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In 1974, Gerald Ford took office after Richard Nixon’s resignation. Gasoline was 55 cents a gallon. The United States was pulling the last of its troops out of Vietnam. And Michael Farrell, MD, was looking for a place to do his pediatric residency.
He had just finished a three-year stint in the Navy as a general medical officer. But finding a residency wasn’t so easy now. “All of a sudden, no one was getting drafted,” he says. “There were no more open slots.”
But Farrell found one, at Cincinnati Children’s. He came here planning to stay just two years. But he continued with a combined fellowship in ambulatory medicine. He followed that with two years in gastroenterology. What happened to that two-year plan?
“Bill Schubert,” Farrell says.
Schubert was Farrell’s residency director. He was also “one of the best pediatricians I ever met,” Farrell says. Schubert had trained in general pediatrics but took a special interest in problems of the GI tract and eventually started the Division of Gastroenterology at Cincinnati Children’s. He was a powerhouse who would go on to become chairman of the Department of Pediatrics, director of the Cincinnati Children’s Research Foundation and president of the hospital.
In 1979, halfway through his fellowship, Farrell realized he needed to find a job. Schubert was rapidly taking on more responsibilities and needed someone to take over the residency program.
“He asked me if I was interested,” Farrell says. “And I said, ‘sure.’ I rolled up my sleeves and I went to work.”
And that pretty much sums up his style to this day. At the age of 67, he is a strapping block of a man with a no-nonsense style, boundless energy and little patience with bureaucracy.
“I had no formal training in education; still don’t. But I knew how the hospital worked and had a pretty good idea of the kinds of physicians we were trying to produce.”
He also knew where the program’s weaknesses were.
“We provided a pretty solid inpatient experience. But we lacked outpatient and adolescent medicine experience and there was little behavioral or mental health,” he says. Eleven of Farrell’s residency class of 17 went into private practice, but they were poorly prepared, he believes, for what he calls “the everyday pediatric stuff” of toilet training and colic.
“My mantra was, before you can be a good gastroenterologist or cardiologist, you have to be a good pediatrician. You have to understand children, growth, development, family dynamics, the effect the family has on the child and vice versa.”
So he set to work, transforming the residency program.
He developed a didactic schedule around what he thought residents needed to know. He added rotations in adolescent medicine and developmental and behavioral pediatrics. He developed more outpatient experiences, sending residents to work in community practices. And he created three combined residencies – one in medicine/pediatrics, one in pediatrics/physical medicine and rehab, and a psychiatry triple board residency.
Farrell also continued working as a clinician – in the ED, on the gastroenterology service, and as the attending in general pediatric inpatient care. “I was doing something clinically with the residents six to seven months a year,” he says. “There was constant interaction with the trainees.”
Farrell credits his military experience – a year in Okinawa and two years in Newport, Rhode Island – for his ability to tackle such an enormous task. His first day in Navy sick call, Farrell spent 20 minutes with his first patient, a marine with nothing more than a sore throat. His chief petty officer quickly reminded him of the 60 patients still waiting for care.
“I began to believe in a triage system,” he laughs.
That belief served him well over the 22 years he led the residency program through a time of enormous changes in medicine.
“Back in the ‘60s, the ideal physician was the rugged individualist,” he says. “But medicine evolved. Teamwork became important. People needed to maintain a sense of ‘I’m in charge but we’re going to work together.’ ”
And women entered medicine in record numbers.
“I remember one of the first years when we had more women than men. We had 25 residents and 17 of them were women. People were worried about silly stuff – their hair is going to clog the shower drains; they’re going to get pregnant. And I said, ‘Yes, women do get pregnant. If they stop having babies, we’re out of business.’”
He also recalls being told he shouldn’t have two female chief residents at the same time, something he went ahead and did anyway. “They did just fine,” he says.
One of the women who served as a chief resident under Farrell was Beverly Connelly, MD.
“I remember sitting in his office when he asked me to be chief and him telling me, ‘You probably aren’t the smartest person in the group.’ And I thought to myself, ‘What does that mean?’” she laughs. “But I knew how to find things out and every kid would get my best effort, every day. Mike knew that.”
Connelly credits Farrell for helping her discover what she really loved in medicine — taking care of the sickest kids. She now oversees Cincinnati Children’s Infection Control program and has turned it into a model for other pediatric institutions. She and Farrell remain close colleagues and friends.
Farrell’s honesty is one of his trademarks and best qualities, says Mitch Cohen, MD, who came to Cincinnati Children’s for his fellowship training with Farrell in 1983. Cohen now heads the Division of Gastroenterology, Hepatology and Nutrition.
“He could be brutally honest, but his honesty had a way of resonating with people,” Cohen says. “He appears gruff and tough but has one of the biggest, kindest hearts in medicine.”
Cohen recalls that in his earlier days, he was not given to political correctness. “Mike had quite a colorful vocabulary, and he taught me that people could do things to inanimate objects that I was unaware they could do.”
But his students love him, Cohen says. “He allows them a degree of independence that is unparalleled. Yet he has an unique sense of when to step in if he sees them going in a wrong direction.”
Farrell guesses that he’s trained at least 500 residents, nearly 100 GI fellows and thousands of medical students over the years. Many of those he trained have gone on to leadership roles.
“Right now there are five chairs of pediatrics across the country who came from here. The incoming president of the American Academy of Pediatrics is a Cincinnati Children’s graduate. I can’t begin to tell you how many division chiefs were trained here,” he says.
The most important lesson Farrell taught each of his residents — the thing he believes most important to any pediatrician’s success — is inscribed on a mug that he keeps in his office.
It reads, “Take care of the kid and deal with the ---- in the morning.”
It’s Farrell-speak for “Listen to the family, look at the kid and do what’s right,” he says. “If there’s any administrative fallout, we can deal with it later. Knowing that is more important than knowing the latest antibiotic.”
Farrell turned over the residency directorship in 2001 to Javier Gonzalez del Rey, MD, (see NextGen Residency Training). He continues as chief-of-staff, working on Cincinnati Children’s nationally-recognized safety program and medical staff issues. He still spends nearly 25 percent of his time in clinic.
It’s difficult to imagine Farrell retiring, but he has been taking some time to travel with his wife Becky. They have four children — three sons and a daughter — whom he calls the “I-90 kids,” each living in cities that stretch from one coast to another along Interstate 90. He has two grandchildren he loves to visit. He enjoys history, visiting museums and any sport “played with a round object.” And he hopes to heed the advice of a Jesuit teacher from his pre-medical school days.
“He told me, ‘You will be immersed in science for years. Promise me you will spend thirty minutes a day doing something else — reading or thinking about the human condition, pondering life’s great questions.’ It was great advice — it led to my being a bibliophile and a bit scatterbrained.”
Michael Farrell, MD.
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