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Oct 1, 2016

Ireland’s First Full Professor of Neurology, Leading in Research and Guidance

Academic Director of the Trinity Biomedical and Science Institute, Prof Orla Hardiman is a pioneer in research who strives to create opportunities for those around her.

Kathleen McNameeFeatures Editor
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Stephen Paul Paclibar for The University Times

In her own words, Prof Orla Hardiman is “a bit of an aberration”. The first full professor of neurology in Ireland and only the country’s 11th neurologist, Hardiman didn’t come from an academic background. Growing up in Dublin and attending an Irish-speaking school, her father was the first in his family to go to college, while her mother wasn’t afforded such opportunities. Speaking to The University Times about her decision to study medicine she explains: “It was just something I was always interested in. I was interested in how the body worked, and as a result of that, I never really wanted to do anything else except medicine.” Despite always knowing she wanted to study medicine, it was only after some time away from her medical degree that she decided to specialise in neurology: “I took a year out and did a BSc in physiology, and then I went back and finished my medical degree and decided that I didn’t like surgery. It makes your hair very flat wearing that hat all the time in the operating theatre”, she says, laughing. “You get very greasy hair too.”

At that time, neurology was a path not widely travelled in Ireland, so her decision was all the more remarkable: “I just liked the idea of understanding how the body worked, and I liked the idea of the principled thinking about things in a sort of very logically-minded way. Neurology is very conducive to that, and also it’s an area that there’s so many different aspects you can look at.”

This decision took her to the US, where she completed a three-year neurology residency under the Harvard Longwood Area Neurology Training Program in Boston. It was while working in the US that she noted an interesting trend, one which would lead to one of the most exciting discoveries of her career. “When I was in America, I was working in Boston. I remember noting when I was seeing patients with motor neurone disease that we didn’t see many people who were black or Hispanic who had this disease”, she explained. “America is a very segregated society, so it was possible that was just because black people and Hispanic people didn’t really have access to health services as people who are white or English speaking, but it always struck me… and it stayed with me.” It was only years later when she travelled to Cuba that she had the opportunity to look into her hunch that people of a certain origin are less likely to have diseases like motor neurone disease.

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The books always said that motor neurone disease had the same frequency the world over, but it clearly wasn’t true, and we were able to show definitively it wasn’t true

“Cuba is a very mixed society”, she explains. “So, we set about a project where we actually tested that hypothesis to show that, yes, people who are of mixed ethnicity are protected. They don’t seem to get as much motor neurone disease.” At the time, this finding was largely discredited because, as Hardiman points out: “The books always said that motor neurone disease had the same frequency the world over, but it clearly wasn’t true, and we were able to show definitively it wasn’t true.” She was able to genetically prove her hypothesis and, as a result, further studies are happening to see what more could be garnered from her original observation.

It was the offer of a Newman Scholarship in University College Dublin (UCD) that lured her from the US back to Ireland and a successful career within the neurology sector here. A highly competitive program, the scholarship aims to recruit talented individuals to UCD and provides them with the financial support to conduct research. In 1993, she also became director of the ALS and neuromuscular clinics at Beaumont Hospital. Hardiman spent several years in her alma mater balancing her time between the clinical and academic side of her work. “I was seeing like 100 patients a week, and there are only 11 neurologists in the country. So I was pretty busy trying to build services and advocacy for patients.” Hardiman’s research interests are mainly focused on the areas of epidemiology (the branch of medicine that looks at distribution and control of disease) and the development of ALS. Before last year, many of these words would have been unknown to most people. The success of social media phenomenon the ice bucket challenge, however, put the world of neurology and the diseases associated with it on the world stage. Early this year, the money raised by the initiative saw a crucial breakthrough in the field. Project MinE, a Dutch-run programme, which co-ordinated the testing of thousands of DNA samples, announced the discovery of new genes related to motor neurone disease. Hardiman, who leads the Irish Project MinE research group along with researchers from 13 other countries, played a pivotal role in ensuring the success of this program. With support from patients and Science Foundation Ireland (SFI), the Irish branch of Project MinE were able to contribute €1.6 million to the project.

The drive that most people have, if you talk to people who made something or achieved something, they’ll mostly tell you is fear of failure. That’s what drove me in the beginning

Hardiman further contributed by having a hand in training two of the researchers responsible for discovering and authoring the paper about the new genes. It’s clear that Hardiman is generous with her knowledge, and she admits it’s always been her aim “to be empowering across both genders”. She also acknowledges that she enjoys attracting the best and the brightest to her research programs. Speaking about the students who go on to do their own research after their time with her, she says: “Those guys are the type of people I like. They’re really bright, and then they stand out on their own independent research, but we continue to work with them.”

Within Trinity, Hardiman also fulfills the role of the Academic Director of the Trinity Biomedical and Science Institute (TBSI). Despite being founded five years ago in the height of the recession, the institute has become something of a success story, raising €83 million in research funding and becoming the home to 599 researchers across biochemistry, pharmacy, medicine, immunology and bioengineering. Speaking at the TBSI’s formal anniversary celebrations two weeks ago, Provost Patrick Prendergast explained that the institute had “created national pride and excitement at a time when it was much needed”.

I like coming up with things that are a little bit different and a little bit unusual nd a little bit unusual or that where you thought about something, and you come from a slightly different perspective

Prof Luke O’Neill, who fulfilled the role of director before Hardiman, praised her work to The University Times in an email, adding his belief that she was the right person for the role: “I’ve known of Orla’s work in motor neurone disease for a number of years – she is an internationally known figure in this field, and it is tremendous to have her as the Academic Director of TBSI.” The only Irish neurologist to have received the Palatucci Advocacy Leader of the Year Award, an award she received in 2004, and the Sheila Essey Award for ALS Research, which she received in 2009, from the American Academy of Neurology, Hardiman’s success is a testament to her unwavering work drive and ethic. A mother to four children, it was only when her last child was born that she finally used her maternity leave. She admits, however, that her own kids have yet to figure out what drives her. “The drive that most people have, if you talk to people who made something or achieved something, they’ll mostly tell you is fear of failure”, she muses. “That’s what drove me in the beginning. But I think now it’s that I’m very lucky in that I’ve worked with people kind of all my life who are really smart. I’m a little bit of a magpie, in the sense that I like really creative people around me, and I like coming up with things that are a little bit different and a little bit unusual or that where you thought about something, and you come from a slightly different perspective.”

Even some of her colleagues are confused by her ability to juggle so many aspects of neurology at once. Zhanna O’Clery, Associate Director of Trinity Development and Alumni, has worked closely with Hardiman since her arrival as professor of neurology in 2007. The then-Head of the School of Medicine, Prof Dermot Kelleher, tasked O’Clery with ensuring that Hardiman’s transition was smooth. Since then, O’Clery and Kelleher have raised, on average, €1 million per year together for research. Speaking to The University Times, O’Clery is full of praise for Hardiman. “It’s easy to work with her because she knows what she wants to say, she’s clear about what she want to say and she’s inspiring,” she explains. “She wants to make sure she creates opportunities for young people who are interested in research, so they don’t have to feel that they have to go somewhere abroad to do it at highest level.” O’Clery, like so many others, is impressed but also baffled by Hardiman’s energy, saying “sometimes I simply don’t know how she does it. It’s fantastic she’s a great role model for all of us”.

She wants to make sure she creates opportunities for young people who are interested in research, so they don’t have to feel that they have to go somewhere abroad to do it at highest level

While extremely driven in an academic and clinical context, Hardiman has also retained a strong sense of social awareness. She’s a vigorous advocate of patients and ensuring the proper structures are put in place to provide appropriate care. In 2003, Hardiman and her team conducted research that showed that people who attend a specialist clinic are more likely to live longer lives than those who don’t. She believes that we should be investing in centres of excellence as patients can live as long as nine extra months. She feels this is a “really important observation” and one which proves that centres of excellence are not only helpful to patients but also are better value for money.

Being at the top of the field in a male-dominated sector such as medicine, however, hasn’t been easy. Hardiman lets out a rueful laugh when asked if she had experienced inequalities, offering up a “well, duh”. From the language used to just generally working out where one stands, it hasn’t been easy finding a spot at the top to call her own.

“There’s not only the issue of you have to play the game and be as good and better than anybody else as a female”, she points out. “You have to reconcile that with the definition of this societal expression of power, which is very masculine.” This “societal expression of power” often boils down to the language used when discussing female leaders in comparison to their male counterparts.

How do you be powerful and be a woman? If you’re powerful and a woman the terms that are used favourably for men are used unfavourably for women. So if you’re assertive as a man, you’re aggressive as a woman

“How do you be powerful and be a woman? If you’re powerful and a woman the terms that are used favourably for men are used unfavourably for women. So if you’re assertive as a man, you’re aggressive as a woman. If you stick to your guns and dig your feet in as a man, you’re consistent. If you’re forceful in holding your point of view as a woman, you’re strident.”

Hardiman is quick to point out, however, that while this is true of her profession, the opposite could be said for many others: “I think it’s that the power play is, in the older professions, very gendered defined, and it’s favourable towards men, but you know it’s also true in other professions the other way around.” She’s also keen that women who have succeeded aren’t portrayed as intimidating or unapproachable: “I think we have to be very careful because success shouldn’t breed this sense or aura of intimidation.”

Despite an impressive resume, Hardiman isn’t finished with her research yet. From speaking to her, it’s quite clear that her passion for her subject is as strong now as it was when she was a student in UCD. If anything, each success just buoys her on to find another seemingly unsolvable challenge.

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