SPECIAL ARTICLE Jose´ Rizal Philippine National Hero and Ophthalmologist Tracy B. Ravin, MD ose´ Rizal (1861-1896) is one of the most revered figures in Philippine history. He was a mul- tifaceted intellectual and a political activist, best known for his political writings that inspired the Philippine revolution and ultimately led to his execution by the Spanish colonizers. Rizal was also a physician who trained in ophthalmology under 2 prominent European ophthal- J mologists, Louis de Wecker and Otto Becker. Arch Ophthalmol. 2001;119:280-284 EARLY LIFE degrees).2 From 1879 to 1882, he stud- ied medicine, agriculture, surveying, and Born 40 miles south of Manila at Calamba, philosophy and letters at Santo Tomas Uni- into a prominent Filipino family, Jose´ was versity in Manila. Dissatisfied with his edu- the seventh of 11 children. Taught first cation there, due in part to the prejudices by his cultured mother, and later by pri- of faculty against native students, he con- vate tutors, the young Rizal grew up in an tinued his studies in Spain. In 1884, Rizal intellectually stimulating atmosphere. completed licentiates in medicine and in His brother and sisters were all well- philosophy and letters at the Central Uni- educated and his family’s private library, versity of Madrid. (The licentiate is an un- of more than 1000 volumes, was quite pos- dergraduate degree similar to the Ameri- sibly the largest in the Philippines at that can bachelor’s degree but with a more time. Rizal was an extremely gifted stu- vocational focus. Further medical educa- dent, especially in the humanities. He won tion was not required to call oneself a phy- literary competitions from a young age. He sician or to practice medicine at that time. had an extraordinary capacity for lan- However, one could obtain a doctoral de- guage; ultimately, he spoke 22 languages gree, similar to a contemporary Ameri- and dialects. His professor of Greek in can doctoral degree, after passing exami- Spain said that he never encountered a stu- nations and writing an approved thesis.) dent who excelled Rizal. Additionally, he Rizal kept meticulous notes of his studied drawing, painting, and sculp- clinical experiences in Madrid. His clini- ture, throughout his life; he even exhib- cal and surgical notes contain details ited a bust at the Salon de Paris in 1889.1 of lectures and case histories. The case reports include the patients’ history, EDUCATION physical findings, diagnosis, differential diagnosis, and treatment, including pre- Rizal received his secondary education at scriptions, diet, course, and even autopsy the Ateneo Municipal of Manila, where he findings. Rizal recorded opinions of pro- was a star pupil. On graduation from the fessors on the cases as well as his own Ateneo, he won first prizes in 5 academic observations. Some comments show his subjects, and his bachelor of arts degree awareness of inadequacies in the system was conferred from Santo Tomas Univer- with an ironic sense of humor: “The San sity (the only institution in the Philip- Carlos clinic which prints a seal of infec- pines authorized to grant academic tion to every wound.”3(p49) Although Rizal completed a thesis for From the Bascom Palmer Eye Institute, University of Miami School of Medicine, his doctorate in medicine, he did not tech- Miami, Fla. nically receive this degree, since he did not (REPRINTED) ARCH OPHTHALMOL / VOL 119, FEB 2001 WWW.ARCHOPHTHALMOL.COM 280 ©2001 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/28/2021 appear to read his thesis aloud as re- Rizal was highly impressed by time to travel through Europe to quired by the Central University of de Wecker’s surgical skills and felt learn from and visit with some ad- Madrid. At the time Rizal com- his surgical training was progress- ditional prominent ophthalmolo- pleted the thesis, he was already ing well. Living in Paris was too ex- gists and scientists. Among the oph- studying ophthalmology in Ger- pensive, however, forcing him to thalmologists he visited, probably many. Reading his thesis in Madrid look elsewhere for additional train- the most well-recognized today is would have required an additional ing. As he explained in the follow- Ernst Fuchs, whom he visited and trip to Spain, which Rizal could not ing part of the same letter, he de- worked with for a short time in Vi- afford. Instead, he mailed his thesis cided to continue his studies of the enna. In Berlin Rizal met Rudolph to the university and hoped for its eye in Germany, where the cost of Virchow, the “father of pathology,” acceptance in this manner. living was more reasonable. He was who invited him to become a mem- undaunted by the task of learning ber of the Berlin Anthropological TRAINING IN another new language: Society. That Virchow, an eminent OPHTHALMOLOGY European scientist, would offer the With respect to the study of the ail- young Rizal such an honor is a trib- Rizal was inspired to study ophthal- ment of the eyes, I am doing well: I now ute to the magnetism of Rizal’s per- mology by his mother’s failing eye- know how to perform all the opera- sonality and intellect, as thus far in sight and his desire to help her. In tions; I only need to know what is go- his career he had made no signifi- ing on inside the eye, which requires the late 19th century, ophthalmol- much practice. In Germany, I am told cant contribution to science. ogy was already a separate spe- that this is taught well, but one has to cialty, but there were no organized be registered and pay a sum of 10$ a PRACTICE OF residency programs. Most post- month....IfIseethat, in effect, the cost OPHTHALMOLOGY graduate training was obtained in of living is cheap, I will have myself reg- preceptorships under the tutelage of istered, and if it is not I will see to it that Rizal practiced ophthalmology, well-known professors. Rizal first two or three months will suffice for me. mainly in Calamba (August 1887- studied the eye under the famous In six months, I hope to speak Ger- February 1888), Hong Kong (No- French ophthalmologist, Louis de man, study a profession, continue my vember 1891-June 1892), and while Wecker (1832-1906). Although he specialty; in five, living among Filipi- in exile in the town of Dapitan (July nos, I have learned French.1(p257-258) held no academic position, de 1892-July 1896). His specialized Wecker was a prolific author and an In February 1886, Rizal moved skills brought him fame, and pa- active teacher. He introduced oph- to Heidelberg. There he found uni- tients often traveled long distances thalmoscopy into France and ad- versity students at a pub and in- to seek his care. In Calamba in 1887, vanced ocular surgery. He modi- quired about good professors in oph- Rizal finally began to fulfill his life- fied cataract and strabismus surgery, thalmology. He was directed to the long dream of caring for his moth- devised a new method of enucle- Augenklinik (Eye Clinic) of Otto er’s eyesight. He may have oper- ation, advocated sclerotomy for the Becker. Becker (1828-1890) was ated on his mother there, possibly treatment of glaucoma, and was the performing an iridectomy as a pre- 4 professor of ophthalmology at the first to use the term filtration. The University of Heidelberg from 1868 liminary to cataract extraction de Wecker iris scissors are still in to 1890 and helped make this (Figure). In Hong Kong in 1892, he use. Rizal served as assistant at de department one of the best in successfully removed the cataract Wecker’s clinic from November Germany. He wrote a text on the from his mother’s left eye. Several 1885 to February 1886. He sent fre- anatomy of the normal and dis- months later, he sent her glasses with quent letters to his family describ- eased lens and collected more than instructions to cover the right lens ing what he was learning in Paris, 1800 pathologic specimens.4 Rizal until he could operate on that eye. such as this excerpt from 1886: spent the next 6 months working as Two years later, at Dapitan, he ex- assistant to Becker. tracted the right cataract. He was From 50 to 100 patients go daily to the dismayed by her postoperative clinic of Wecker; there are days when they course, however, as she disobeyed perform as many as 10 major opera- I practise in the hospital and I examine tions. Many cross-eyes are set right....In the patients who come every day: the pro- his instructions and removed the the past days a young woman tall, very fessor corrects our mistakes in diagno- bandages prematurely. He learned a tall, taller than myself by at least one sis; I help in curing and although I do lesson on the difficulty of taking care palm, very elegant, beautiful, with a bad not see as many operations as I do in of family members: white eye that could not see, went there Paris, here I learn more the practical also. Wecker had to blacken her eye side....[Iplan] during the spring of ‘87 I have operated on Mother with much which was not hard to do, for it only to return again to Paris and observe the success and she could see with much needs time. As it is a luxurious opera- operations of Dr de Wecker who, as a sur- clearness immediately after. The post- tion, she could not complain of pain and geon, seems to me very superior to all the operative course went well for three days, she smiled.