Ralph Counahan was a colleague and contemporary, a friend always and a foe occasionally, an academic who chose a career in clinical paediatrics and a cosmopolitan man who settled in rural Ireland. Ralph was always a committed paediatrician, deeply involved in the service and administration of his regional unit and committed to the care of his patients.

He did his undergraduate medical training at University College Dublin in the 1960s and completed his early paediatric training in Ireland prior to moving to the UK. He spent many productive years in clinical research at the nephrology units at Guy’s Hospital and Great Ormond Street. He was fortunate in being under the tutelage of the then two brightest sparks in British paediatric nephrology, namely Cyril Chantier and Martin Barratt. Ralph produced a significant clinical study on the problematic Henoch-Schonlein nephritis, a paper which is still widely quoted. He also made a significant contribution to physiology in attempting to validate the value of serum creatinine as an estimate of glomerular filtration rate, the formula now widely known as the Schwartz formula which could just as easily have been called the Barratt or Counahan formula.

Ralph made contributions to the British Association of Paediatric Nephrology and the European Society for Paediatric Nephrology. He seemed set on an academic career in a teaching or university unit and in modern business terms was certainly ‘head hunted’. He however chose to return to his native Waterford where he became a very active and energetic member of a two man paediatric team serving most of the south east corner of Ireland. Ralph and his colleague served a region which is now staffed by nine paediatricians.

He was actively involved in the British Paediatric Surveillance Unit from its inception. Following his nomination as Irish representative to the Confederation of European Specialists in Paediatrics, he became its vice-president and was to take up presidency of the Confederation in 1996, the year of his sudden and unexpected death.

Ralph was a man of many parts, actively involved in the local sailing club, an enthusiastic golfer, keen tennis player, and able guitarist. He lived his half century to the full. Always energetic, affable, often argumentative, never less than direct, Ralph made a critical and constructive contribution to the activities in which he involved himself. Enthusiastic, occasionally enigmatic, and empathic, are words that can be used in relation to Ralph.