THE GRUELING YEARS
To become an ophthalmologist, an eye surgeon, one must not only complete medical school but you also need to train for three years in an ophthalmology residency. Competition for these slots is very fierce and only the very top medical students get a chance to apply. You usually need something to set yourself apart as well, exceptional research being the best. I decided to apply for the most prestigious research program available in the United States, the Howard Hughes Research Scholarship. If you are lucky enough to be chosen, a Howard Hughes scholar is given a chance to perform research in the top labs at the National Institutes of Health NIH in Bethesda, Maryland. I had done some research at NIH while in college studying neural regeneration for a summer. I think that gave me a leg up on the competition and I was one of 24 medical students selected for the Howard Hughes program. I spent my year of NIH research working at the National Eye Institute’s laboratory of immunology. It was a great honor to present my research at the end of the year at the grand rounds of the NIH in front of the world’s top medical scientists and to publish my findings in two top medical journals.
Throughout my 20’s I constantly had my nose to the grindstone, working 18-hour days and weekends. The hard work paid off. With top grades, shining recommendations from my clinical rotations and a year of research I was very fortunate to secure a spot at Emory University’s Department of Ophthalmology. Before you can start your residency, however, you need to complete a year of internship in internal medicine. For my internal medicine year, I decided to see another part of the country and so I chose the University of California. How naïve I was. For the next year I would get one day off per month, if our service was slow and if the senior resident would allow it. Call was every fourth night which meant I would show up to work on a Monday and work non-stop for 36 hours before returning home late Tuesday night. Back to work at 6:00 am on Wednesday and then Thursday would start the cycle off again. I was so tired I rarely got a chance to see any of California. I lived in the small surf town of Seal Beach so in those rare hours where I wasn’t working or sleeping, I would grab my long board and surf. I learned more in that year than I thought possible, caring for the sickest of the sick, but also in the most painful way imaginable. Years later congress would step in and limit the abuse of interns in hospitals but that help arrived too late for me.
The next three years were spent in Atlanta, Georgia at Emory University. At the time, Emory University boasted one of the top 5 ophthalmology residencies in the country. Emory was known for producing the toughest residents who had seen and operated on every eye condition. Atlanta is a city of around 6,000,000 people but has only one trauma hospital, Grady Hospital. Emory ophthalmology residence not only worked in the beautiful gleaming Emory clinic but they also staffed and ran the Grady ophthalmology clinic. It was at Grady where you earned your education. Huge amounts of trauma. Exotic diseases affecting the eye from all corners of the globe. The worst end-stage diseases one could imagine. Once you completed a residency at Grady, there was nothing in the world that could phase you in private practice. So, another 4 years with no sleep but an amazing training experience.
While at Emory, I had the chance to work with two true pioneers in the LASIK refractive world. The first was Dr. George Waring. Dr. Waring was in many ways the father of LASIK in the United States. While at Emory, Dr. Waring spearheaded one of the first U.S. multicenter clinical trials in refractive surgery, the PERK study for Radial Keratotomy, and he received the first FDA approval for LASIK in the mid-1990s, a feat that has enabled many to receive vision correction surgery in this country. The second was Dr. Doyle Stulting. Dr. Stulting has been performing LASIK for 30 years and has conducted hundreds of trials investigating refractive surgery. Together, Dr. Waring and Dr. Stulting provided the “dream team” for me to work with. It was during my cornea rotation with them that I first saw the magic of LASIK surgery.
I’ll never forget witnessing my first LASIK surgery. Dr. Stulting carefully created the flap in the patient’s cornea. There was no pain, the patient was relaxed and comfortable. He then activated the laser and invisible pulses of light gently reshaped the patient’s cornea. He smoothed the flap back into place and allowed the patient to sit up. Miraculously, the patient could instantly see. I thought back to one of my favorite quotes by author Arthur C. Clarke, “Any sufficiently advanced technology is indistinguishable from magic”. This was magic I was seeing. In a painless, quick procedure Dr. Stulting had given clear sight to the patient for the first time in their life. This was what I wanted to do with my life, become a LASIK surgeon.
After residency I could have gone out into the world and begun to practice ophthalmology. I could have taken a 2-day weekend course to learn LASIK skills like most ophthalmologists. This would have been the easy route. I could sleep! I could start to pay down my huge school loans! But I wanted to be the best. If I was going to become a refractive LASIK surgeon, I wanted to be the best LASIK surgeon possible. So, I applied for a year-long LASIK/Cornea fellowship at the University of Minnesota. It meant another year of grueling work. It meant many more sleepless nights of call and weekend clinics for low pay. But the experience was unmatched. I learned from Dr. Andrew Huang , one of the finest eye surgeons I have ever met. He taught me the intricacies of corneal transplant surgery and the art of a good bedside manner. Dr. Jay Krachmer was a legendary figure in the corneal world, having published the definitive textbook on Corneal disease and surgery. I owe much to these two fine surgeons.