Why Ophthalmology?
“What made you want to be an ophthalmologist, Dr. White?”
Not a day goes by that at least one of my patients doesn’t ask me this question. Today it was a new patient, 75 years old or so, and a young man in for his first glasses at age 12. Sometimes it’s “why did you want to become an eye doctor?” I have a quick answer for the office of course, but I thought I’d use this as an opportunity to go back in time and “watch” myself make the decision all over again. It was a good decision then, and it’s been a good decision ever since.
I originally thought I would be an orthopedic surgeon. After all, I’m a washed up, blockhead, brain-damaged ex-football player. Orthopedic surgery just seemed to be a really good fit. I loved my Ortho rotation during my 3rd year rotations at UVM. Loved everything about it. The work, the patients, the clinical problems we encountered. I loved the surgeons–heck, they were all basically ME 10 or 15 years older. Loved it all.
Then I met Peter Linton, Chairman of the Division of Plastic Surgery at UVM, and Peter very quickly became my mentor. He and his wife Pam “adopted” my wife-to-be and me, feeding us and giving us a safe place to bring the problems that arise in a young physician and in a young marriage. And what cool surgery! Putting broken pieces/parts back together. Rebuilding a self-image through a combination of technical skill, vision, and artistry. I was smitten, and Peter lobbied day and night, enthusiastically pushing me to follow his career path.
There were a couple of problems, though, with each of these specialties. In the first place people die, and the broken patients in these two surgical specialties are no exceptions. I struggle with death; always have. How would I handle this? Also, I was deeply in love with Beth and committed to doing whatever it might take to be the very best husband and eventually father I could be. We talked for hours about the impact of residency on our new family, about the killer hours in Ortho and about the 7-9 YEARS of training that most Plastic Surgeons undergo. I can still remember, as if it was last night: “I love you dearly, but I’m not sure if I can love you 9 years of residency.”
My Dad spent his entire working career in ophthalmic manufacturing, running companies that made all kinds of things associated with eye care and vision. I grew up around optometrists, opticians, and optical fashion designers. To see what the medical side of my Dad’s world looked like I took a “flier” on an elective in Ophthalmology to see what the medical part of Dad’s world was like. Two weeks of cataract surgery, glaucoma checks and new glasses for nearsighted kids. I followed this up with rotations visiting the academic programs at Georgetown, Wills in Philadephia, and Pacific in San Francisco. A local surgeon in Burlington took me in for a month and showed me what the real life of an Ophthalmologist felt like. What a cool world! What cool gadgets! High frequency ultrasound to dissolve cataracts. Lasers–all kinds of lasers that did all kinds of cool stuff. This was it.
To top it off the residency programs were a total of 4 years long, and most of the Ophthalmologists I met were home for dinner with their families. Score! Although my choice DID come as somewhat of a surprise to the rest of the faculty. When the residency Match results were published the Chair of the Department of Family Medicine cornered me, a concerned and sympathetic look on her face. “What happened, Darrell? You matched in Ophthalmology?” To which I replied “I know, Marga, isn’t it great?” “Hmm…we were all sure that you would be an Orthopedic Surgeon; you were just the right amount of malignant.”
Well, Marga, this Ophthalmology thing has turned out pretty well for me so far. I married that girl, My Beautiful Bride and Better 95% Beth, and we are married to this day. I’ve been home for dinner most nights with her and the kids since then. For the most part my patients don’t die, at least not from anything that I’M treating. Ophthalmology patients get better, and because vision is such an integral part of the human experience, both physically and emotionally, the gratification that one gets from returning someone to the sighted world is simply immeasurable. Oh yeah, we still have the coolest gadgets in all of medicine, and we get new ones to play with every year. And for whatever it’s worth, most of my best friends in medicine are also washed up blockhead ex-jocks, most of whom are slightly less brain-damaged than I.
Except, that is, my Orthopedic Surgery buddies…
This entry was posted on Wednesday, April 15th, 2009 at 8:31 pm and is filed under Eye Care. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
April 15th, 2009 at 8:48 pm
Great story, but I’m not surprised. Those of us who slept through Creative Writing would simply answer the career questions with a shrug and a “it’s a long story.” Of course, this would be the reply, not because it is a long story, but rather because we can’t weave a thread, let alone a sentence.
June 4th, 2014 at 7:53 pm
I’m an ex-jock (Track & Field); almost exact story to a T. Ortho elective, then plastic elective, then ophtho elective. Settled on Ophtho, hoping to match this coming January.
June 5th, 2014 at 12:55 pm
Best of luck! Still one of the most rewarding specialties in all of medicine. Thanks for finding the blog.
December 4th, 2016 at 7:48 am
I think that choosing ophthalmology requires more mental extrapolation than most other specialties. We get very little exposure to it as medical students and the exposure you get can be highly variable. With most specialties, you are immersed in the world as a med student, and as a result, have a fairly good understanding of what the specialty entails. You have to seek an ophthalmology rotation, and then you have to think about what you are seeing. Ophthalmology tends to be much more subtle and the clinics do not always have teaching scopes, which can make things very esoteric for students. I was in a similar position. In college, I was ambition obsessed. It was neurosurgery, ENT, or bust. I threw in the ophthalmology rotation just as an aside. During the rotation, I was making it home on time to see my fiancée and spend time with her, and more importantly, I was having fun. Medicine isn’t supposed to be fun, I thought. I struggled with that concept for a good month only to realize that I desired fun. Something we abstain from for far too long. Why shouldn’t I have my cake and eat it too.
December 4th, 2016 at 6:41 pm
All true, Matt. All true. There are plenty of neurosurgeons who have very fulfilling home lives. Think back surgeons. Same for ENT. My buddy the allergist sleeps awfully well every night. T’was a time when there was a huge difference in the “getting there”, the residencies. As an ophthalmology resident in the 80’s I rarely worked more than 70 or 80 hours a week unless I had weekend call (we were in house for 2 years). Neurosurg was rarely under 100. With time limits now, not so much.
Medicine of all kinds was always fun for me. Heck, there are a dozen specialties I would have had a blast practicing. Ophthalmology simply fit into the shared worldview of my fiancé, now wife and I had at the time. Heck, one of my happiest med school classmates bailed on med school and became an architect because NONE of it looked fun! One should be careful not to assign near-magical powers to a specialty when it comes to lifestyle, though. I have dozens of colleagues around the country who struggle with their nonprofessional lives because they only enjoy ophthalmology cake, and it’s all they eat. My wife and I looked at the professional opportunities I had as a young attending, and frankly we walked away from pretty much all of them; I joined and built a thriving private practice, went to the OR or the office, and come home. No consulting, speaking, administration, etc. I had a job that I enjoyed and I went home to a family I enjoyed.
In the end one always has his/her cake because we’ve chosen it. One should strive to have fun at work. My hope for you is that the epiphany that you had in your ophthalmology rotation, that you liked home, like seeing your fiancé, liked having fun at work, informs all of your life decisions from here on out. Don’t be a stranger. Let me know how it turns out!