Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

On Call with... Professor David Kennedy, Class of 1972

01 November 2018
Q&A with Professor David Kennedy, Rhinology Professor, Perelman School of Medicine, University of Pennsylvania, USA.

Professor Kennedy has chaired the Department of Otorhinolaryngology - Head and Neck Surgery and has served as Vice Dean for Professional Services for the Perelman School of Medicine, and as Senior Vice President of UPHS.

IRISH CONNECTIONS?

We have always had family in Ireland. My grandfather Dr Denis Kennedy, also an RCSI graduate, was a general surgeon who lived in Merrion Square in Dublin. He was the recipient of the Surgery Medal in 1889, and, when I went back for my reunion last year, I made a special point of looking for his name on the board. My dad, Dr Michael Leo Kennedy, was a general surgeon who emigrated to the UK, where I was brought up, and who subsequently sub-specialised in urology. My brother, a radiologist, now retired, lives in Galway.

EXPERIENCE OF HEALTHCARE IN IRELAND VS THE US?

In the US, I think physicians in general are significantly involved in hospital administration. This is perhaps not the case in Ireland. Colleagues [in Ireland] speak of disillusionment with the system which is a shame. I feel I was lucky to work in what I believe was a golden era: now, the economics have changed somewhat and the pressures to push throughput of patients is immense. My first job was a baptism of fire, no sleep and no weekends. We were used to a 110-hour week, nobody does that now.

WHY ARE YOU DESCRIBED AS AN INNOVATOR?
I think it was because I enjoyed problem solving. In the mid-1980s, I was credited with the introduction to the US of endoscopic technology for sinus surgery. I utilised the advantages of endoscopy to improve diagnosis and treatment of sinonasal disease. It was a privilege to develop and disseminate the applications via my teaching role at Penn and around the world. I also developed the first subspecialty fellowships in rhinology while at Hopkins, and some instrumentation required for this type of surgery.

WHAT WAS THE IMPACT OF THAT INNOVATION?
Up to that point, an otolaryngologist would have used a headlight or, less frequently, a microscope to perform sinus surgery. We used a microscope at Hopkins and this made it easier to transition to an endoscope. To put it mildly, it wasn't a move that was well received initially by much of the otolaryngology community, but my courses were always fully subscribed and the methods were internationally adopted over time. Today, the younger generation of surgeons is trained using an endoscope for sinus surgery and a microscope for ear surgery.

2017 Reunion
Professor Kennedy and family with his classmate, Dr Bobby Braunstein and his wife at their 2017 RCSI reunion

YOU WERE ELECTED TO THE NATIONAL ACADEMY OF MEDICINE?

I was only the third otolaryngologist ever to be elected to this group, a significant honour of which I am very proud. The National Academy is an advisory board to the US government on matters related to medicine, so plays an important role in shaping how medicine should change.

TYPICAL WORKING WEEK?
I believe being a good time manager is the key to life and success. You can have a number of people with the same skills and qualifications, but it will be the person who administers the best who does the best job. When in the role of Vice Dean, I had 1400 physicians and 18 clinical departments to direct as well as my own clinical workload, the latter taking up at least half my time. Now that I have given up all my administrative duties, I can concentrate on seeing patients and doing surgery, often from 7am-7pm three to four days a week, and having academic time on Fridays.

WEEKENDS?
I love Chesapeake Bay where we have a place on the water. My wife and I each have two children, so between us we have four, aged from 36 down to 15; a blended family. The older three are working or studying but the youngest lives with us. I am an early riser and we love to do something active at the weekends, like a long bike-trail, maybe 30 miles, or more, or we go out on our sailboat. It's a gentle 1950s style of life. I take it easy and relax too, and we enjoy a lovely social life there.

Chesapeake Bay
Chesapeake Bay

HOT TOPIC IN HEALTHCARE NOW?

About 50 per cent of people in western countries show evidence on testing of allergy. Research has shown that the epidemic of allergy and asthma appears to result from reduced exposure to natural environments and a broad bacterial microbiome. For example: The Finnish and Russian Kerelia are adjacent areas in northern Europe. A study was undertaken in 1998 to characterise the allergy profiles in the two areas. The key finding showed that allergic symptoms and disease were much more common in Finnish children and adults than in their Russian counterparts. The conclusion was that if people are not exposed to bacteria as children, they have a higher risk of a compromised immune system. A similar finding was made when an allergy profile of two Amish communities; one with the animals living close to the house, and one where they were more separated. Living close to farm animals gave the Amish a greater immunity to allergy.

WHAT ACTION SHOULD BE TAKEN?
In general we need to be more cautious in prescribing oral antibiotics, and not just because of antibiotic resistance. We need also to focus on preserving the microbiome in the gut: there is evidence to implicate a role in obesity and depression. It's an exciting area, and an important evolving area also within the field of rhinosinusitis with the potential for local probiotics.

1972 Yearbook Committee
David Kennedy (circled) and the 1972 Yearbook Committee

LOOKING BACK?
The College was much smaller then but it was nonetheless an international experience. I do remember not working very hard in first year, taking time to utilise my glider and pilot licenses and enjoying lots of "offline" activities. I took my exams, thought I had done fine, and asked my girlfriend if she would check the board to see if I had passed. She wrote me a note which began: "I am terribly sorry to tell you..." I read no further. For three days I thought I had failed. Then, my brother (who was then a medical student at UCD) informed me that no, I was on the honours board. My girlfriend, needless to say, had not bothered to look at the honours board. Those three days changed my life. I vowed it would never, ever happen again!

Overall, I really enjoyed my time at RCSI, and I want to express my extreme gratitude to the College for giving me an opportunity to pursue a career which I have loved and which has provided some many rewards. None of this would have occurred without RCSI.

Thank you Professor Kennedy.

'On Call' is our new alumni interview series in which alumni supply the answers to our searching questions. If you have any comments, feedback, or would like to be put in contact with Professor Kennedy please email alumni@rcsi.ie.

» Read past ‘On call with...' interviews here