The psychiatrist as philosopher: an appreciation of Dr Séamus Mac Suibhne (Sweeney) (1978–2019)

Abstract

Dr Séamus Mac Suibhne (Sweeney), consultant psychiatrist and writer, who died on 8 September 2019, was a unique, much admired figure in Irish psychiatry. His interests ranged from clinical care to philosophy, from medical education to history, from innovative technology to the natural world. He was a dedicated family man as well as a doctor, scholar and writer who moved between academic fields with ease and erudition. As a clinician, he consistently placed compassion at the centre of care. Séamus’s work appeared in the Lancet, BMJ, British Journal of Psychiatry, International Journal of Social Psychiatry and Irish Journal of Psychological Medicine, among other publications. He also wrote for the Guardian, Spectator, Scotsman and Times Literary Supplement. Séamus had a particular passion for better acknowledgement and treatment of mental illness among psychiatrists, and his compelling advocacy on this theme is one of his lasting legacies.

Dr Séamus Mac Suibhne (Sweeney), consultant psychiatrist and writer, who died on 8 September 2019, was a unique, much admired figure in Irish psychiatry. His interests ranged from clinical care to philosophy, from medical education to history, from innovative technology to the natural world. He was a dedicated family man as well as a doctor, scholar and writer who moved between academic fields with enormous ease and erudition. As a clinician, he placed compassion at the centre of care. He is deeply missed.

Séamus was born in 1978 and grew up in Dublin. He attended Blackrock College where he completed his Leaving Certificate in 1996. He graduated as a doctor, MB BCh BAO (honours), from University College Dublin (UCD) in June 2002. In his undergraduate years, Séamus completed two medical electives in Western Australia, at Fremantle Hospital Emergency Department and Dalwallinu District Hospital (2001).

Séamus took an active role in UCD undergraduate life, acting as a committee member and auditor of UCD Philosophy Society and serving on the editorial board of the University Observer. In 1998, Séamus was a member of the victorious UCD team on Challenging Times, a prestigious television quiz show. In 2001, he won the undergraduate section of the Sheppard Memorial Prize, awarded by the Irish College of General Practitioners. In 2002, the year he graduated, Séamus received a richly merited Special Award on the Faculty of Medicine’s Dean’s List and the UCD President’s Award for Excellence in Extra-Curricular Activities.

Séamus’s education continued long after he left UCD. In 2003, he completed a Certificate in Humanities with the Open University and, in 2009, a Certificate in Neuropharmacology with the International College of Neuropsychopharmacology. He attained membership of the Royal College of Psychiatrists in 2006, winning the Standish-Barry Prize (for the highest marks by an Irish trainee). In 2009, he completed a Postgraduate Diploma in Medical Education with the University of Dundee.

Séamus held two master’s degrees. The first was an MA in the Philosophy and Ethics of Mental Health, awarded by the University of Warwick in November 2010. His dissertation was titled: We should not teach philosophy of psychiatry to medical students, but we should integrate philosophy into the teaching of psychiatry to medical students. Séamus also retained an active interest in medical education throughout his career. He was the pioneer of an innovative blended learning approach to the teaching of psychiatry to medical students during his time as lecturer in St. Vincent’s University Hospital in Dublin. In June 2012, he was awarded a Masters in Medical Education by the University of Dundee for a dissertation titled: The introduction of summative self-assessment to undergraduate psychiatry teaching. His contribution to both the personal and professional development of medical students under his tutelage during his career was evident in the tributes paid to him on social media platforms following his death. One read simply:

He was kind, inspiring and patient in teaching us. A true gentleman, he left a lasting impression on me and many of my classmates

Following his graduation from UCD in 2002, Séamus worked as an intern in the Mater Misericordiae University Hospital, Dublin and St John’s Hospital, Limerick. In July 2003, he commenced his training in psychiatry and held psychiatry registrar posts in Naas, Crumlin, St Patrick’s University Hospital, and child and adolescent psychiatry in Ballyfermot. In July 2006, Séamus took up a post as special lecturer in psychiatry at St Vincent’s University Hospital, Dublin and, in July 2007, a post as senior (specialist) registrar and lecturer at St Vincent’s and UCD. In July 2009, he became senior registrar in Ardee, County Louth, and was also an examiner for the Diploma in Clinical Psychiatry (run by the Royal College of Physicians of Ireland and Royal College of Surgeons in Ireland).

Following completion of his specialist training in June 2010, Séamus worked as locum consultant psychiatrist in Cork University Hospital for 3 months and Ardee for 10 months. In July 2011, he took up a permanent post as consultant psychiatrist with the Health Service Executive (HSE) Carlow/Kilkenny/South Tipperary Mental Health Service. In this position, Séamus combined his role as clinical lead for a catchment area of 27 000 people (in Kilkenny East) with responsibility for delivery and supervision of liaison services at St Luke’s General Hospital in Kilkenny. Séamus assumed these responsibilities in the context of the restructuring of these services, with the closure of St Michael’s Unit in Clonmel and the ongoing development of community supports.

Séamus chaired the liaison group between the Department of Psychiatry, Emergency Department and an Garda Síochána in Kilkenny. He also chaired regular meetings between the Department of Psychiatry, Emergency Department, Medical Assessment Unit and the general hospital, reviewing the operation of care pathways and addressing issues that arose. At local level, he took a lead in clinical audit, Schwartz rounds and the HSE National Clinical Programme for the Assessment and Management of Patients Presenting to Emergency Departments Following Self Harm. Séamus was also a key figure in the development of patient advocacy services in Kilkenny.

Most of all, Séamus brought deep humanity and compassion to the day-to-day provision of psychiatric care, in collaboration with his dedicated team. He was acutely aware of the central role of compassion and the therapeutic relationship in the alleviation of suffering. Drawing on his religious and cultural influences, he offered frequent personal reflections on his blog (seamussweeney.net) about entering into solidarity with those who suffer. Séamus exemplified this compassion in his dealings with patients. In 2018, one of his patients wrote movingly about the enormous positive impact that Séamus and his team had on her life (Brennan, 2018).

Throughout his training and professional life, Séamus maintained a number of active intellectual interests that reflected both his enquiring personality and his chosen profession. In addition to his diploma (2009) and master’s degree (2012) in medical education from Dundee, and his posts as lecturer at St Vincent’s, Elm Park, Séamus was also appointed senior clinical lecturer in psychiatry with the Royal College of Surgeons in Ireland, based in Kilkenny. Séamus researched, wrote and co-wrote about medical education continually (Mac Suibhne et al. 2007; Guerandel et al. 2008; Mac Suibhne, 2010a; Naughton et al. 2011; Mac Suibhne, 2012a). He was especially interested in technology as part of both teaching and clinical care (Mac Suibhne et al. 2014; Parvathaiah et al. 2015; Thompson, 2018) and was an active participant in the Irish Network of Medical Educators and the All-Ireland Society for Higher Education (2008).

Philosophy was, perhaps, Séamus’s greatest intellectual passion. In addition to his master’s degree in the philosophy and ethics of mental health from Warwick (2010), Séamus read and wrote extensively on a range of philosophical topics (Mac Suibhne, 2009a). In 2005, he contributed a chapter about Homer to a book titled Meet the Philosophers of Ancient Greece: Everything You Always Wanted to Know About Ancient Greek Philosophy But Didn’t Know Who to Ask (Sweeney, 2005a). When it came to philosophy, we could always ask Séamus.

Séamus’s thinking was deepened by his keen awareness of the history and development of psychiatry, and he wrote perceptively about Thomas Szasz’s classic text The Myth of Mental Illness: Foundations of a Theory of Personal Conduct (Szasz, 1961) on its 50th anniversary (Kelly et al. 2010), and Erving Goffman’s Asylums: Essays on the Social Situation of Mental Patients and Other Inmates (Goffman, 1961) around its 50th anniversary too (Mac Suibhne, 2009b; Mac Suibhne, 2011a; Adlam et al. 2013).

Over the course of his training, Séamus gained particular experience in psychotherapy and he often blended his interest in psychotherapy with his other academic interests. In September 2009, for example, he presented on the subject of ‘The Creon Complex’ at the University of London at a meeting about ‘Classical Myth and Psychoanalysis’, organised by the Institute of Greece, Rome and the Classical Tradition (based at the University of Bristol). He also presented at meetings of the College of Psychiatrists of Ireland (on many occasions), the International Society for Quality in Healthcare (Copenhagen, 2008), the Association for Medical Education in Europe (Prague, 2008), the Irish Learning Technology Association (Dublin, 2009) and the Classical Association of Ireland (UCD, 2009), among many other meetings and conferences, national and international.

Séamus’s other contributions and publications concerned a multitude of topics including psychiatric liaison with primary care (O’Reilly et al. 2010), ‘vampirism’ as a mental illness (Mac Suibhne & Kelly, 2011), translation and interpretation in psychiatry (Mac Suibhne & Ní Chorcoráin, 2008; Mac Suibhne, 2012b), synaesthesia (Mac Suibhne, 2012c), ‘new’ mental illnesses such as solastalgia and hubris syndrome (Mac Suibhne, 2009c; Mac Suibhne, 2012d), various aspects of psychiatric medication (Mac Suibhne & Lyons, 2007; Mac Suibhne et al. 2010), bibliotherapy (Mac Suibhne & Abu, 2014) and the work of the remarkable Nicholas Culpeper, a 17th-century English physician, herbalist, botanist and astrologer who clearly intrigued Séamus (Mac Suibhne, 2010b). Séamus had a particular passion for better acknowledgement and treatment of mental illness among psychiatrists themselves, and his compelling advocacy on this theme will undoubtedly prove to be one of his lasting legacies (Mac Suibhne et al. 2017).

Séamus loved books and often reviewed them. To describe his interests as broad would be an understatement. His intellectual appetite was boundless and possibly infinite. In the Guardian, he reviewed books about leprosy (Sweeney, 2005b) and polio (Sweeney, 2005c), and in the Times Literary Supplement he reviewed books about philosophy, medicine and health services (Sweeney, 2017a), studies of human development (Sweeney, 2017b), cardiac surgery (Sweeney, 2017c), neurology and nature (Sweeney, 2018), and hormone replacement therapy (Sweeney, 2019). In the Lancet, he reviewed books about Valdimir Nabokov and lepidoptery (Sweeney, 2000), and mathematics and the search for infinity (Sweeney, 2001a), as well as Malcolm Gladwell’s celebrated book The Tipping Point: How Little Things Can Make a Big Difference (Gladwell, 2000), which did not especially impress him (Sweeney, 2001b).

Séamus also wrote about books and various other themes in many other publications (Sweeney, 2003), including established blogs such as The Dabbler as well as blogs he created himself such as Psychiatry and Society (http://psychiatryandsociety.blogspot.com/). Up until his death, he posted frequently on his own blog, seamussweeney.net, which (in typical Séamus fashion) took its motto from Dante Alighieri’s Divine Comedy: ‘Poca favilla gran fiamma seconda’ (‘A great flame follows a little spark’).

Séamus was probing, sympathetic and measured in his comments about books. For the Irish Journal of Psychological Medicine, he reviewed books about ‘the physician as patient’ (‘there is a wisdom and a realism to the book’) (Mac Suibhne, 2008), psychosomatic medicine (‘not the blockbuster definitive textbook’) (Mac Suibhne, 2011b), homesickness (‘a humane and thought-provoking work’) (Mac Suibhne, 2012e) and brain imaging in psychiatry (‘it is hard to advise readers to part with their money for this volume’) (Mac Suibhne, 2018).

Séamus’s other activities are too numerous to list in full. He was a member of the Senior Registrar Committee of the Irish Psychiatric Training Committee (2007–2009), a representative of UCD graduates on the UCD Governing Authority (2008–2013), secretary (2007–2009) and then president (2009–2014) of the Section of Psychiatry of the Royal Academy of Medicine in Ireland, and associate editor of the Irish Journal of Medical Science (2012–2019). He was a member of the HSE National Shared Record Project and deeply involved with the Council of Clinical Information Officers as clinical lead for the Bipolar Lighthouse Project, an initiative within the eHealth Ireland Ecosystem.

Séamus contributed to Newstalk radio’s ‘Off The Ball’ sports programme, reviewed sports books, contributed interval talks on Lyric FM radio station, and published in a bewildering variety of other publications, ranging from Old Age Psychiatrist to The Scotsman, from Forum: Journal of the Irish College of General Practitioners to the Spectator (Sweeney, 2004). Séamus also wrote short stories (Sweeney, 2013) and won the 2010 Molly Keane Writing Prize.

The extent of Séamus’s achievements and the breath of his knowledge across such a diverse range of subjects were extraordinary, and yet, in the presence of friends, colleagues and patients, he was always personable and self-effacing. It was this humility that was so consistently endearing about Seamus. An April 2019 reflection by Séamus, again on his blog, written in reference to commentary on T.S. Eliot’s Four Quartets, perhaps best captures this core ethic:

For me, humility is at the root of science and religion and art and indeed any human endeavour.

It is difficult to sum up a life as rich and diverse as that of Séamus Mac Suibhne. He summarised it best himself, perhaps, in 2009, when he wrote an article about the Meditations of Roman Emperor Marcus Aurelius, from the point of view of reflective practice (Mac Suibhne, 2009a). In this paper, Séamus focused on Aurelius’s exhortation to ‘wrestle to be the man philosophy wished to make you’:

Keep yourself therefore, simple, good, pure, grave, unaffected, the friend of justice, religious, kind, affectionate, strong for your proper work. Wrestle to be the man philosophy wished to make you. Reverence the gods, save men. Life is brief; there is but one harvest of earthly existence, a holy disposition and neighbourly acts.

Most of us do not succeed in these tasks. Séamus did.