The Efficient Ophthalmologist
The Efficient Ophthalmologist
A Time to Remember Our Mentors
By Steven M. Silverstein, MD, FACS
In its ideal, the holiday season is most of all a time for reflection. Each of us can list the many experiences to which we may attribute our own success, but I would like to use the privilege of this column to take the opportunity to share with you those mentors to whom I am most grateful. We should always remember that ophthalmology is a specialty for which advances have come incrementally and over time. All of us owe a great debt of gratitude to those who have come before us.
In sharing my personal reflections, I hope it will in turn spur you to remember those who ignited and encouraged you to dream big and illuminated your path to success. Corny you say? Perhaps. But whether through their direct guidance or by emulating our specialty’s innovators and educators, we each have those to whom we owe great thanks.
My Early Mentors
During residency in the mid-1980s, I was exposed to many professors who served as both good and bad role models. I realized some of my most important glimpses of the physician I was to become were influenced as much by the harsh and negative professors as by the great and caring teachers we admired.
Among those whom I remember fondly is the late Dr. Moshe Lahav, a retina professor and ocular pathologist. Trained in Israel and the United States, Dr. Lahav was hard but fair. When residents or fellows earned his trust, he turned over great responsibility to them. This method of apprenticeship was both unorthodox and a bit risky, but Moshe was always available to instill confidence in our decisions, or to show us a better path.
Other notable role models in the retina department at Tufts were Dr. Lory Snady-McCoy and, head of pediatric ophthalmology, Dr. David Reese. Each taught with patience and expertise, attended us through difficult cases, including trauma, into the night, and yet always had a kind word for residents and fellows — true friends even years later — in an era during which the Socratic method of instruction was popular in Boston.
On to Fellowship
My fellowship at The Kellogg Eye Center, University of Michigan, was particularly special to me. Dr. Paul Lichter was chair and led the department with extraordinary vision and enthusiasm, recognizing that the future of the clinics and eye hospital were meant for greatness. It was a privilege for both the students and faculty to be part of the facility which delivered such high-caliber care to patients of every demographic.
Many faculty in the department were already recognized experts in their respective fields. One in particular, Dr. Greg Skuta, was destined for new leadership roles though he, in his modest way, would never have acknowledged so. At the time, Greg was recently out of fellowship and doing some of the first work with mitomycin C as an adjunct in the care of glaucoma surgical patients.
Gifted Cornea Mentors
However, it was my cornea faculty that perhaps inspired my young career the most. Even 21 years later, I think back on their lessons and wisdom often, hoping that the care my patients receive would make them proud.
Directed by the now-retired Dr. Roger Meyer, we ran a busy service, performing hundreds of grafts each year. Inpatients in our hospital were sporting every assortment of pathology: horrific ulcers, scleritis, uveitis and multi-ocular system failure demanding the attention of several specialties in an attempt to save or preserve vision. Dr. Meyer was the most gifted corneal surgeon I have ever witnessed, and in the early days of my fellowship, I used to tease him that he should sew his initials in each graft as they were such works of art. Even today I will ask myself if I am placing a suture bite as Roger would have recommended.
I also had the extreme privilege of working under Dr. Alan Sugar, unquestionably the brightest physician I know. Alan has a photographic memory in the truest sense, and can quote the internal medicine literature as well as he can the ophthalmic literature. His diagnostic skills were frankly remarkable, and though he could be hard at times, it was always in the best interest of patient care and our learning.
And finally there was Kaz Soong. Dr. Soong was relatively new to the cornea department but had already established himself as an extremely bright and talented clinician and surgeon. Kaz was most sophisticated with newer techniques and technologies, which complemented and balanced the gold standards of care Drs. Meyer and Sugar delivered brilliantly. A friend to the residents and fellows, Dr. Soong took us under his wing to help ensure that we left the program well trained and competent. Most of all, each of my professors taught me that even in the most difficult clinical or surgical moments, we have several ways to approach a given scenario. Sometimes the best approach may be either a combination of options, or something unconventional.
Learning From Peers
Learning does not end after fellowship. During the course of my career, I have worked with a number of superb ophthalmologists in the Kansas City community. I am very grateful to have partnered with Drs. John Hunkeler, Phil Hoopes, Bob Weir and Dan Durrie, each of whom, in addition to being terrific surgeons, have been visionaries in both the science and business of medicine.
From this group of colleagues I learned most of all that in business, the key is to surround ourselves with advisers (legal, consulting, IT, etc.) who are as expert in their respective fields as we are in ours. We cannot be at our best going it alone.
Lastly, without question, my father, Paul Silverstein, a brilliant plastic surgeon and burn specialist, continues to play an important role in my medical journey. Among many lessons, he taught me the three A’s of success in medicine: Affability, Availability and Ability.
Now in private practice for 21 years and serving as adjunct faculty to medical students and residents, I am cognizant of my responsibility to instill these values in those who learn from me. I have framed pictures of my three cornea faculty hanging on the wall of my clinic as a daily reminder of those I have to thank for my success. To quote Sir Isaac Newton, I am “standing on the shoulders of giants.”
I hope each of you pause to acknowledge those who have been your inspiration. It is important for each of us to periodically stop and look back with appreciation and gratitude. By doing so, we gain a deeper understanding of how far we have come. I wish each of you a most peaceful and happy New Year. OM
||Steven M. Silverstein, MD, FACS, is a cornea-trained comprehensive ophthalmologist in practice at Silverstein Eye Centers in Kansas City, Mo. He invites comments. His e-mail is firstname.lastname@example.org.
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