Far from easing into a quiet retirement, paediatric oncologist Dr Fin Breatnach hit the ground running as chief executive of Barretstown. Now he has a lot to say about plans for the National Children's Hospital, writes Gráinne Faller
FULL-ON RETIREMENT was probably never going to suit Dr Fin Breatnach. As the first paediatric oncologist in Ireland, he had spent 27 years in Our Lady’s Hospital for Sick Children in Crumlin treating children with cancer. It was a way of life rather than a job, but finally Breatnach decided he had had enough and, to the surprise of some, took early retirement in 2008.
His reasoning was simple. “I didn’t want to break bad news anymore,” he says. “Breaking the news of a diagnosis, breaking the news of a relapse, you know, it’s very difficult. I think people sometimes think that consultants and doctors generally don’t care about their patients, but they do. They really do and I don’t think any of us leave a session where we have broken bad news unaffected. It takes something from you every time and I guess I had reached the point where I realised there was very little left in the tank.”
After a break of 12 months however, he found himself back in the thick of things, albeit in a different capacity, as chief executive of Barretstown – a specially designed camp in Co Kildare, which provides a programme of activities, fun and adventure to help children with serious illness regain their confidence and self-esteem.
“I popped myself in here really to fill a gap after the last chief executive left,” Breatnach says. “At one level I suppose I thought it would be nice and relaxing down here. I knew the grounds were lovely and I thought I’d have a nice easy time. Of course, I didn’t realise that the Celtic Tiger was about to die and that the challenge of raising almost €100,000 per week was one we faced.”
Now, things look set to get busier still for Breatnach with the announcement that the new national children’s hospital on the Mater Hospital site is planned to open by 2014. Breatnach, who has long campaigned for a single national children’s hospital, firmly believes that the Government is making a mistake of enormous proportions. The Mater site, he says, does not meet the accessibility, space or expansion needs of such an institution.
“It’s a national children’s hospital,” Breatnach says. “Many of the seriously ill children who are treated there are coming from outside Dublin, and their parents have to bring them, not only to Dublin, but into the centre of town? It makes no sense,” Breatnach says.
“The HSE has allowed for a 20 per cent expansion on the site over 10 years,” he continues. “But Crumlin, for example, expanded by 40 per cent in 10 years.” None of the staff working in Crumlin or any of the children’s hospitals was consulted by the people who made the decision about the site. “They eventually met some of us from Crumlin. That was after we requested, well begged for, a meeting,” Breatnach says. “But by that stage the decision was made without having consulted the proper stakeholders.”
He is hugely persuasive and intends to help the campaign that is currently urging the HSE to rethink the decision. “We cannot afford to make a mistake like this now,” he says.
Breatnach isn’t one to shrink from a challenge. Indeed, he admits he craves it. “In many ways I suppose the greater the challenge at one end, the greater the reward at the other. Medicine has the capacity and possibility for creating the greatest sense of satisfaction of any job, I think.”
It almost sounds as though he misses his old job. He shakes his head. “Since I’ve left that level of stress, I don’t miss it at all,” he says. “Not in the slightest. I miss the staff and I miss the challenge but I think to have continued in that area would have destroyed me. I just knew that the time was right for me to leave.”
It comes as a surprise to learn that the choice of medicine as a career was something of a fluke for Breatnach. “When I was about 16 years old, there was an older boy who lived nearby me who qualified as a dentist,” he recalls. “He went over to the UK, and six months later he arrived back with a red sports car. I thought, ‘I want to be a dentist.’ ”
Two years later, having achieved the requisite number of honours in the Leaving Cert, Breatnach found himself in the registration queue for dentistry in University College Cork (UCC). “I seem to recall standing in the queue to register for dentistry and next door was the queue for medicine,” he says. “For some reason or other there was nobody at the registration desk for dentistry, and we just stood there waiting and waiting and the queue for medicine kept moving and moving. I just got fed up and I joined the end of the medical queue.”
He worked in paediatrics for a number of years, firstly in Ireland and then in the UK. The decision to become a paediatric oncologist was partly born of a desire to return home. “I got wind of a position in paediatric oncology coming up in Ireland,” he says. “At the time I had thought I would become a paediatrician with an interest in oncology but when I heard about the job – I was working at Great Ormond Street at the time – I decided to extend my time there in order to become fully trained.”
Childhood cancer survival rates were still low, but they were improving all the time, Breatnach explains. “By the time I started in Crumlin in 1981 the cure rate for lymphoblastic leukaemia, the most common form of the disease, was about 40 to 45 per cent. It’s about 95 per cent now. Huge strides have been made.”
He admits he had little idea of what he was getting into at the beginning, rapidly discovering that managing and curing disease was just one part of the job. His ward of eight beds came under pressure due to an overwhelming demand for the specialised cancer services. It became apparent that a separate facility was needed to cater properly for the children and their families.
Parents and supporters rallied around and started fundraising. Breatnach’s evenings and weekends were spent driving all over the country to support fundraising efforts. “I realised that if you went and collected cheques from people, they were more likely to support you again the following year. We needed an ongoing campaign.”
With such a full-on career, inevitably family time was often limited. Nonetheless, two out of his four children opted to follow him into medicine. Breatnach smiles slightly. “Well some time back I was having a chat with them both and I said, ‘You know guys, I didn’t encourage you to study medicine, I told you it wasn’t a job, it was a way of life and you saw the amount of time I had to commit to it in my time. But I have to say that I’m chuffed that you decided to follow in my footsteps.’ My son Cormac has a peculiar sense of humour – at least I hope that’s what it was. He said, ‘Follow in your footsteps dad? It’s got nothing to do with that. We both decided that since we saw so little of you when we were growing up, it had to be interesting!’ ”
The arrival of the next generation of Breatnachs has hammered the point home. “My first grandchild, Niamh – I suppose more than anything she reminded me of how much I missed of my own children growing up. I think that produced some painful reflection as well at the time.”
By the early 1990s the hours and the effort had paid off. It took nine years, but they managed to raise enough money to build the unit that exists in Crumlin today. “We built a bone-marrow transplant unit, a playroom and accommodation for families,” Breatnach says. “The only element of the unit provided by Government consisted of a Portakabin structure. Granted, it’s a very fancy Portakabin but that’s the only element of the thing that was provided.”
Doesn’t that make him angry? Breatnach shrugs. “Well the 1980s in Ireland were a miserable time. Banks weren’t lending, Government had no money – unemployment was very high,” he says.
“Subsequently, when talking to a senior official in the Department of Health, I asked him how it was he could justify not helping me build this clinic that was so necessary for the children and his answer was, ‘We knew you would raise the money.’ ” Breatnach smiles wryly. “So that was the kind of mindset that was in the Department of Health at that time.”
As more children survived, Breatnach began to understand the importance of a facility such as Barretstown. He had been involved on an administrative level with the organisation since its inception. However, as the years went by, he began to recognise the impact that cancer and its treatment had on his patients.
“Many of the kids I’d see, a few years out from their treatment – particularly in their teens – would not be achieving academically,” he recalls. “Parents would tell me, ‘He’s not doing well at school, he’s not mixing very well with his pals.’ When you’d see these kids come into the clinic, they’d be looking at the floor, eye contact was poor. You’d struggle to get a conversation going with them. They looked depressed and down on themselves.
“But then six months later, the same child would come into you full of chat, good eye contact. The confidence was back and I’d look at the parents and say, ‘What’s happened to him?’ And they’d reply, ‘He’s been to Barretstown.’ So I began to get more interested in the programme here and in the therapeutic recreation model.”
As most Irish people know by now, Barretstown was set up in 1994 by the actor Paul Newman after the success of his Hole in the Wall Camps in the US. Children affected by serious illnesses come from all over Europe to the camp where they participate in activities and challenges such as canoeing, horse riding, arts, crafts and drama. Barretstown provides full medical back up and the children can come entirely free of charge up to three times. “Parents say remarkable things,” says Breatnach. “Things like, ‘I left my sick child in Barretstown and 10 days later, I collected my old child.’ That’s powerful stuff.”
He won’t be slowing down for some time. There is the debate about the children’s hospital, which shows no sign of abating, and when his contract at Barretstown ends, Africa beckons. “A colleague of mine, Dr Patricia Scanlan, is working over in Tanzania at the moment,” he says.
“The conditions under which they are attempting to treat the children over there are pretty appalling. There seems to be some light at the end of the tunnel and I could see myself going out. My colleagues in Crumlin are willing to go out and lend their expertise in order to train doctors and nurses over there. Self-sufficiency is what you aim for.”
The other ambition involves another passion of his – sailing. Breatnach smiles. “The challenge of a transatlantic trip is something that might interest me yet. My dear wife won’t let me get on with that – certainly not with her on board – but you never know. It’s good to have something to look forward to.”
Barretstown hopes to invite 1,800 children with serious illnesses to take part in therapeutic recreation in 2010. If you’d like to help, please ring 045-864115 or see www.barretstown.org
INTERVIEW