1. How did you come to choose retina as a profession?

During medical school, I became familiar with ophthalmology, and I particularly liked the combination of medical and surgical practice within the field. As a medicine/ surgery intern, I had the opportunity to take 2 months of elective in ophthalmology at California Pacific Medical Center in San Francisco. During that time, I observed all types of ophthalmic surgery, including retinal surgery. Retinal cases were always unique and were the most challenging. During residency, Marion Humphries, MD, encouraged me to pursue the field of retina. I extend my thanks to Wayne Fung, MD; John Cavender, MD; and Gil Cleasby, MD; for their mentorship during my intern rotation in ophthalmology and retina fellowship. John Shock, MD, my chief in the Army for 2 years, was also an important retina mentor for me and helped me get a faculty appointment at Bascom Palmer Eye Institute.

2. What is the most rewarding aspect of working at Bascom Palmer Eye Institute?

The short answer to the question is “the people.” The driving force behind Bascom Palmer Eye Institute is the high quality and energy of the residents and fellows; they are the true engine of the institution. A second rewarding aspect is that the faculty colleagues of Bascom Palmer Eye Institute have many different subinterests in the field of retina as well as in the entire spectrum of ophthalmology. Finally, our patients are mostly referred by other ophthalmologists locally as well as nationally and internationally. With more than 217 000 outpatient visits per year and more than enough surgeries for all of the faculty and house staff, Bascom Palmer Eye Institute is a very exciting place to work. I love writing papers with the residents and fellows.

3. What was your experience like participating in the 10-year Early Treatment Diabetic Retinopathy Study (ETDRS)?

First, the ETDRS was the primary reason for my job offer to come to Bascom Palmer Eye Institute. In 1978, the Diabetic Retinopathy Study (DRS) was ending, and the new ETDRS was about to start. My former colleague George Blankenship, MD, ran the DRS but did not want to take on the ETDRS. Edward Norton, MD, offered me a faculty position with the assignments to manage the ETDRS, care for patients with endophthalmitis and other challenging cases, and be a utility player for the retina service. The ETDRS clearly showed that laser treatment for diabetic macular edema reduced rates of moderate visual loss. There are many hidden pearls in the ETDRS; for example, 1 of every 20 patients had vitrectomy during the study's 5-year follow-up. Keep in mind that all of these patients had less than proliferative diabetic retinopathy at baseline. Diabetic retinopathy is not a stable disease.

4. As an educator, what skills do you try to instill in your students?

Mentors of mine always emphasized the importance of understanding the natural course of the disease. All too often, treatments are recommended without fully understanding the clinical course of a particular problem or tailoring the treatment to the unique issues of the individual patient. Observation is an excellent choice for many conditions, but nowadays, there seems to be an emphasis on treating early and often for every patient who walks into an office for the first time. The second basic skill is to ask for a second opinion when you face a particularly complex problem with a guarded prognosis. By getting second opinions, patients will usually feel positively about your personal concern to provide the best care for their conditions. Finally, work hard, respect your patients and your colleagues, and listen to your patients.

5. What do you consider your greatest personal achievement outside your profession?

My personal achievements outside of ophthalmology are simple and low-key. I like to hang out with my grandchildren. I enjoy playing tennis in a “grumpy old men's league.” I am very happy when I see former fellows and residents achieve success in their personal and professional lives.