The moving story of an Irish immigrant’s life, from a poverty-stricken childhood in Ireland to becoming a captain of industry, After the Roof Caved In is a powerful, poignant look at how hard work and education enabled one young man to change his life and circumstances completely.

Today, Michael J. Dowling is president and CEO of Northwell Health, New York state’s largest healthcare provider and private employer, with over 68,000 employees and over 700 facilities. But he grew up in deep poverty in the village of Knockaderry in rural Ireland, in a small home without running water or a stable roof, in a family with little hope for improvement and a place with little opportunity—and he overcame it all to become wildly successful.

After the Roof Caved In is Dowling’s rags-to-riches story of his life and journey from his destitute youth to his realization of the power of education and his eventual departure from his home to attend university in Cork, and onward through his life as he gradually improved himself and his circumstances. Full of memories both fond and painful, this powerful memoir examines the family dynamics of his childhood—including the lives of his deaf mother and arthritic father—as well as the social systems of the time, the politics and concerns of the day, and the way a variety of disparate events came together to help Dowling change his life completely. Most importantly, it chronicles his lifelong effort to rise above the circumstances into which he was born and to create the sort of life he dreamed possible.

For anyone interested in the stories of immigrants, the experiences of the Irish in the mid-20th century, or the value of hard work and education in changing one’s life, After the Roof Caved In is an essential read, and a heartfelt, deeply moving meditation on an extraordinary life.