Ophthalmology off the Grid
Episode 68

Giving Thanks

In this special Thanksgiving episode of Off the Grid, host Blake Williamson, MD, MPH, and several of his colleagues take a moment to share why they feel thankful to be in ophthalmology and which mentors they are most grateful to have in their lives.

Blake Williamson, MD: On today’s episode of Ophthalmology off the Grid, we’re taking some time to reflect on our careers as ophthalmologists and discuss what, and who, we’re most thankful for this holiday.

I hope you’ll enjoy listening as I discuss with several of my colleagues what aspects of being an ophthalmologist make them feel most grateful to be a part of this profession. In addition, each of them will discuss the mentors that they are most thankful to have in their lives.

Speaker 1: Ophthalmology off the Grid is an independent podcast produced by Bryn Mawr Communications and supported by advertising from Alcon. For a full listing of podcasts for eye care professionals, go to eyetube.net/podcasts.

Blake: Welcome everyone. So, I’m really excited about this special Thanksgiving episode of Ophthalmology off the Grid. When the Ophthalmology off the Grid team approached me with this idea that they had to do a Thanksgiving episode, I thought it was great. In thinking about who to interview, it kind of occurred to me that there’s a select group of people that I just spent some time with over at the American Academy of Ophthalmology, and I thought it would be really unique to speak with them because we kind of represent ophthalmologists at different stages of their career. We were at a special dinner, and I noticed that there were sort of three different stages of people in terms of what part of their career, whether they’re in the prime of their career, or whether they’re just in the first few years like I am, or whether they’ve been practicing for quite a long time. So, I thought that I would invite a few of them on today to talk to us about, not only what they are thankful for, to be ophthalmologists, but also, just about mentorship and people that affected them and have been mentors to them as they’ve gone on in ophthalmology.

I thought I would go first talking about what I’m most thankful for. I think that all of us in ophthalmology understand how blessed we are to be in this specialty. It's often said that our worst day in ophthalmology is better than many other specialties’ best day. I think that all of us listening to this podcast truly believe that. You can go on and on about what you’re thankful for, but if I had to narrow it down, I think there are three things that I’m most thankful for to be a practicing ophthalmologist today, and that is the responsibility that’s on me to take care of somebody’s most precious sense, which is their sight, the ability to transform a life, and the chance to be around happy people every day.

So, first, the responsibility of taking care of someone’s most precious sense, I think that most people, they value their sight more than anything else, and when they’re having eye surgery, their biggest fear is going blind. For me, I thrive on knowing that this is my responsibility to take care of this patient, and I think it’s that responsibility that sort of pushes me and motivates me to do everything I can to make sure that I give them the best outcome possible. That’s a huge reason why I got to all these meetings, and I try to connect with other colleagues, and I’m constantly learning and trying to adopt new technology and understand what’s new and what’s the latest and greatest, because I know that it is ultimately our responsibility to take care of these people and their vision. So, I actually like that, and I think that we’re very lucky to have patients trust us with that ultimate responsibility.

The second thing is the ability to transform a life. So, just going into medicine in general, if you’re a physician, you’re already restoring someone’s health. You’re taking them from sickness to health. But, when you practice ophthalmology, specifically the area I’m in, which is refractive and refractive cataract surgery, what you are doing is not just restorative, but it is actually transformative, in that you’re making someone better than they ever have been. For me, when I was training, I had intellectual curiosity, so it was fun being on the internal medicine rotation and things like that, but a lot of those times I felt like I was just prescribing medication and just taking labs and seeing what happened. But, that’s not the case with ophthalmology, and specifically with cataract surgery, you really are going into that patient’s eye and performing a service for them that is going to have a tremendous impact on their life, and not only that, but it’s going to have an impact the next day, and that was just so attractive to me, and it’s something that I still enjoy every single day. Post-op day one is still one of my favorite times to be practicing in my clinic.

And then lastly, it gives us the chance to be around happy people. We have the greatest specialty, and everyone is just so fun to be around. I always tell residents, specifically medical students who are considering what specialty to go into, just try to find the happiest people and gravitate toward them and emulate them and try to figure out what makes them tick. If you do that, more often than not, you’re going to find that ophthalmologists are probably some of the happiest people at whatever institution you’re training at. I think we’re very lucky to have that. We have just such exceptional people. I also love that you have these amazing ophthalmologists who are way more experienced than me that routinely take time out of their schedule to help me, and who have always been there from the get-go. Very thoughtful people.

One story that comes to mind, and I always try to tell him this story just to remind him that I’ll never forget it, I remember one time being at an eye meeting in Mexico, the Caribbean Eye meeting, and I was going to an ad board, it was one of my first ones, and I was getting a taxi, and Dr. John Doane walked out, and he didn’t have a ride, so I said “Yeah, ok, come with me,” and we get out to the ad board, and he goes to reach into his wallet to pay for the taxi cab, and lo and behold, he didn’t have any cash on him. I said, “Oh, no problem, I’ve got it,” and he said, “Ok, well I’ll get you back,” and I said, “Oh no, it’s my pleasure.” To me it was just great to be able to be in a taxicab with John Doane and pick his brain for 10 minutes on the way to the restaurant for this ad board, and I didn’t think anything of it. Well, lo and behold, about a week later, I get an envelope in the mail, and it is a personal note from Dr. Doane, to me, saying “Hey Blake, thanks so much, really enjoyed meeting you. Good luck in your career,” and there was a ten-dollar bill in there. That just blew my mind, the fact that someone who’s that busy and has that much going on would just take the time out of his day just to write me a personal note and send that to me, I had to sit down. It was a moment for me when I realized, we’re in the greatest specialty in the world. That goes back to being around awesome people, the happiest people, and I think that’s what I’m most thankful for in ophthalmology.

So, that’s a good segue into the idea of mentorship and why that’s important. I really look forward to hearing from each of our guests on today’s podcast, because I think it’s so important. I believe that the generational flow of knowledge is one of the most unique things about medicine, more than any other discipline or professional trade. And specifically, it’s so common with ophthalmology. I’ve always been taught that, if you want to know the best way to walk through a minefield, it’s to follow somebody. That’s what mentorship is all about. Being behind someone who’s been there and done that. I think that’s so unique and so important. Frankly, I have so many mentors, and I’m sure everyone on this podcast does as well. I’m just trying to think of a few off the top of my head that I’ve learned something from, and I guess the best way to think about it is, right after I got done with training, I went on a small surgery tour where I went and visited different surgeons’ practices. Two of those surgeons were in Texas, that’s Steven Dell and Jeff Whitsett, and I obviously keep up with both of them today. They’re both big mentors of mine. I think from Dr. Dell, I just learned how to think differently. When I visited him, this was 5 or 6 years ago, he was already mixing and matching IOLs and placing accommodating IOLs with multifocal IOLs, depending on the patients’ needs, and that’s something that’s obviously come in vogue recently in the last year or two, but he was doing that years before. So, from him, I just learned that you always need to think differently. Also, the psychology of the patient — I learned a lot from him, sort of how to break down what kinds of patients are going to be good candidates psychologically for certain types of vision correction procedures, and just the art of the consult, and the way he carries himself in the cataract consult is something I’ll never forget. He’s someone I will always look up to, so I appreciate him for that.

With Dr. Whitsett, he’s in Houston, Texas, just the ability to relate to the patients. I just really liked his bedside manner. It’s something that I’ve tried to emulate when I’m talking to my patients. And also, just how to make good use of your time. I learned from him that you can’t be the best at everything. If you want to be a high-volume refractive cataract surgeon, you’re probably not going to be the world’s best DSAEK surgeon or blepharoplasty surgeon or pterygium surgeon, maybe you can be, but in general, it’s usually good to find out what you’re really good at and do a lot of that one thing. From the get-go, I really focused in on just a few procedures in my practice, and I learned that from him.

Once I started practicing and getting out, my first year or two, in private practice, I started going to a lot of meetings, and I started gravitating toward several people who are always at these meetings and are always kind with their time. Just a few of them, Dr. Bill Wiley in Ohio, I think from him I’ve learned, just the energy that he has is incredible, the energy for learning, the energy for ophthalmology, and always being up to going to the next meeting or adopting the next technology — just his thirst for new technology is something that I’ve always looked up to and admired from him.

Dr. Gary Wörtz as well, my esteemed cohost from Ophthalmology off the Grid, really just from him, how to be a good person, how to be a great family man, and how to involve the next generation. I feel like every meeting I go to, especially if there are young people there, you always see Gary holding court and giving young people opportunities. One of the first opportunities I ever got in consulting was through Gary, and I’ll never forget that.

And then lastly, Dr. Rob Weinstock. From Rob, I’ve felt like I’ve learned so much, but definitely how to run and organization, he’s got a very large practice, similar to how ours is here in Louisiana. How to perform really quality surgery at a high volume is something very unique that he does, and many of the guys on this list do, but I’ve had an opportunity to spend time with Dr. Weinstock and learned a lot in that regard. And lastly, how to have a good time. There’s a lot to life other than ophthalmology. Family and friends are so important.

The very last person I should probably talk about is my dad, obviously. I think that, not a day goes by that I don’t feel like the luckiest guy in the world to be in a practice like I am with my family. I’ve learned so much from him. I think that, on the business and medicine side, he taught me to never let anybody else do your thinking for you. It’s important to make your own plans or else you’ll be a part of someone else’s. In the operating room, he taught me to always be prepared for war. Cataract surgery can seem easy at times, once you do a lot of it, but it can be devious, and it can always be that next case when you find yourself in the fight of your life. So, he taught me to plan accordingly and that it’s always better to be a warrior in a garden than a garden in a war. I think one of my dad’s greatest qualities is his kindness and how he treats his employees. It’s why a lot of people who work with us have been there for over 30 years. So, this is something that I always try to emulate whenever I am taking the time with my staff, with my team, and my clinic. The ability to know how to treat people and how to really care for your team around you is something I’ll always be thankful for.

We have a very select group of guests from all over the country that I’m very proud to have. Dr. Julie Schallhorn and Dr. Malik Kahook, as well as Dr. Doug Koch, Dr. Nicole Fram, and Dr. Arsham Sheybani.

I’m very much looking forward to speaking to all of them throughout this episode of Ophthalmology off the Grid.

First up, we hear from Dr. Julie Schallhorn.

Julie Schallhorn, MD: As an ophthalmologist, there is really so much we have to be thankful for, I think. Modern medicine is amazing. We really have the ability to change patients’ lives. I'm thankful for something that is probably the most basic and the most straightforward thing that we do on a daily basis, or at least most ophthalmologists do. I'm thankful for the ability to do cataract surgery.

It's such a simple, easy, safe surgery that we do nowadays that has such an amazing and profound impact on people's lives. Taking patients that are literally blind, LP one day to 20/20 the next day, and watching them as they see their families faces, as they see things that they hadn't seen in Lord knows how many years, it is such an amazing and transformative experience.

It's easy to become immune to it, because you see patients, you sign them up, you put them on the schedule, and you just burn through phacos in the OR day, and the next day during post-ops, you've got all these post-ops and you can just burn through them. But, sitting with patients, hearing their experiences when they see the blue in the sky for the first time and how they didn't realize how it would be looking foggy and dim and yellow. They see the flowers in their garden. They see their cookbooks as they're cooking. There are just so many really transformative events in people's lives that it's just so easy to take for granted.

When I got the email for this topic, trying to really think about what I was thankful for, there was just no other answer for me. It's just such a wonderful surgery. It's so elegant. It's fun to do, and it really has an amazing effect for people.

The other thing that I'm thankful for this Thanksgiving Day season is really the mentorship that I've had in ophthalmology and in my career and in life decisions.

Probably the biggest mentor that I've had is my father, Steve Schallhorn. He has just had a huge influence on, really, my whole life, because he's my dad of course, but really on my career and my growth and my development as an ophthalmologist, really teaching me to be a really caring physician, to really think deeply about problems, about solutions to problems, about the what and the why behind things, and I am just immensely thankful for that.

The other mentor that I've had in ophthalmology that has been really, really powerful and has really helped shape my view of the field is Dan Schwartz, who is a retina specialist here at UCSF where I practice. He's just been an amazing mentor, just thoughtful, again, innovative, really trying to ask the hard questions, the whys, and to really look for insightful and innovative solutions. So, the two of them have just really made me who I am today.

There are so many great people out there. I really feel lucky to be in a field where virtually everyone that I work with, everybody that I see at meetings, everywhere I go, it's just that I like and I respect (them) and that I know that they are doing the right things for their patients. It's a really wonderful, warm, nice fuzzy feeling. That is what I am thankful for this Thanksgiving Day.

Blake: Now, over to Dr. Malik Kahook from the University of Colorado.

Malik Kahook, MD: The first question is, “what am I thankful for when it comes to my practice in ophthalmology?” I think it all comes down to one word, and that word is support. I'm extremely thankful for all of the support that I've been given by colleagues in the clinic and in the operating room, as well as all of the support that I've been given to translate some of our ideas from the bench to the bedside to reach as many patients as possible. I'm extremely lucky to be in this environment and certainly thankful for all that has been provided to me.

The second question is about mentorship, who my mentor is, and maybe an example of mentorship in action. My mentor over the last 15 years or so has been Joel Schuman, who I did my fellowship with at UPMC in 2005. Joel is really the consummate mentor. He has all of the skills that I'm learning over time are required to mentor young physicians. In particular, he's taught me several aspects of professionalism, including integrity and really performing research without cutting corners.

He's also known for being very giving with his time, and I've experienced this firsthand. I've never had an instance where I reached out to Joel for advice where he hasn't picked up the phone right away to get back to me. One story in particular that I recently told at a meeting that both Joel and I attended was something that happened over a decade ago at my first Hawaiian Eye meeting.

I remember being nervous. It was one of my first bigger talks on a national scale, and I was at the meeting alone. Joel took his time out of a very busy meeting, which he was running, to take me out to dinner and have a talk about various parts of my career, as well as my talk and what I was going to try and convey to the audience the next morning.

I'll never forget that, because I know how busy he was, and the fact that he took time to spend a whole dinner, a whole evening, just going over things and mentoring me meant a lot, and I carry that with me, and I try and do the same for those that I am training and mentoring today. I consider myself very lucky to have Joel Schuman as my mentor.

Blake: Next, we hear from Dr. Doug Koch.

Doug Koch, MD: I have so many things to be grateful for as an ophthalmologist. Above all, it is the ability to improve my patient's vision, and therefore their lives, and to get to know them as people and to learn so much from them. Patients teach us so much about themselves and about ourselves. For this, I am truly grateful.

I have had many fabulous mentors during my career, but I want to single out Dr. Dan B. Jones. Danny was my mentor throughout my career, and he taught me so many things. Let me list a few. First, the importance of attention to detail in all aspects of patient care, examination, the history, and truly understanding your patient. He also demonstrated absolutely meticulous and thoughtful surgical skills that were really a model, I think, for how one should act as a surgeon in the operating room.

I also learned from him a wonderful joy in caring for patients. It didn't matter who the patient was or where they were from, Danny would get to know them and grow very fond of them and demonstrate this fondness. It was truly a gift to watch him in this setting. He was a perfectionist, and he showed me how important it was to accept nothing but excellence in every aspect of work, whether it be patient care, research, education — and he loved to teach.

He loved to teach residents, medical students, fellows. Maybe this was the best gift of all because as I look back on my career, I think that teaching has been the most gratifying aspect. Danny was a caring, considerate, brilliant man who was the best mentor a person could have. I am so grateful for what he did for me throughout my career.

Blake: Up next is Dr. Nicole Fram.

Nicole Fram, MD: I'm most thankful for the privilege to care for patients and restore sight, even in the most complex circumstances. When a patient says thank you to me, my response is, "Thank you for the privilege to be in the position to help you see."

My most influential mentor is Sam Masket. Every day I'm in the operating room, I encounter a complex situation, and I'm thankful that he taught me to think on my feet and perform the safest procedure. I hear his voice guiding me through the toughest cases. Some very important lessons he's taught me is that what's good for the patient is good for the doctor, that great technology always wins, and that you're only as good as your next case. This humility allows me to succeed and constantly improve as an ophthalmologist, a surgeon, and as a person.

Blake: And last but not least, the one and only Dr. Arsham Sheybani.

Arsham Sheybani, MD: This is a pretty important question and I think a lot of us as physicians don't take the time to think about. When I think about what I'm most thankful for, at least in practice, I'd have to say having the ability to teach fellows and residents. They really keep you grounded. They keep you motivated. This is why I do academics.

I think it's our best way to be able to impact patients, beyond just who's in front of our chair. When you think about it, the effect is multiplicative, and I love that about my job. I also love when fellows and residents leave and send messages back about how they've managed something complicated or just made a difference in their own patients' care. I could never imagine another world in which I do what I do without having that to be thankful for.

I think a lot of this really stems from my mentor, and just being able to do fellowship with Ike Ahmed. I can tell you that no one has taught me more clinically than he has. I think a lot of people would look at him and say, "Oh, it's going to be a purely surgical thing," but really, it all begins in clinic and how you manage patients and how you set expectations and how you case select what you're going to do, and a lot of it is calculated risk, and that's something that he taught me.

But beyond anything else, what he has done is, he's just shown me how selfless someone can be and has been so overly supportive of my career, despite the fact that I'm not in his practice, I don't work there, but there has never been anyone who has had my back more than he has and continues to have my back more than he has, and for that I am eternally grateful. I think he's the reason why I've been able to have the career that I have so far. So, there is a lot to be thankful for. I love where I work, I love the people I teach, and I think it's all possible because of the mentor that I had.

Blake: From our ability to improve the lives of our patients, to the mentors who helped shape us into the physicians we are today, it’s obvious that there are countless reasons to be thankful.

Thanks to my fellow ophthalmologists for taking the time to share what they are personally grateful for, and thanks to all of you for tuning in today.

With that, this has been our special episode of Ophthalmology off the Grid, Thanksgiving edition. Happy Thanksgiving to all. Until next time, this is Dr. Blake Williamson for Ophthalmology off the Grid.

Speaker 1: Ophthalmology off the Grid is an independent podcast produced by Bryn Mawr Communications and supported by advertising from Alcon. For a full listing of podcasts for eye care professionals, go to eyetube.net/podcasts.

11/26/2019 | 26:44

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