At the height of the early lockdowns, Dr Tony Holohan’s stature was such that murals were painted in his honour. In one on Dublin’s Camden Street, Holohan appeared in superhero garb, springing from a telephone box, TH emblazoned on his chest. Holohan had become the singular figurehead of Ireland’s pandemic response, his advice rarely, if ever, questioned.
For public health professionals, whose advice is usually refracted through the political, policymaking and lobbying worlds before it makes contact with the public, it was remarkable. They were telling people to do something inimical to human nature — stay inside, stay away from each other — and people were doing it. What’s more, the officials doling out the advice were being lionised.
Across town, in the Department of Health on Miesian Plaza, officials were delighted. In our 2021 book on the pandemic in Ireland, Pandemonium, Hugh O’Connell and I related how Holohan was shown a picture of the mural by a delighted member of his communications staff. “Don’t worry,” he responded. “That will change”.
Even at that early stage, he had the insight to know that in the long run, things would get tricky. And so it was: Holohan became a much more divisive figure — but no less a figure of enduring public fascination if often frustration.
We Need To Talk, the publisher’s promotional spiel tells us, reflects on his experiences and “inspires us to have those difficult conversations that ultimately make life more meaningful”. This sounds more like the self-help genre, surprising given Holohan has been at the apex of health policymaking for almost 15 years, and weathered multiple storms, not to mention working at close quarters with some of the most influential political figures of recent years. But the book initially risks presenting as an interchangeable, soft-focus memoir.
This is a shame, because while it lacks a piercing central theme, all of those key events are there, and Holohan doesn’t shy away from letting his reader know when he disagreed with or felt let down by the actions of others, including his political masters. Simon Harris’ handling of the CervicalCheck scandal is to the fore here, as is his Leo Varadkar’s stunning admonishment of the National Public Health Emergency Team’s unexpected Level 5 lockdown advice in October 2020 — and the handling of the controversy sparked by the botched move to second Holohan to TCD when he decided to step down as chief medical officer.
We Need to Talk follows a well-worn path of memoir, gathering up childhood experiences and a rattle through his early professional life and as a father of a young family.
While it is a valuable account of the important moments of Holohan’s professional life, its heart is in the description of his relationship with his wife, Emer Feely, their family life, and ultimately her untimely death from multiple myeloma in 2021. In a manner that is artfully woven through the book, Holohan writes about her illness and its effect on their family in a very human way that is dignified, careful and compelling. He manages to confront the emotional burden without being maudlin, and the impression the reader forms is of a marriage and family life that was nourishing and sustaining even in the most unimaginably difficult times.
The chapter dealing with her funeral, under Covid restrictions, is a vivid repudiation of the callow school of thought that Holohan was some sort of control freak who was indifferent to the impact of his advice on real lives. The book also reveals that Holohan is happy in a “lovely relationship” with psychotherapist Ciara Cronin.
There are valuable insights into one of the questions most people will want answers to: what makes Holohan tick. He tells his reader early on that as a medical student, he learned the importance of being decisive. “Some people are naturally good at it and some people struggle. As a doctor, you learn the importance of believing in yourself”. Certainly, the single-mindedness this engendered was on display throughout the pandemic.
The book gives glimpses into the cloistered world of the civil service while there are engaging firsthand accounts of key moments in the development of healthcare policy and scandals and crises from pig meat dioxins to swine flu, although sometimes these are dealt with too briskly. But for the really big stuff, like CervicalCheck, abortion reform and Covid, large chunks of the book are given over. Sometimes it can feel a bit like Holohan getting his version of events on record and lengthily validating his approach — indeed, the overriding verdict of the book on most challenges is that the system did well, achieved the best possible outcome and ultimately everyone acted in good faith.
While this is undoubtedly Holohan’s honest view, it can feel a little undernourishing for the reader. That being said — and true to type — he doesn’t resile from politically difficult opinions or criticism, especially around the fateful Christmas 2020 decisions on hospitality, when he says many deaths could have been prevented. Neither does he shy away from stinging verdicts, such as how the State’s reliance on nursing homes for the care of older people created the perfect conditions for placing residents at risk from Covid.
While at first glance the fear is We Need To Talk might get bogged down with some of the more forgettable tropes of memoir and autobiography, it thankfully largely eschews them to add significant value and from both his personal and professional lives.