dublin, he travelled to Canada for a specialist-type of radiation.

He recalls sitting in the waiting room in the Canadian hospital feeling “very sorry for myself”.

“My hair had fallen out and I wasn’t able to eat, I had lost 20 kilos, was freezing cold. I was just saying this is an unbelievably hard life.

“The patient being wheeled in before me was a little bald five-year-old girl with a mother and father in tears . . . so, it put things in perspective,” Hickey says, the emotion evident in his voice.

“The main thing a doctor can offer a patient is support, confidence that they are going to make it. Even if they are not going to make it – that their time is pleasant, it’s comfortable and that you always give them hope no matter how bad the situation is, so I think it enhanced those situations.”

After four months of treatment in Canada he travelled to Cuba; a country for which he has a huge passion where he feels free from crime, harassment and “all the ills of consumerism”.

Hickey won his own battle with cancer.

He will, no doubt, continue to fight for improved services for his patients and a more caring society, which he believes has been eroded in recent years.

“We have had more suicide donors this year than ever before . . . It is a very striking indictment of our so-called caring society,” he says.