ADHD Comes to City Hall: Boston Mayoral Aide Shares His Struggle with ADHD
The chief of staff to Boston Mayor Marty Walsh thrives despite (and because of) his attention deficit.
One morning last August, Daniel Koh, chief of staff to Mayor Martin J. Walsh, drove to a speaking engagement at Excel High School in South Boston. He was uncharacteristically nervous. Koh was scheduled to address City Year corps members on their first day of working with at-risk students. But he had something else on his mind besides the mayor’s vision for education. Should he tell his own story?
At the last minute, he decided to do it. Speaking without notes, Koh, 30, told the audience of 350 about something he’d never revealed to anyone except his family and a few close friends: his struggle growing up with ADHD.
“I wanted the people at City Year to know that when they go into schools and see those kids in the back row who are struggling to pay attention, it doesn’t mean they don’t want to learn,” Koh said in an interview.
It may seem surprising that a few years ago, Koh — whom many regard as a City Hall wunderkind for his youth, academic achievements, and innovative approach to improving city services — was that struggling kid himself. As a student at the high-powered independent Pike School in Andover, he had boundless energy but trouble concentrating and staying focused. He was disorganized.
“Sitting at a desk for an hour was close to impossible,” Koh said. Reading — “just disciplining myself to sit down and do it” — was the hardest, he said. “What I do know is that the ADHD has caused me to learn practices and habits that I wouldn’t have learned otherwise, and I see it as a strength’
At home, if the TV was on or his mother was cooking, the noise was so distracting it derailed his homework. As he got older and homework got harder, Koh sensed he was on a “downward spiral.” One teacher suggested in a report card that “in essence, I was a lost cause,” Koh said. “It was crushing.”
To look at Koh’s meteoric professional trajectory, one would find those painful days hard to imagine. He has two degrees from Harvard. He was general manager of HuffPost Live, the Huffington Post streaming network, and an adviser to Mayor Thomas M. Menino when he was 26. Forbes Magazine named him one of its “30 under 30.”
He recently spearheaded the CityScore initiative at City Hall, a method of using data analysis to make city services more efficient, which he unveiled in October at a TEDxCambridge technology event.cele
But there were many times when he wondered if he’d ever succeed. He grew up in a family of high achievers. His father, Dr. Howard Koh, is former assistant secretary for health for the US Department of Public Health and former commissioner of public health for Massachusetts. His mother, Dr. Claudia Arrigg, is an ophthalmologist.
“I grew up with a certain standard of sitting at your desk and studying, and achieving as much as you can achieve,” said Koh, who is tall and lanky, has run 21 marathons, and has a bone-crushing handshake.
When he was 14, his mother read an article in a medical journal that described a disorder called ADD (Attention Deficit Disorder, now known as ADHD), with symptoms that matched her son’s. According to the National Institute of Mental Health, ADHD affects 9 percent of American children ages 13 to 18, and is characterized by inattention, hyperactivity, and impulsive behavior. It is four times more common in boys.
She asked him if he wanted to be tested. He agreed, reluctantly, scared of being seen as one of those stigmatized kids he knew in school who were dismissed as “hyperactive.” A battery of tests confirmed he had ADHD. “Quite honestly, we all shed some tears,” his father said in an interview. “But we told him…this should not hold him back.”
His doctor prescribed medication. He took Adderall at first, switching to Concerta about three years later. The medication helped him focus, but he also learned to accept his challenges. “I am physically behind the eight ball,” he said, “so I have to work extra hard to work as efficiently as possible.”
His mother kept the house quiet while he did his homework. His father sat with him when he read. “My parents refused to accept that I was not destined to do good things in life,” he said.
But someone else believed in him too, the teacher Koh calls “Mr. Hutch” – his seventh-grade adviser, Bob Hutchings. “He would sit with me and make sure my work was organized. He gave me hope that I was a smart guy.” Hutchings, who still teaches at the Pike School, says he suspected that Koh might have had an attention deficit disorder. He also saw him as “lovable” and impressive.
“He had this huge personality, and in fact I called him ‘the Mayor’ in seventh grade,” Hutchings said. “The fact that he is now the mayor’s chief of staff is just a hoot to me.”
Koh became adept at finding ways to manage the disorder, writing tasks down before they’d slip his mind and completing them promptly. In the work world, Koh has always pursued high-intensity jobs that require multitasking and quick decision-making, and lives with a certain quirky intensity. Last April, he completed the Boston Marathon — in 3:38 — and proposed to his girlfriend, Amy Sennett, at the finish line, videotaping it all with a GoPro camera he wore on his head.
“Being chief of staff is really ideal for that kind of thing,” he said. “You can’t get hung up on one issue too long and let it dominate your day.”
Koh said he informed Walsh that he had ADHD before speaking about it publicly. Walsh, who said he hired Koh based on his “incredible work ethic,” personality, and accomplishments, acknowledged he was surprised. He encouraged Koh to tell his story.
“I thought it was incredible and courageous,” Walsh said in an interview. “People in a similar situation will read about it and not be afraid to address it.”
Koh is no longer on medication; he stopped taking it when he was 26, after discussing it with his physician parents. “I’m not qualified to say I no longer have ADHD,” said Koh. “But what I do know is that the ADHD has caused me to learn practices and habits that I wouldn’t have learned otherwise, and I see it as a strength.”
Whether people grow out of ADHD in adulthood “is hard to fully say,” said Dr. Mark Wolraich, former chair of the American Academy of Pediatrics subcommittee on ADHD.
“There are a lot who go off medication, some of whom would likely still benefit from it. But there are certainly people who reach a point where they can function well without medication.”
Koh hopes his story will give reassurance to other young people. “It’s not something to be ashamed of,” said Koh. “You can do anything other kids can do.”