Jonathan Hourihane is Professor of Paediatrics at the Royal College of Surgeons Ireland. His primary area of clinical and research interest is in paediatric food allergy and anaphylaxis. He was a 2019-2020 Fulbright-HRB HealthImpact Scholar to the University of Colorado.
“Denver in winter? I should have expected snow. But not 2 feet deep on my walking route to the Childrens’ Hospital Colorado. On my first morning, as the only person walking to work, not driving, I was offered food from a truck because I was presumed homeless!
My Fulbright-HRB Health Impact-sponsored project about modelling allergy prevention programs for Irish infants got started but couldn’t finish due to the lockdown that was looming from almost my first week. By the time I decided to leave, in mid-March the hospital unit had been deserted for 3 days already, as American doctors and scientists have long been trusted to work from home and do telemedicine. It is great to see the HSE embrace this since the lockdown.
What learnings would I take from my experience of American hospitals? No surprise to hear I think the staff are very well-trained and highly skilled and resourced but the delivery of US health care is motivated as much by patient expectation and a hospital’s financial interests as it is by defined clinical need. Clinics are heavily staffed, low patient volume and inefficient, in stark contrast to Ireland where they are poorly staffed, high patient volume empower families to make decisions and take health promoting actions for their children sooner. My Irish experience of practicality and pragmatic compromise unnerved them a little as I tried to increase my hosts’ clinical and academic “efficiency”.
I never got to give the planned formal lectures in the birthplace of food allergy care (National Jewish Hospital, Denver) or cross the Rockies by train. I did ski down a few of them, though, which was costlier but easier skiing than in Europe, using chairlifts without safety bars (personally terrifying and bizarrely unsafe in the land of litigation).
In other news, I attended political rallies in Denver for Bernie Sanders and Pete Buttegieg, very grandstandy, and after queuing for 3h in 2C weather, failed to get in to a massively oversubscribed Trump rally. I saw bighorn sheep in Arapahoe county and buffalo, prairie dogs and a bald eagle in Rocky Mountain Arsenal National Park, and experienced police drawing their guns in the social security office as I “stood in line” for my social security number. My proudest moment? I got a painting in Denver Art Museum correctly re-attributed to the Irish artist Nathaniel Hone (the Elder) on the basis that if he had been an American artist active before 1775, he would not have been described as English! (I think they might have thought I was a Professor of Art History!)
On my last day, I walked down Corona Street. A fitting, premature end to my visit, cut short by some pandemic or other.”