The Newsletter of the Senior Ophthalmologist Summer 2018 | Volume 22 | Issue 3 SCOPE
Leonard Christensen: A “Greatest Generation” Ophthalmologist Gerald R. Christensen, MD
he journalist, Tom Brokaw took on the entire rep- dubbed the generation that ertoire of surgical eye Tgrew up in the Great Depres- procedures. Thus, he sion and then went on to fight in was one of the last World War II the “Greatest Genera- of the high-volume tion.” The ophthalmologist and eye surgical ophthal- pathologist Leonard Christensen is a mologists who “did splendid example of that generation. everything.” Well, not quite everything. He was born August 16, 1913, in Since he often declared Cloquet, Minnesota, the youngest that his expertise in of three children of working-class pediatric ophthalmology Norwegian immigrant parents. only included patients over He graduated from the Univer- age 65, he referred pediatric sity of Oregon Medical School in motility patients to his associ- 1941 and after a one-year intern- ate and department chairman, ship at Ancker Hospital in St. Kenneth Swan MD. Being based Paul, MN, he served in the South at the university, he was restricted Graduation Portrait of Leonard Pacific as a Navy flight surgeon to seeing only patients referred Christensen, MD, MS, from the until the end of World War II. to his care by other physicians. University of Oregon Medical School, class of 1941. He served He completed his ophthalmology Nevertheless, Dr. Christensen as a resident, and faculty mem- training at the University of Oregon had an extremely full practice that ber from 1951 to 1978 and helped Medical School and received a Heed included retinal, corneal and cata- create the pathology lab and eye Fellowship for a one-year study of ract surgery as well as all aspects bank for the Casey Eye Institute in Ocular Pathology with Georgiana of glaucoma. At the same time, he Portland, OR. Dvorak-Theobald, MD, in Chicago was the working ocular patholo- and Algernon Reese, MD, in New gist, as well as director of the Eye York. He returned to Oregon and Pathology Laboratory. He was one He was a busy man who always joined the faculty at the University of a generation of eye pathologists had time to get something else of Oregon Medical School where who were essentially the founders done. He established the first eye he worked until his retirement in of this subspecialty in the United bank in Oregon, served on and 1978. From 1978 until 1989 he was States. It was a time when train- was chair of the American Board in private practice in Portland, OR. ing in the discipline was difficult of Ophthalmology, and pub- to come by and took initiative lished dozens of research articles, Dr. Christensen began his and sacrifice to obtain. He was an book chapters and symposia. career in clinical ophthalmology early member of the Eye Pathol- before the days of widespread sub- ogy Club, which evolved into The He was a shy, almost reclusive specialization, when the specialist Verhoeff-Zimmerman Society. man and yet (Continued on page 2) OPHTHALMIC HISTORY
Leonard Christensen With chemical burns, it is neces- enlarged lens and/or wound leak, (Continued from page 1) sary to remove all damaged tissue the prevailing wisdom at the time. while planning a lamellar graft was very approachable. He had a repair. Many chemical burns will During his early career, it was relaxed and easy demeanor that involve the limbus and adjacent not uncommon for some practi- brought him an abundance of sclera. In such cases those areas tioners, including a few ophthal- friends and acquaintances. To need to be removed as well. In mologists, to prescribe long acting them he was just plain “Chris,” to his American Ophthalmologi- topical anesthetic ointments for many in his family he was “Len” cal Society thesis, “The Nature of corneal abrasions and other sur- and for me he was “Uncle Len.” the Cytoid Body,” he presented a face problems. Topical anesthetics He was introspective and deeply significant advancement in under- are not appropriate for chronic analytical in his thinking and had standing the pathological changes use for several reasons including great confidence in the ability to involved by carrying out an elegant corneal drying, loss of the blink solve difficult clinical problems histochemical study of the subject. stimulus and its action to stop through a combination of basic mitosis of the corneal epithelium. science and common sense. Ironically the earliest of his He reported these severe com- scientific firsts nearly became his plications and even advocated This approach to solving prob- last. It occurred on one of the abolishing their production. lems is well demonstrated when Admiralty Islands in the South one reviews his list of publications. Pacific Ocean where he was sta- A rare but devastating complica- He had several “firsts” to his credit: tioned with his Navy medical unit tion from cataract surgery is epi- first histologic demonstration of during World War II. There was a thelial ingrowth, usually through cytomegalovirus in a human eye; problem of severe and sometimes a corneal-scleral surgical wound. first person in Oregon to perform fatal intestinal illness, which was One study showed about 1% inci- a penetrating keratoplasty; first narrowed to a drinking water dence when no limbus-based con- report of a drug that when given source. But which one? The only junctival flap was used. By using systemically reduced elevated option to find out was to test the a limbal-based conjunctival flap intraocular pressure without exert- water sources on the person- this complication didn’t appear ing a mechanical effect on the eye. nel themselves. Dr. Christensen in a series of 3,000 cataract cases This drug, Dibenamine, was first volunteered, and the problem studied. He also described numer- reported in the pharmacology was eventually solved but he was ous surgical innovations, many literature in 1947 and considered hospitalized for months, severely of which are still in use today. the prototype of a particular class emaciated and dehydrated. of adrenergic blocking agents. Even at the end of his profession- During his hospitalization, Dr. al career, he was looking forward In 1949, Drs. Christensen and Christensen received a visit from to and excited by new develop- Swan completed and published a Robert Hill, MD, who was passing ments and innovations in oph- study of this drug’s effect in low- through the island. Dr. Hill, who thalmology. His enthusiasm was ering intraocular pressure when had been a college and medical infectious to those around him. I given systemically. These findings school classmate of Dr. Chris- was privileged to live in his home prompted other investigators and tensen, did not recognize him ini- during my medical school years, eventually led to the discovery tially and was shocked to learn that a time during which he was wid- and use of carbonic anhydrase his former colleague’s weight had owed with three small children. inhibitors, which are widely used dropped to less than 100 pounds. Our numerous talks developed my in glaucoma treatment today. Dr. On leave to the United States, own interest in ophthalmology. Christensen submitted this work as subsequently, Dr. Hill stopped in Most ophthalmology topics usually a thesis and was awarded a Master Corvallis, OR, to visit with Dr. centered around procedures and of Science degree in pharmacology. Christensen’s brother Bert. Dr. recently published scientific data. Hill informed Bert that that he He was one of the first surgeons didn’t think Chris would survive. When his daughter Laurie was in to show that eccentric corneal medical school and it was 20 years lesions not amenable to trephine Dr. Christensen was also an later, his focus was on care and isolation could be excised and the iconoclast and frequently skepti- empathy, especially for patients who defect successfully repaired by cal of the ophthalmic dogma of his were going blind. He felt that care freehand keratoplasty. The proce- day. He demonstrated that narrow was more important than diagnosis dure is useful in corneal melting angle glaucoma and flat anterior and treatment in these cases, but disorders, deep corneal ulcers and chambers required a component of diagnosis and treatment were still is especially helpful with acid and positive posterior vitreous pressure important and necessary. Also, he 2 alkali burns that affect the limbus. and was not caused simply by an reminded her to (Continued on page 3) OPHTHALMIC HISTORY
Leonard Christensen which he felt would be stable and alone but out of panic and fear he (Continued from page 2) conservative. His investment habit picked up a large box of pencils began in 1938 during medical and asked the Dean where they retain a caring attitude with patients school. The stable and conservative would get the money to pay for experiencing complications. self-restrictions followed this first all this merchandise. Eventually it endeavor. He and fellow classmate was decided they could stay tem- He never talked much about the Robert Rinehart decided to open porarily. When I was a student war, but he told Laurie that his a for-profit bookstore at the medi- (‘57-61), the student bookstore near fatal illness made him realize cal school (image on next page) was still going strong and was how frightening these situations as the students believed that the privately owned by a couple of my can be and why kindness, care downtown stores were too expen- classmates who were required to and empathy are so important. He sive. It started in a large closet in sell their interest upon gradua- was the perfect role model of the the Basic Science building and tion. The store is still in business; dignified, compassionate physi- was only open for limited hours. I am not sure of the ownership. cian with excellent clinical skills and a strong science background. It wasn’t long before the admin- You might ask what Dr. Chris- His keen intellect and dry wit istration responded to complaints tensen did in his spare time and revealed a particularly insightful from the downtown booksellers. what were his hobbies? Most Satur- view of the world. This alone was When the partners were ordered day afternoons he played golf. He an invaluable experience, which to close the store, they began to had a low handicap, and one year has served me well. He had an avid operate only in the evenings and he was the champion at his coun- interest in current events, especial- required a secret code knock- try club. He was also a football fan ly political and economic issues. ing sequence to gain admittance. both as a spectator watching TV However, it wasn’t long before football on Sunday, and occasion- He always looked for investment the “secret knock” turned out ally playing touch football in the opportunities, preferring those to be the dean. Chris was there back yard with his (Continued on page 4)
Multnomah County Hospital house staff, 1946-1947. Dr. Christensen is fifth from the left in the top row.
3 OPHTHALMIC HISTORY
Leonard Christensen birth mother, Virginia, had died (Continued from page 3) after a long and debilitating ill- Historical Excerpts ness when Laurie was only 4. In and Quotations boys, the neighborhood kids, and addition to her stepmother duties, me. Since he and I were the only Kaye was part of the volunteer Corner adults, we were always on opposite administrative staff whenever Ophthalmic History Editors: Daniel sides. My position was usually a the American Board of Ophthal- Albert, MD and Donald Blanchard, MD roving one but his was quarterback mology oral exams were held. and he passed almost all the time. I will say he had an advanced skill Dr. Christensen encouraged ur history editors compile set for backyard touch football, his children to follow their own quotes and wisdom from which usually beat my team. dreams and they did. His son Omedicine’s long history. Mark is a novelist; his other son Send your favorite timeless pearls on Other interests he enjoyed were Scott is a musician and com- ophthalmology to [email protected]. reading, moose hunting once a poser; and his daughter, Laurie, year with his brother Harold, and chose to be a pediatric ophthal- raising Norwegian Elkhounds. mologist. Had they elected to As a result, we all got to enjoy practice together, the office “The art of medicine consists moose meat several times dur- could have included motility in amusing the patient while ing the following winter as well patients under the age of 65. nature cures the disease.” as having bones for the dogs. Leonard Christensen, MD, died — Attributed to Voltaire (1694-1778) He expanded his non-medical peacefully in his home Nov. 2, interests in 1961, when he mar- 1999, from cancer and complica- ried Kathleen “Kaye” Mahoney, tions of Parkinson Disease. who among other things had a “Why has not Man a wonderful positive influence as a Ophthalmic History Editors: Dan- microscopic eye? stepmother for the children. This iel M. Albert, MD, MS and Donald L. was important for all the kids but Blanchard, MD For this plain reason, especially daughter Laurie, whose Man is not a Fly.
Say, what the use, were finer Opticks given
T’ inspect a Mite, not comprehend the Heav’n?”
— Alexander Pope (Patient of Chevalier John Taylor) “An Essay on Man,” Epistle I
“The intention is to stare into space to ease tired eyes but seeing more disturbs the tranquil spirit.”
Leonard Christensen, MD, (left) and Robert Rinehart, MD, as medical stu- — A zen-like quotation from an dents, working behind the counter in the student bookstore, spring 1941. 11th-century Buddhist monk. Note: Wilson tennis ball also for sale. Submitted by Jurn Sun Leung PhD.
Correction: In the online version of the 2018 issue of Scope, the article “Retina Pioneer, Paul Anton Cibis, MD: A Personal History” was originally published with incorrect author information. The information was corrected on June 25, 2018. Gerhard W. Cibis, MD and Andrea Cibis-Tongue, MD are the sole authors of the article. Daniel M. Albert, MD, MS and Donald Blanchard, MD are co-editors of the history section of Scope, but are not authors of the article. 4 rewarding avocations in their mind he has by combining the sci- retirement, and it occurred to us at ence of cataract surgery with inter- From the Scope that we might share some of national espionage. An “inter- those activities with our readers in nationally acclaimed eye surgeon” Editor’s a new, ongoing column titled is called upon by the State Depart- Desk “What We Are Doing Today.” ment to create and assist in the implantation of an “information- The nidus for this idea came gathering” IOL in the eye of a Rus- when I received a correspondence sian ambassador, which brings the from one of our colleagues, Robert ophthalmologist into unexpected E. Kellan, MD. His history is like so and frightening contact with the many distinguished members of CIA and Russia’s Federal Security our profession. He Service. It is a clever graduated magna plot and a good read. cum laude from More recently, he has Boston College, published another obtained his medi- novel, titled C.A.G.E., What We Are cal degree at Tufts and both books are Doing Today Medical School and available on Amazon. completed his resi- M. Bruce Shields, MD dency at New York This is just one Eye and Ear Infir- example of what our downside of retirement is mary. After more colleagues are doing losing track of many of our than 40 years as a today, and we hope to A colleagues with whom we fellow of the Ameri- share more such sto- established friendships throughout can Academy of ries in the coming our careers. One of the things I Ophthalmology, issues of Scope. To be looked forward to when going to during which time successful, however, medical meetings was being with he enjoyed a busy we need the help of those friends and hearing what new practice and our readers. If you and exciting activities they were designed several surgical instru- have an interesting hobby or second enjoying. In retirement, we keep up ments and intraocular lenses, career, or know of a colleague who with some friends, but eventually including the Tetraflex IOL, Dr. does, we hope you will share that lose track of others, and that is a Kellan moved on to the next chap- with us by contacting our assistant sad loss. I often wonder what they ter of his life by becoming a writer, editor, Neeshah Azam, at scope@ are doing today in the new chapter with several plays and novellas to aao.org. of their lives. his credit. We very much hope to hear from We know that many of our One of his recent novellas, titled you and begin learning more about friends have found interesting and Implant, shows what a creative what we are doing today.
Growth of the Independent the comparison of sites among Organization, Pt. 2 Washington, DC; Chicago; and San Francisco, Dr. Spivey’s home. Susan H. Day, MD They wanted Spivey! The Spivey years have been described as the n our last issue, we published gy and otolaryngology. We now era of growth. Growth springing “The Great Split: Our Oral His- pick up on his description of the out of a much broader role the Itory, Pt. 1” from Mr. David American Academy of Ophthal- organization could fulfill by maxi- Noonan’s Academy history, he mology’s infancy under the leader- mizing members’ interests beyond recalled his first days with the ship of Bruce E. Spivey, MD. clinical education. combined American Academy of Ophthalmology and Otolaryngolo- Moving the American Academy No sooner had the ink dried on gy, the singlehanded focus on edu- of Ophthalmology to San Francis- the divorce papers than the mem- cation, the governance and co was approved by the new Board bership recognized decisions were meetings, and the “divorce” orga- of Directors, ostensibly based on a being made in Washington affect- 5 nizationally between ophthalmolo- 30-page document demonstrating ing research and (Continued on page 6) OPHTHALMIC HISTORY
Growth of the Independent Organization
(Continued from page 5) residency training. It was deemed advisable to have an Academy “listing post office” in Washington DC, to be sure you had a voice. As this voice grew in volume and suc- cess, members who belonged to both organizations (AAO and American Association of Ophthal- mology) recognized the employ- ment of similar tactics and began to wonder if one voice would bet- ter serve the profession.
If divorce was hard, marriage can be difficult too, particularly when it calls for joint family reunions. Issues and egos were assuaged. New membership cate- gories allowed for a much broader membership involvement, the new Academy Board represented a Bruce E. Spivey, MD, broader pallet of interests beyond Academy EVP, 1979 – 1993 education. and public service aspects of the Dissatisfaction grew within some The merged ophthalmic Acade- organization. As a result, EyeCare members of the Academy with its my included a Council that you America remains the only national decision process, organizational rep- might recognize today. The Board medical society service outreach resentation, and strategic direction. saw the Council as an advisor to program, recognized by presiden- It grew out of the belief that a House issues needing organizational tial citations from multiple admin- of Delegates structure would lead to involvement by the Academy. istrations. The Foundation also a more representational governance. gave rise to our Ophthalmic Heri- This structure had been adopted by Here are some examples of growth tage Program, which we hope will the American Medical Association and expansion of scope for the finally evolve to a freestanding and many state medical societies. Academy: Museum of Vision. This dissension led to the largest and most comprehensive examination of When 600 members of the Acad- When I was a high school stu- the Academy in its history. emy were told that their malpractice dent, my father’s opinion was that insurance was no longer going to be in any organization, you will find The final report preparation underwritten, OMIC (Ophthalmic about 2 percent who do not behave included 220 individuals involved Mutual Insurance Company) was well either out of avarice or igno- in its creation, review and critique formed. OMIC not only under- rance. In recognition of this, the with the report 79 pages in length. wrote those immediately affected, Academy established its Code of The study concluded that a House but within five years could demon- Ethics. With its clear, concise, aspi- of Delegates structure would not strate that the level of malpractice rational principles, coupled with serve the Academy well. It recom- incidents could be reduced from examples of appropriate behavior, mended that a Board of Trustees that comparable to neurosurgery, to the Academy’s Code rarely has had involving highly representational that akin to family practice. This to employ its enforcement provi- positions with staggered terms and fact alone caused other insurers to sions to the final disposition. In my responsibilities was a better path- reduce their premiums as well. opinion, this program ranks as way. The Council would continue high as any achievement, developed as an advisory body to the Board The “new” Academy, upon merg- by the Academy in protecting the and represent both state and sub- er, required an amended tax sta- public opinion of your profession. specialty interests. This report was tus. This, in turn, permitted the submitted to the entire membership creation of the Foundation, which A challenge to the organizational at the Annual Meeting and was could advance the philanthropic structure occurred in 1990-91. adopted by a vote of 2011 to 6. 6 Private Equity Buyouts of Ophthalmology control in day-to-day decisions and Practices – Update 2018 actions as compared with the cen- tralized model. Thomas S. Harbin, MD, MBA, and Gary Markowitz, MD There is an extreme variant of Do you really want that including billing, collections, opti- the decentralized model done by $50 million? cal, etc. Here the doctors lose all one company under which the per- control over decisions heretofore spective is much longer term than year ago, Scope published theirs. All acquired practices in the centralized model and the an article on Private Equi- employ the same EHR system. The objective of the practices is to grow Aty (PE) Buyouts of Oph- goals of the new owners are effi- both internally and externally, thalmology Practices in which the ciency, control and cost savings. thereby increasing practice profit- first sentence was a question: “Do The focus is on acquiring more and ability. As practices are added in you want $50 million?” Now the more practices with centralized different areas and incentivized to question is slightly different. Be management and maximized short grow individual practice profits, sure you can answer it. to medium-term profits, thus mak- the entity as a whole grows. In this ing a future sale of the rolled-up model doctors, invest only in their Seniors viewed this article in entities more attractive. own practice and the philosophy is unprecedented numbers and, given buy and hold and there are no that level of interest, we now pres- These practices are usually plans of a future sale. ent an update. One of this article’s acquired for cash, note and stock. authors, Gary Markowitz, MD, The stock is in the management The majority of models are decen- participated in one of the early company, which is essentially a tralized with different blends of cen- buyouts and has experienced this mutual fund of practices which is tralized management. A common phenomenon. The past year has generally sold in three to seven years. feature of all models is reduced seen a number of new companies future income for the doctor in enter the arena and many more Several companies employ this return for a lump sum of cash, taxed practices have sold. At the end of model, and many practices have at capital gains rates, based on cur- this article we list the companies been acquired under this scenario. rent practice profits— earnings that are engaged in some sort of PE before interest, taxes, depreciation acquisitions. Decentralized: and amortization (EBITDA). In This model has fewer centralized addition, the doctors receive stock Private Equity Models services or administrative functions in the new entity, which theoretical- and a smaller corporate structure. ly will grow in value. Private equity buyouts comprise a Practices have more ability to con- number of different features with a tinue in much the same way as Is the bloom coming off continuum from extremely cen- before they were acquired. At the the rose? tralized to decentralized. same time, the practice is incentiv- ized to grow by endogenous growth Paul Koch, MD, wrote an editorial Centralized: and local acquisitions. The doctors for Ophthalmology Management With this model, the acquiring receive money and stock in the buy- (March 2018, p. 16) titled “You company takes over all adminis- ing entity as in the centralized may want to think twice about pri- trative and management functions model and frequently have more vate equity.” The subtitle was “Every positive has a negative, and PE is no exception.” His practice was one of the first to sell to a pri- vate equity company. As time went by, he noted the lack of long-term planning because of the short-term profit mentality. He noted that “requests for equipment and facili- ties that would enhance the prac- tice over the long term stalled.” His practice is now with a different company with a different model.
Another quote from his editori- al: “Once this model achieves 7 national penetra- (Continued on page 8) Private Equity Buyouts of Ophthalmology Practices Private Equity Companies — Summer 2018 (Continued from page 7) Authors’ note: We contacted several sources before assembling tion, it’s hard for me to see why this list, and it is as complete as we could make it. Companies any medical group would go the wishing to be listed should contact Scope at [email protected] PE route and be subjected to short-term practice management Acuity Eye Specialists – Eye South Partners-Shore Capital instead of long-term stability; Comvest Partners senior partner cash-out versus all Gauge Capital – Comprehensive doctors having skin in the game.” American Vision Partners EyeCare Partners (AVP) GP Partners Clearly, there is a lot to consider Ampersand Capital before embarking on such a jour- Grand Rapids Ophthalmology – ney, if one wants to go there at all. Amsurg (publicly traded) Sterling Partners Ares Management Private Lineage Capital What to do? Equity Group McLarty Capital Partners Plan, plan, plan. Due diligence to Belhealth Northwood Healthcare Partners the max. The article last year listed Blue Range Capital, LLC reasons why a private equity buy- Omni Eye Services – New out might be right for a given Boyne Capital Mainstream Capital practice. The doctors in a practice Centre Partners Pleasant Bay Capital need to engage in considerable long-term planning before decid- Century Vision Global Revelstoke Capital Partners ing to go with a buyout. Be sure Covenant Surgical Partners Revere Capital you know the model the company (publicly traded) employs and whether you can live Sheridan Capital Partners with the constraints, whatever Eye Care Partners – FFL Southeast Eye Services – they may be, as well as the reduced Partners Flexpoint Ford future income. Be sure the details Eyecare Service Partners Spectrum Vision Partners – are fair to all doctors in the prac- (ESP)– Harvest Partners, LLC tice, young and old. In fact, you Blue Sea Capital-(OCLI) should have a plan to attract new EVP Eyecare-Cortec Group Unifeye Vision Partners (UVP) – doctors to the practice. Have an Eye Health Partners (EHA) – Waud Capital idea of how the change in owner- LLR Partners ship will affect the culture of your Vision Group Holding practice and the care of patients.
Get advice from attorneys and other advisors. Matt Owens, a cor- can be very expensive so get the desire to maintain the financial porate partner at Arnold & Porter fees set ahead of your engagement. health of their new company. Such in Washington, DC, says, “While doctors could be heavily invested PE firms and other potential part- Doctors should talk to as many in the company you are consider- ners will be doing their due dili- other doctors as possible. Reach ing with a consequent conflict of gence on the physician practice, out to unhappy people as well as interest. Your due diligence should the physician practice likewise happy ones. You want to discover be extensive. needs to do its due diligence on its problems. Some ophthalmologists potential partner. It’s not always have been squeezed out of their After long-term strategic plan- about the money; you want to practice with nowhere to go. They ning, getting advice from knowl- make sure you and your new part- may have received a nice sum of edgeable attorneys and other ner share the same vision with money, but does that compensate advisors, you may decide private respect to the future of your prac- for losing their practice? equity is the way for your practice tice and how it will grow and be to thrive. Or, you may not. Selling managed.” Be savvy with your Be aware that some doctors now is not imperative. Some prac- choice of attorneys and be sure enmeshed in a new entity may not tices need time to grow on their there is specific experience in the be able to be totally frank and own before considering this area of practice buyouts. Invest- open for legal reasons such as a option. Whether you sell or hold, ment bankers and practice brokers non-disparagement clause or the we wish you the best. 8 Academy Foundation Update
News From the Chair of the Academy Hutchinson, remember him Foundation Advisory Board fondly. “Daniel and I are still trying to get through each day Christie L. Morse, MD without our sweet and gentle Chair, Foundation Advisory Board Tom, a gentleman in the tru- est sense of the word, a man cal public service program in of honor and goodwill,” June In Memory of American medicine, recognized said. “We are so proud of his Tom Hutchinson, MD by every U.S. president since amazing accomplishments, and Ronald Reagan. To date, EyeC- more importantly his ability s many of you know, are America has helped to connect with almost any- our dear friend nearly 2 million people one and communicate that he Aand colleague, B. get sight-saving care. was on their side. Dan and I Thomas Hutchinson, hope that there is a place of MD, died April 10 at the “Tom Hutchinson warmth and love to shelter age of 84. impacted every facet our Tom’s beautiful soul.” of our profession. He A long-time resident of was a superb and car- If you’d like to make a memo- Boston, Tom earned ing physician who rial tribute gift, visit aao.org/ his undergraduate B. Thomas Hutchinson, MD always put his foundation/donate and select degree at West Vir- patients’ interests “The Hutchinson Fund.” The ginia University and his medical above all else,” said David W. Academy has established degree from Harvard Medical Parke II, MD, Academy CEO. this fund in Tom’s memory School. He pursued ophthalmic “But he also played a pivotal role to support EyeCare America training at the Massachusetts in establishing and serving our and other public service pro- Eye & Ear Infirmary, where he sentinel public service program, grams of the American Acad- completed residency and a fel- EyeCare America, our ethics emy of Ophthalmology. lowship. A force in the academic initiatives, the Academy Founda- realm, he inspired and mentored tion, quality of care programs Join us in Chicago at our generations of residents and and advocacy initiatives. He was 15th annual Orbital Gala medical students at institutions elected by his peers to serve as including Harvard Medical Academy president. He was a Join the American Academy School, where he was a revered true servant leader. But above of Ophthalmology Founda- associate clinical professor. all else, he was a warm, genuine, tion for a groovy evening at our and devoted friend and colleague ‘60s-themed Orbital Gala on Tom served as the Academy’s whom we will dearly miss.” Sunday, Oct. 28. This 15th annu- president in 1993. But perhaps al fundraiser will be the social we’ll remember him best for his Aside from his prolific con- event of AAO 2018. Dine, dance, role in establishing EyeCare tributions to the field of oph- and enjoy live entertainment America®, a public service pro- thalmology, Tom was an avid under the Chicago Cultural Cen- gram of the Academy that pro- antique clock collector, with deep ter’s stunning Tiffany stained- vides eye care through a pool of knowledge of early American glass dome. Get great silent nearly 6,000 volunteers. history gained as he sought to auction deals on fine wine, vaca- understand the life stories of the tions, ophthalmic equipment and More than 30 years ago, Tom clockmakers whose creations he more. Proceeds will support the had the foresight to harness the admired. Fishing was also a pas- Academy’s educational, quality support of Academy member sion for Tom, and he looked for- of care and service programs. ophthalmologists to provide ward to the running of the blues access to medical eye care for off Nantucket Island each season. To learn more, visit aao. underserved older Americans. org/gala. To donate an item to Tom helped build EyeCare Tom’s wife, B. June Hutchin- the silent auction, contact Claire America into the largest medi- son, and his son, Daniel Thomas Lewis at [email protected]. 9 BOOK REVIEWS What You’re Reading This Summer
Book Review Editor, Thomas S. Harbin, MD, MBA
enior ophthalmologists civil war or an Ebola crisis? Where share the best of what does strength come from? What Sthey’re reading this might a woman do to express her summer. Share what you’re femininity as well as authority in a reading and send your review to predominantly male environment? [email protected]. Would I ever love to share a From Susan H. Day, MD cup of coffee with this president!
Madame President: The Extraordi- From Samuel Masket, MD nary Journey of Ellen Johnson Sirleaf by Helene Cooper. Open by Andre Agassi
Admittedly, it was the title of this “Open,” Andre Agassi’s autobiog- book that caught my eye. This raphy, will surprise readers on sev- philanthropist, and, yes, tennis biography chronicles the “journey” eral levels. We learn from the player along the way. of Madame President Ellen Sirleaf: outset that Agassi hated tennis; he her devotion to her country (Libe- always did. Yet, having played it This book captured my interest ria); her political rise (first woman with such passion and success over and became that rare page-turner president in Africa); her well- so many years, readers will find that one loves to read and hates to deserved honors (Nobel Prize). the concept dichotomous to their finish. Highly recommended. own beliefs. From J. Kemper Campbell, MD The book is largely about human relationships with tennis as a back- The Monk of Mokha by Dave Egg- drop; at the center is the relation- ers and Alfred A. Knopf. ship with his father, a poor, albeit highly motivated displaced person The year is half-way over, and at the end of World War II. His this reviewer may have already father was also an intense and read his favorite nonfiction book accomplished athlete. Often, to the of 2018. “The Monk of Mokha” unintended detriment of their by Dave Eggers is that book. It children, parents foolishly attempt is a story about coffee, entre- to correct or relive the flaws of preneurship, Yemen, the lives their own life or childhood by of immigrants, and pursuit of exerting rigid control over the lives the illusive American Dream. of their children. Typically, that Eggers has plan is a recipe for published suc- failure at best, cessful works of disaster at worst. both fiction and nonfiction and his It is the “extraordinary” compo- We come to spare, Heming- nent, however, that creates such a understand and way-esque style captivating read. When is it time appreciate the suits this true tale to draw a line in the sand, and rebellious nature of danger and when is it time to retreat and plan? of young Andre, determination, What happens to a survivor who his failed relation- which requires no has witnessed the murder or tor- ships with (cele- literary embel- ture of loved ones? How does one brated) women, lishment. convince an international audience his dedication to to not only forgive a multimillion- his siblings, and Mokhtar dollar debt but also to provide seed his ultimate suc- Alkhanshali is money for a country’s re-birth? cess as a husband, a young Yemeni 10 What is tougher to endure — a human, father, (Continued on page 11) BOOK REVIEWS
What You’re Reading story. Either because we humans (Continued from page 10) will go extinct or simply because we humans will no longer be inte- gral to the vast network of infor- American raised in the hard- mation flows. Only information scrabble Tenderloin district of San will have value. The new religion Francisco. After an aimless suc- is dataism. And the new gods may cession of menial jobs, he chances be a very few super-elite who live upon the unlikely scheme of re- in Silicon Valley, or they might not establishing Yemen’s five century- be people at all. Maybe that is what old tradition of coffee exportation. the TV show, Westworld, is about. Lacking business acumen and expertise in either growing, or From M. Bruce Shields, MD even drinking, coffee, his chance of successfully achieving this dream Grant by Ron Chernow. was dismal at best. And to compli- cate his task further, a brutal war If you think you know the his- with Saudi Arabia and stringent torical facts of Ulysses S. Grant, American travel restrictions to the story of homo sapiens is com- you should read this book. The Yemen occurred simultaneously. ing to a tipping point. We are about media (basically newspapers) of to turn into something new. The his day and many of his subse- The author describes Mokhtar’s conclusion of the first book became quent biographies have depicted dogged pursuit of his goal to its the premise of the second. A capac- him as a drunkard, a butcher ultimate conclusion despite the ity to tell myths that are full of val- with little concern for human life deadly surrounding circumstances. ues and rich with meaning allows and the president of a dysfunc- Meanwhile he introduces the read- men to organize, not on the scale of tional and corrupt administra- er to a previously unknown region dozens, as in a hunting party, but of tion. Ron Chernow, in Grant, of the world and to the esoteric thousands and millions. Cultures, presents a more nuanced picture craft of producing gourmet coffee. civilizations as well as religions and of the general who won the Civil armies, inspire and even compel War and served as the 18th This handsomely bound book the individual to suborn himself to president of the United States. provides a worthy companion the greater good. This has given us to a comfortable armchair and greater control over other animals, Grant attended West Point and a freshly brewed cup of coffee. our enemies, and the world, but graduated in the middle of his Unfortunately, no photographs are less control over our own future. class (not at the bottom as some provided of the exotic locales or the have rumored), then served with colorful characters involved in this Only our stories have changed. distinction in the Mexican War. adventure which seems torn from Where we once had myths, reli- But, by the late 1850s, his life was the pages of “Arabian Nights.” gions and gods, we now have in shambles, as he was forced to humanism, science and technol- resign from (Continued on page 12) From Alfredo A. Sadun, MD, PhD ogy. As a consequence, we have almost overcome famine and Homo Deus: A Brief History of disease. For the first time in our Tomorrow by Yuval Noah Harari. history, more people will die from overeating than starvation. I thought that Harari’s first book, Sapiens, was one of the most Having increased our access thought-provoking and remarkable to the world’s energy and other books I had ever read. So, I had resources, we are now tapping very high expectations with this into the greatest resource of all second and related compendium. — data. Technological advances Perhaps my expectations were set have not only allowed the accu- too high as I was less “wowed,” but mulation and processing of mas- still, this is an outstanding work. sive amounts of data, but now, human values, and even human The NY Times bestseller, Sapiens, beings, can be left out of the loop. described man in evolutionary terms as a peculiar primate. It Hariri suggests that we have ended as Homo Deus begins, that come to the end of the human 11 BOOK REVIEWS
What You’re Reading SCOPE (Continued from page 11) The Senior Ophthalmologist Newsletter
the Army due to alcoholism and having failed at one business Ideas and opinions expressed in enterprise after another. He would Scope are those of the authors and editor and do not necessarily have been less than a footnote in reflect any position of the Ameri- American history had it not been can Academy of Ophthalmology. for the outbreak of the Civil War.
After struggling to regain his commission, his rise through the Scope Editorial Board ranks in the Union Army was Editor Emeritus meteoric, with successful cam- David W. Parke, MD paigns in the West, while Union Editor generals in the East were losing suc- M. Bruce Shields, MD cessive battles to Robert E. Lee and the Confederacy. This caught the Why isn’t British Columbia Associate Editors attention of President Lincoln, who part of the United States? A few Daniel M. Albert, MD, MS promoted him to lieutenant general, answers reside in this book. Donald L. Blanchard, MD the highest rank in the military, Thomas S. Harbin, MD, MBA and charged him with defeating Lee In 1810, John Jacob Astor, already Alfredo A. Sadun, MD, PhD and winning the war, which he did. wealthy from fur trading, dreamed Assistant Editor of a Northwest trading station Neeshah Azam Although the loss of life was that would extend his empire and staggering under Grant’s com- exploit the vast natural resources Design mand, Chernow depicts a man reported by Lewis and Clark when Lourdes Nadon with great compassion for human they returned in 1806. Meriweather 2018 Senior Ophthalmologist life, but with a soldier’s dedication Lewis had strongly recommended Committee to do his duty. As to his drinking, to President Thomas Jefferson that Susan H. Day, MD, Chair he apparently inherited a family such a seaport on the Pacific rim Richard L. Abbott, MD trait of alcohol intolerance, but he should be established. Jefferson gave Brad H. Feldman, MD, is said to have avoided drinking Astor his blessing and approval. Secretary for Member Services when his sobriety was required, Thomas S. Harbin, MD, MBA even though the press continued to Astor sent a ship, the Tonquin, Samuel Masket, MD emphasize his problem during the and an overland crew. The Tonquin David W. Parke, MD war and throughout his presidency. made it to the Columbia River, Jean E. Ramsey, MD, MPH crossed the bar and thus Astoria Alfredo A. Sadun, MD, PhD Chernow pictures Grant as a was founded. Unfortunately, the M. Bruce Shields, MD quiet, modest man, who refused to Tonquin then sailed to Vancou- write his memoirs until forced to ver Island, treated the Clayoquat Academy Staff by his dire financial state (another Indians poorly, was attacked Neeshah Azam business failure due to his trust in and blown up by its own crew. Gail Schmidt the honesty of others). His biggest vice, at least the one that finally The overland crew finally made brought him down, was smoking it to Astoria, but continued poor cigars, which led to throat cancer treatment of the Native Ameri- and a painful death. With one cans, vast distance from the East final show of courage, he worked Coast, and the War of 1812 allowed through his pain, completing his the British to take possession of memoirs within weeks of his death. Astoria. Ownership of this area remained in limbo until 1846 and From Thomas S. Harbin, MD, MBA the 49th Parallel Agreement. P.O. Box 7424 Astoria: John Jacob Astor and If Astor’s plan had succeeded, San Francisco, CA 94120-7424 Thomas Jefferson’s Lost Pacific the United States might now own Empire: A Story of Wealth, Ambi- British Columbia. A fascinating T: +1 415.561.8500 tion, and Survival by Peter Stark. history of the Pacific Northwest. aao.org/senior-ophthalmologists 12