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The Newsletter of the Senior Ophthalmologist
SCOPE
Winter 2021 | Volume 25 | Issue 1
David William Parke, MD Lions Club, but also volunteered to
set up and run the clinic, which he
Nov. 19, 1922 – Nov. 13, 2020 did faithfully for nearly 20 years.
By M. Bruce Shields, MD I have saved most of the back
I
issues of Scope and, when I learned
t is not the general policy of league, friend and inspiration ever of Dave’s passing, I got them out
Scope to acknowledge the since my wife and I came to Yale in and looked through the ones when
passing of our colleagues. 1996. He and his wife, Joyce (who he was editor. It reminded me of
But there is one person without preceded him in death by 12 years), how much he contributed to the
whom this newsletter might not were among the first to welcome us newsletter and how he set a stan-
exist today. For 14 years, David into their home upon our arrival. dard of excellence that has been
W. Parke, MD devoted his time Our department needed a low a challenge for those of us who
and talents to shepherding and have followed him. He person-
growing the Scope newsletter, a ally wrote many of the articles in
publication we senior ophthal- each issue and insured a level
mologists continue to enjoy.
of quality in all the articles
Although his work he approved and edited,
with Scope was a major notably those from his
contribution to our two excellent associ-
profession, it is only ate editors, Drs. W.
one of countless Banks Anderson Jr.
accomplishments and the late Wil-
in his remark- liam S. Tasman.
able life of nearly
I especially
98 years (he
enjoyed reading
missed it by one
his thoughtful
week). His many
editorials. One
accomplishments
that has stayed
are outlined in
with me over
the obituary pre-
the years was the
pared by his son,
editorial he wrote
Academy CEO David
in the Summer 2013
W. Parke II, MD; his
issue titled “Roles.”
daughter Marna Borg-
In it, he recalls the ups
strom, CEO of Yale-New
and downs of raising three
Haven Health and Yale-New
children with their “emerg-
Haven Hospital; and Lucian
ing desire for independence” and
Del Priore, MD, chair of the Yale
the often-heard refrain. “I do it
University Department of Oph- David William Parke, MD myself,” as he put it. Of course,
thalmology and Visual Science.
all three went on to be remark-
As with so many of his friends ably successful, and then there
vision clinic, and Dave (as he pre- were grandchildren and great-
and colleagues, it is a personal loss
ferred to be called) not only helped grandchildren with more success.
for me. He was a cherished col-
us raise funds for it through the
David William Parke, MD
His editorial fast-forwards to a
day when we were honored to have
his son David come to Yale as a
visiting professor and speak at our
grand rounds. Of course, Dave was
in the audience with Marna by his
side. Over the years, the roles had
reversed, and the children now
cared for their father, somewhat to
his irritation. So, as David helped
his father to a waiting car, Dave
I consider how blessed
all who knew him
have been – to have
had our lives touched Pictured left to right – Academy 2021 President, Tamara R. Fountain, MD;
by a gentleman of David W. Parke, MD; and Susan H. Day, MD at the 2015 SO Committee
Retreat.
such good humor,
compassion, humility
and integrity.
was tempted to say, “I do it myself.”
But I’ll let him tell the rest from
the final words of his editorial.
“My first impulse was to pull
away, but then a warm feeling
came over me as I remembered
the little boy whose hand I had
held when we crossed the street
many years ago. He opened the 2015 Senior Ophthalmologist (SO) Committee Retreat.
door for me, and as I sat down,
he reached in and gave me a
gentle kiss on the cheek as he said
goodbye. What a role reversal!
A tear ran down my cheek.”
And I feel a tear welling in my
eye, as I consider how blessed I
have been – how blessed all who
knew him have been – to have had
our lives touched by a gentleman
of such good humor, compas-
sion, humility and integrity.
To those who might be inter-
ested, you may also make a
donation to an Academy pro- David W. Parke, II, MD, Academy CEO and David W. Parke, MD
gram in Dr. Parke’s memory. pictured at a family fly fishing trip. 2
History”. I wish
to sincerely thank
From the Dr. Albert and his
Editor’s colleagues and am
pleased to report
Desk that he has agreed
to continue his con-
tributions to Scope.
Another regular
feature that has been
well received is our
book review series,
which has been
edited by Thomas S.
Harbin, MD, MBA.
New Blood for Dr. Harbin and I are
the New Year grateful to our many
colleagues who have
By M. Bruce Shields, MD shared with us their
A
favorite non-oph-
s we enter a new year thalmic books, and I
(mercifully, some might thank Dr. Harbin for
say), I am pleased to this contribution and
announce that Scope is also am delighted that
entering an exciting new phase this feature will also
with the appointment of Alfredo continue to appear
A. Sadun, MD, PhD, as edi- in our newsletter.
tor of Scope, our newsletter for
the senior ophthalmologist. It has been a
special pleasure Alfredo A. Sadun, MD, PhD - 2021 Editor of Scope.
This will be a wonderful shot for me to write
of new blood for our publication, the “What We Are Doing Today” were associate editors of Scope long
since Dr. Sadun is truly a Renais- series, which has revealed how before I became editor and who
sance man, with a breadth and many talented colleagues we have, continued for many years to grace
depth of knowledge that I have not only as outstanding ophthal- us with their wisdom and wit.
seen in few people. I am looking mologists, but also their avoca-
forward to the new directions he And a most sincere thanks
tion. Scope has included artists, to Neeshah Azam and her col-
may take our newsletter, and I wish photographers, world travelers,
him the very best in his new role. leagues at the Academy, including
musicians, a writer of crossword Gail Schmidt, Psyche Pascual,
puzzles, cabinet maker, collector of Lourdes Nadon and Jim Frew,
It has been a privilege for me to
ophthalmic artifacts, documenter without whom I can guaran-
serve as editor of Scope, especially
of bird life, dog breeder and stu- tee you this newsletter would
because of all the generous and
dent of Sanskrit. More recently, never happen. It has been a joy
talented colleagues with whom I
we have explored the nonscientific to work with them, and I know
was fortunate to work. During my
writing talents of our colleagues that Dr. Sadun will continue
tenure, we introduced several new
in the “What We Are Writing” to profit from their talents.
features, none of which would have
series, and I am grateful to all these
been possible without the help of
individuals who shared aspects Finally, I wish to thank you
these individuals. Our “Ophthal-
of their special talents with us. our readers for your generous
mic History” series, which is one of
the highlights of the newsletter for acceptance of Scope. Many of
I also want to sincerely thank all you have provided comments
many of us, has been ably edited by those who have written articles for and other content, and I encour-
Daniel. M. Albert, MD, MS, who Scope, most of whom have been
was initially assisted by Donald L. age you to continue doing so,
members of the Senior Ophthal- since this is our newsletter, to be
Blanchard, MD, and more recently mologist Committee of our Acad-
by Ms. Jane Shull. Dr. Albert also shared and enjoyed by all senior
emy. A very special thanks to W. ophthalmologists. It has been my
introduced the intriguing feature, Banks Anderson Jr., MD, and the
“Notable Dates in Ophthalmic privilege to be a part of it, and I
late William S. Tasman, MD, who wish each of you the very best. 3
WHAT WE ARE DOING TODAY
Susan H. Day, MD: A Life of San Francisco in the 1970s was
barely on the map for a young
Medicine, Music and Repotting lady from Louisiana, but during
By M. Bruce Shields, MD
a fortuitous trip there with the
“E
LSU band, to play at the East-West
veryone needs repotting But a fascination with embryol- Shriner’s game, she was captivated
times.” Those words ogy and comparative anatomy, as by the beauty of the region that
were once spoken well as a part-time job as a surgi- would eventually become her new
by Dr. Jerry Bateman to a young cal technician, soon convinced her home. She returned a few years
ophthalmologist, who would take where her true destination lay: her later for an internship at Letter-
them to heart and follow her life first “repotting,” as it were. So, after man Army Medical Center and
trajectory, from a love of music to graduating magna cum laude, she then her ophthalmology residency
ophthalmic practice and teach- matriculated at the LSU School of at Pacific Medical Center (now
ing, medical ethics, assurance of Medicine, where she earned her California Pacific Medical Center).
quality international health care MD. Her experiences during those She recalls the serendipity of enter-
and eventually back to her music. years also convinced her that she ing “the elite worlds of Drs. Bob
wanted to be an ophthalmologist. Shaffer, Bruce Spivey, Bill Spencer,
Such is the unfolding world But this led to a rude awakening, Art Jampolsky, Alan Scott and Bob
of Susan H. Day, MD, who when she learned how difficult it Stamper.” These luminaries of our
continues to bring joy and wis- profession helped shape her career
dom to each life she touches. in such a way that her name would
Dr. Day was born in Shreve- one day be added to that list.
port, La., and grew up in a After her residency, Dr.
house filled with music. Day completed two fel-
Her mother played the lowships in pediatric
piano and was the ophthalmology
accompanist for a and strabismus at
glee club in which The Hospital for
her parents met. Sick Children
Her father also in London,
played the with David
piano, as well Taylor, and at
as the caril- the Univer-
lon in the sity of Iowa,
Rockefeller with Dr. Bill
Chapel at the Scott. She
University of then returned
Chicago, and to her new
later became home in San
professor of Francisco,
music educa- where, with the
tion at Louisiana exception of a
State University. brief time at King
With such a fam- Khaled Eye Specialty
ily background, a life Hospital in Riyadh,
in music seemed to be Saudi Arabia, she would
her destination. At a young remain throughout her
age, Dr. Day began to study ophthalmic career. In 1981, she
piano, play the flute and sing in her joined the faculty at CPMC as ser-
church choir. But it turned out that Susan H. Day, MD vice chief for pediatric ophthalmol-
her early experience in music may ogy and strabismus. She became
have been what led her to consider program director for the residency
a career in medicine, when a female was for women to be considered
for positions in surgical fields in in 1997 and was appointed chair of
pediatrician in the choir took the department three years later.
the young Day under her wing. the southeast United States dur-
ing the 1970s. It turned out to be
During her years in ophthalmol-
Still uncertain about her future, a blessing in disguise, however,
ogy, Dr. Day rose to international
Dr. Day entered LSU with a major since it led to one of the most
prominence as a clinician and sur-
in zoology and a minor in music. important repottings of her life. 4
geon, an educator, administrator
WHAT WE ARE DOING TODAY
Susan H. Day, MD
and a leader of our profession. She
served as president of the Ameri-
can Academy of Ophthalmology,
the American Ophthalmological
Society, American University Pro-
fessors in Ophthalmology and the
American Association for Pediatric
Ophthalmology and Strabismus,
and was the chair or member of
numerous other organizations and
committees. It was my pleasure to
serve with her on the American
Board of Ophthalmology’s Board
of Directors and the Academy’s
Senior Ophthalmologist Commit-
tee, which she chaired for many
years. During these and other
encounters with her, I came to
love her bright spirit and warm
sense of humor, both of which
bring joy wherever she goes.
Dr. Day has been in constant Susan H. Day, MD playing the flute. Photo taken by Dr. Ralph Eagle,
demand nationally and interna- archivist. Image courtesy of the American Ophthalmological Society.
tionally as a visiting professor and
guest lecturer, which includes 17 nam to Saudi Arabia, Guatemala which will become effective at the
named lectures. She has published to Finland, Singapore to Haiti and end of July, 2021. She has been
extensively in her chosen field of many, many more. Possibly the accepted to the Schulich School of
pediatric ophthalmology and stra- biggest sacrifice was leaving her Music of McGill University, where
bismus and has been the recipient beloved San Francisco to be near she plans to immerse herself for
of numerous honors and awards, the ACGME headquarters in Chi- the next few years in studying the
including the AOS Lucien Howe cago. But she maintained her home science of music with the goal of
Medal, the Academy and AAPOS in the Golden State, always with combining medicine with music.
Lifetime Achievement Awards and the thought of one day returning.
the Academy’s EnergEYES Award. “I would like to take on a project
And now, as Dr. Day contem- where both disciplines are essential
In 2014, Dr. Day sensed that it plates yet another repotting, her to make a contribution,” she said.
was time for another repotting. thoughts return to her love of “Specifically, I’d like to explore
With a passion for medical ethics, music, but this time to combine how musical aptitude develops in
education, standard-setting and it with her passion for medicine. people with congenital blindness.”
quality assurance in health care Throughout her career in ophthal- She will continue to play the flute
both nationally and internationally, mology and medical education, and learn piano to a greater depth,
she could not resist when the presi- music remained an important but as for singing, she says, “That
dent and CEO of the Accreditation part of her life. During medical will most likely be limited to lead-
Council of Graduate Medical Edu- school, she played in a woodwind ing choruses of Happy Birthday.”
cation, Dr. Thomas Nasca, offered quintet and later joined a group
her a leadership position to help of ophthalmology musicians who And so, the remarkable life
other countries create their accredi- provided noontime concerts for of Dr. Susan Day continues to
tation programs. She soon learned many years during the Academy’s unfold with multiple repottings.
that graduate medical education annual meetings. Her most memo- And, although it is hard to say
internationally is “the wild, wild rable musical experience came in precisely where this new chapter
west,” with widely disparate stan- 1982, when she performed Mozart’s will lead, two things are clear.
dards, and that there was a great D major concerto in Davies Hall She will continue to bring joy to
need for her services. Over the next with the San Francisco Symphony. the lives of others through her
six years, she would travel 250,000 dedication to medicine and music.
to 300,000 miles annually to coun- Dr. Day has decided to step down And she will eventually return to
tries around the world: from Viet- from her position at ACGME, her beloved home by the Bay. 5
never lose that tag or else “some-
Twenty-Five Years Behind Bars: Treating thing” would happen. ”Some-
Patients Inside Massachusetts Prisons thing” was later described to me
as a shutdown of the entire prison
By Jean E. Ramsey, MD, MPH site as all visitor tags needed to be
I
’m not going to tell you stories the paperwork completed. Once accounted for. Maybe the officers
about the terrible things that cleared, I was herded through just wanted to get the point across
may happen inside the prisons security with a large group of to a newbie, but it worked. The
… although you do hear and see a staff and correctional officers who importance of securing that tag
lot over a 25-year period. I’m not were about to start their shifts. I left a lasting impression on me.
going to tell you how difficult the learned that day that you don’t
inmates are … because most are refer to the correctional officers as As I entered the prison site I was
not. I am not going to tell you how guards. Good to learn that early. struck by the number of locked
scary it is inside a prison … because doors and gates I had to walk
I don’t feel scared when I am there. I was then subject to a visitor through in order to reach my desti-
search: the officer went through a nation. I would count them. There
The story I have to tell is about detailed inspection of my exam bag were between six and eleven locked
a grateful population of patients, and personal belongings. I was pat- doors/gates between the entry point
and a team of correctional offi- ted down and instructed to walk and my final destination. The exact
cers and medical staff that make through the metal detector. I then number varied depending on where
it possible to care for inmates in a had to wait for someone to escort I was going. Traveling to the disci-
prison ophthalmology clinic. I hope me through the grounds to the plinary unit, for instance, inevitably
what follows will answer some of added at least six additional doors/
the questions I have been asked gates to that final number. I found
through the years about working myself thinking that a prison is
within the prison system. probably not a good place
for someone who suffers
First of all, I am the from claustrophobia.
on-site prison oph-
thalmologist in The grounds were
Massachusetts. I well-kept but bar-
don’t go to the ren. There was
jails, just pris- a large area
ons. Most peo- with multiple
ple in jail are identical block
awaiting trial buildings for
or have been inmate hous-
convicted ing. I did not
of minor walk past
crimes. I that area.
go to pris- But I did
ons where walk past the
people have culinary area
been tried for staff and
and convicted inmates with
of more serious the unmistakable
crimes. Con- smell of breakfast
sequently, many being cooked. The
of the inmates have inmates were in single
lengthy prison sentences file as they prepared to
and I have managed their enter the “chow hall.” The
eye care for many years. line of inmates obstructed the
walkway, but as I approached the
I remember well the first time I inmates would clear a path for me
entered the prison. I had to wait to Jean E. Ramsey, MD, MPH to walk through. Officers were posi-
be allowed entry into the institu- tioned throughout the area, and
tion, as I was unknown to security regularly patted down the inmates.
health service unit. They gave me
staff. I was not able to proceed into
a visitor ID tag, which I attached Upon entering the health service
the facility until the clearance
to my jacket. I was instructed to unit, I was dismayed by the gray-
authorization was verified and 6
Jean E. Ramsey, MD, MPH
ness of it all: the gray floors, walls,
clothing, the disheveled men in
the inpatient ward, some in bed,
some in wheelchairs, some walk-
ing around, and the emaciated
patients — patients dying of AIDS. I
remember thinking, “Where are the
colorful get-well cards?” It seemed
like a terrible and lonely way to die.
But these AIDS patients were the
reason I was there. The Department
of Corrections’ health care team had
sought me out to examine the eyes
of these very sick HIV patients.
That was 25 years ago. Things
have changed since then. My
responsibilities quickly expanded
from AIDS patients to comprehen-
sive ophthalmology services, and
from one prison site to nearly all are 15 to 30 patients scheduled. The accompanied by multiple officers.
prison sites throughout the state inmates are held in the health unit Inside the prison, the correctional
of Massachusetts. I no longer have “cage” until I call for them. The cor- officers are immediately available
to routinely wait for entry into the rectional officer assigned to the clin- should they be needed. Restraints
facility. I now possess a Department ic does a “pat down” on each inmate are primarily placed on inmates
of Corrections ID, and I go through prior to entering the exam room. from the disciplinary units, who
security like other staff and cor- The hours for clinic are limited as are also escorted by multiple cor-
rectional officers, with no special the inmates need to return to their rectional officers. I have felt safe
modifications. The exception is if I units in time for “count,” which with my patients in prison.
happen to be the “search of the day.” occurs at a regular time each day.
I recall only one episode during
In that case, I would be subject my 25 years of caring for prison
inmates when I experienced a fleet-
to a more detailed security clear-
ance process, similar to what I
I recall only one ing concern for my safety. A patient
experienced in the early days. I episode during my with a history of mental illness and
a phthisical (dying) eye insisted that
have learned the rules, and there
are a lot of them: rules specifying 25 years of caring I restore the vision in his phthisi-
cal eye. While I focused on trying
what types of bags can be carried
into the facility, what size coffee for prison inmates to reassure him about the good
cup is allowed entry, what is con- vision in his seeing eye, he became
sidered “contraband” such as paper when I experienced increasingly agitated and angry
and demanded that I immediately
clips, binder clips and pens. Cell
phones are typically not allowed in
a fleeting concern fix the vision in the dying eye.
the institution. Rules vary some-
what by prison site, and they often
for my safety. Unable to relieve his anxiety, I
backed out of the exam room. As
change, so you learn to be flexible
a routine precautionary measure, I
and patient. I no longer need to be No movement is allowed throughout
stand between the patient and the
escorted through the facility. I know the institution during count time
door during my visits with patients.
the facility, the staff, correctional until “count clears,” indicating that
Some of the prisons have red emer-
officers, and they know me. They all prisoners are accounted for.
gency buttons on the wall. On one
call me “doc.” I don’t need a visitor
Some people are surprised to learn occasion, I mistakenly pressed the
pass, so I don’t have to worry about
that I spend most of my exam time red button outside the bathroom,
losing the pass. (It is funny how
alone with the inmates and that thinking it was a light switch for
some things stick in your mind.)
generally they are not in restraints. the bathroom. Eight to ten cor-
Nearly all of my scheduled After all, when inmates are seen rectional officers appeared almost
patients will typically show up for in the outside hospital clinics, they instantaneously from seemingly
nowhere. That was a big surprise 7
their appointments with me. There are likely to be in restraints and
Jean E. Ramsey, MD, MPH
and slightly embarrassing, as I had
obviously created a false alarm.
The officers had good spirits about
it, reassuring me that things like
this happened and they were there
to protect us. As I think about it, I
imagine they were probably relieved
that it was not a true emergency.
Although many of the inmates
appear disheveled, it is not infre-
quent for an inmate to present to
the on-site ophthalmology clinic
freshly showered with clean clothes
in anticipation of their visit with
me. They are very respectful and
express appreciation for my care.
I have followed many of these
patients for 10 to 20 plus years. and processes that can be chal- the inmate’s molestation of a young
The most common disease I see in lenging and frustrating at times. child. It was then that I made the
prison is glaucoma. These patients decision to avoid any knowledge of
People often ask me if I know a patient’s criminal background. I
are ready for my questions because
what crimes an inmate has com- was concerned that my knowledge
I ask them every visit, “Are you
mitted. I do not know because I of an inmate’s crime could unwit-
having any trouble getting your
choose not to know. Early in my tingly affect my care of the patient.
drops?” and “Are you ever without
drops?” Then I move to the more It is my firm ethical and profes-
standard questions: “What drops sional belief that my job is to give
are you using? How many times a I mistakenly these inmates, and all patients,
the best possible care that I can.
day do you put them in? How often
do you forget to put them in?” We pressed the red
I do believe that the inmates are
have regular discussions about the
importance of using eye drops.
button outside the grateful for the care they receive.
Although many start with a distrust
In any institutional setting,
bathroom, thinking of the system, I do my best to reas-
there is a lot that can go awry in
the process of ordering, receiving
it was a light switch sure them and hopefully a trust-
ing relationship evolves. Recently,
and dispensing medications that is for the bathroom. the inmates heard a false rumor
that I might be leaving the posi-
beyond the control of the patient.
But prison adds an additional list Eight to ten tion that allows me to visit prisons.
Word of this apparently spread and
of unpredictable obstacles: unit and
cell searches, lockdowns, trans- correctional officers one after another of the inmates
fers, disciplinary unit admissions expressed their gratitude, their
and more. Eye drops may get lost appeared almost concern and their fear. “What are
we going to do without you?” was
or be temporarily unavailable to
the patient after a move, or dur-
instantaneously from a common concern expressed,
ing disciplinary segregation. seemingly nowhere. some with tears in their eyes.
All this can make it difficult Over 25 years, I have learned a lot
for patients to strictly adhere to prison work an event occurred while about the prison system, the inmates
the medication plan. I typically working in the prison dedicated and the people that keep it running.
schedule many patients to see me to inmates who have been deter- The on-site ophthalmology clinic
sooner than might otherwise be mined to be sexually dangerous. has allowed more inmates to get
necessary for the sole purpose of the eye care that they need. I hope
checking on the status of their Once while waiting for a patient my work may inspire others in oph-
medications and their adherence to arrive, I scanned a page of his thalmology to care for this special
to the medication plan. Taking paper chart that was opened to population of patients, a popula-
care of prison patients necessitates information about his criminal tion that needs to be seen, even if
background. It outlined details of they are often kept out of sight. 8
interacting with numerous systems
OPHTHALMIC HISTORY
J. Donald M. Gass, MD: Physician, Gass was in medical school.
Scholar, Teacher & Mentor Dr. Gass completed an intern-
ship at the University of Iowa
By Anita Agarwal, MD and moved to Johns Hopkins for
J.
his ophthalmology residency.
Donald “Don” M. Gass, graduated with high honors in 1950 Media, their daughter, was born
MD, is one of the most and soon after was enlisted in the during his time in Baltimore.
influential ophthalmolo- Navy and served in the Korean war.
gists of the 20th century. At Johns Hopkins, he idolized
On his return from the war, Frank Walsh, MD, the most dis-
Dr. Gass was born on Aug. 2, Dr. Gass and his wife lived for a tinguished neuro-ophthalmologist
1928 on Prince Edward Island, short while in San Diego, Calif., of the time. As a resident, Dr. Gass
Canada to a physician father and where their first child John was wrote many papers, ranging from
an attorney mother. His father was born. Finishing his tenure in corneal iron lines to Waarden-
the head of tuberculosis hospitals the Navy, he entered medical burg’s syndrome. He was chosen
in Tennessee at that time. He rode school at Vanderbilt and gradu- chief resident at Johns Hopkins and
a train with his mother at age of ated with the highest honor, the completed an ocular pathology fel-
2 weeks to Nashville, where he founder’s medal. Dr. Anderson lowship at Armed Forces Institute
grew up and attended the two- Spickard, his medical school of Pathology (AFIP), between his
room Grassland primary school. It classmate and professor of inter- residency and chief residency.
housed three grades in each room. nal medicine at Vanderbilt recalls,
Dr. Gass had the best notes in This ocular pathology fellowship
He credits his love for reading and was the perfect blend to young Dr.
learning to a primary school teacher Gass’ abilities as a clinician, scientist
who used to fill her station wagon and doctor. It gave him the uncan-
with books from the library each ny ability to visualize retinal
week so that the students diseases in layers and he
could read them. Since became a ‘master’ at that.
three grades of lessons He went on to describe
were taught in the numerous new dis-
same classroom, eases throughout
Dr. Gass was eas- his career with
ily proficient in his knowledge of
the higher-grade ocular pathol-
lessons that left ogy. An early
him a lot of example is cho-
time to read roidal osteoma.
and learn out- Fundus cameras
side his school- were not com-
work. This was mon in the early
the founda- ’60s and people
tion for his handmade draw-
super abilities. ings of clinical
Dr. Gass met findings with elab-
Margy Ann Loser, orate notes. Many
his high school sweet- eyes were enucleated
heart, on the school those days for fear of
bus. She was his first tumor growth when
date and only love, and they elevated lesions were seen.
were married in 1950. Dr. Gass One such eye was sent to the
attended Vanderbilt University for AFIP during Dr. Gass’ fellowship.
his undergraduate education. His He learned that the lesion had thin
plan was to enroll in engineering J. Donald M. Gass, MD, pictured
with his slides on the view box. cancellous bone in the choroid, the
school at Vanderbilt, and when he Haversian system of canals with
arrived for admission, there was a blood vessels were also present and
their medical school class, and
shorter line for arts and science. If these vessels emerged on the surface
everyone wanted to borrow
the engineering line was shorter, we resembling spiders. In the mid-
them. Their second son Carlton
may have only known him from a 1960s, as a young faculty member
was born in Nashville while Dr. 9
distance as a brilliant engineer. He
OPHTHALMIC HISTORY
J. Donald M. Gass, MD
at Bascom Palmer Eye Institute, he
saw a patient with a yellow- orange
elevated lesion, on the surface of
which he noted spider vessels. He
sent the patient to the radiology
department for a plain X-ray of
the skull looking for bone in the
orbit. When the radiology report
returned as normal, he walked over
to review the X-ray himself and
saw the fine, eggshell-like cancel-
lous bone within the eye socket.
Such were his clinical skills and
ability to recall features in different
patients and connect them up later.
Dr. Gass was recruited to the
faculty of the University of Miami
in 1963 by Dr. Ed Norton as a com- Pictured left to right: Drs. Alan Bird, Don Gass and Pierre Amalric review-
prehensive ophthalmologist. He ing a fluorescein film, 1968.
performed all types of intraocular
surgery ranging from cataracts Dr. Norton suggested to Dr. to fully understand the clinical
to glaucoma, lid and orbital pro- Gass to see if the fluorescein appearance and the pathogenesis
cedures. Fundus and fluorescein camera could be used to study of many retinal diseases. He went
angiography (FA) cameras were new retinal diseases. Thus, was born on to describe for the first time at
additions to the eye department, his incredible journey into deep least three dozen diseases and fur-
along with Johnny Justice, a pho- and masterful understanding of ther understanding of many other
tographer who had spent a couple retinal diseases. He used his supe- previously recognized conditions.
of years at the North Carolina rior clinical examination skills;
Veterans Affairs hospital, (which knowledge of ocular pathology and When he described new retinal
also had housed a FA camera). interpretation of the FA features diseases, he named them with long
descriptive names such as acute
posterior multifocal placoid pig-
ment epitheliopathy (APMPPE)
or acute zonal occult outer reti-
nopathy (AZOOR) that made it
easy for the novice reader to know
part of the disease process just by
learning the title alone. He drew
many illustrations and cartoons,
as he called them, with details of
his understanding of pathology
within the retina and choroid. His
drawings from more than three
decades ago are now being sub-
stantiated by modern-day OCTs.
In 1984, he wrote a paper on
his understanding and interpre-
tation of Type 2 juxta foveolar
telangiectasia with blood vessels
dipping from the retina and grow-
ing through the photoreceptor lay-
ers towards the sub retinal space,
thinning of the inner retina with
loss of inner retinal cells, partial
Dr. Gass instructing a patient the method of using an Amsler grid. outer retinal holes or spaces; all of 10OPHTHALMIC HISTORY
J. Donald M. Gass, MD
which can be confirmed on pres-
ent day OCT and OCTA images.
Dr. Gass’ ability to completely
focus on the problem at hand
and delve into it wholly, made
him successful in solving many
clinical issues and conditions. His
uncanny ability to find the minut-
est changes in the patient’s fun-
dus and the ability to remember
similar features in other patients
and to tie them together mean-
ingfully has benefitted innumer-
able patients and physicians.
In addition to his brilliance in
diagnosing and managing medical Dr. Gass building a Model ship.
retinal diseases, he was a skillful
surgeon and an innovator. He was
He spent three decades at the Bas- sation is animated; all are engaged.
practical and looked for simple
com Palmer Eye Institute in Miami, As I walk by, I recognize our sin-
ways to make surgical instru-
from 1963 until 1995. His youngest gular good fortune in having such
ments more useful. He flattened
son Dean was born in Miami. Dr. a true academician in our midst.”
the tip and made a hole in the “lens
Gass along with Drs. Edward Nor-
hook” that was used to hook extra- Dr. Gass credits his parents Mary
ton, J. Lawton Smith, Victor Curtin
ocular muscles and pass the bridle and Dr. Royden Simpson Gass
and John Flynn were considered
sutures all in one sweep. When and his parents-in-law, Pearl Dean
the five pillars of Bascom Palmer.
he was trying to decompress the and J. Carlton Loser, for inspira-
Together they contributed to a sig-
vortex veins in an eye with idio- tion, support and help during their
nificant fund of our knowledge of
pathic uveal effusion and ended up early days. Dr. Gass was not only a
ocular diseases. Dr. Gass credited
sacrificing the vein in very thick fabulous husband and father, oph-
Dr. Norton for his unusual vision
sclera, he came up with the idea thalmologist and teacher; he was
for the institute and its future. Dr.
to remove a significant layer of the creative and enjoyed his pastimes
Norton’s ability to raise funds and
sclera and make scleral windows immensely. He loved fly fishing and
the foresight to acquire property
that resolved the uveal effusion. river fishing, built many wooden
around the institute, along with
trusting his faculty and “giving toys for his grandchildren and other
them the ball to run with” made kids in his workshop attached to the
Bascom Palmer the most successful garage. His attention to details while
ophthalmic institute in the country. building model ships exemplifies his
core nature. A kind and easygoing
Dr. Gass and Mrs. Gass moved personality came naturally to him.
back to Nashville, his home town He never delayed acknowledging
and his alma mater Vanderbilt in any present or gift with a handwrit-
fall 1995. He continued clinical ten note to the giver: I witnessed
practice and described and added this on innumerable occasions.
to our understanding of retinal
diseases while at Vanderbilt. Fel- He was funny and could pull
lows and residents were attracted to a trick or two on his fellows or
the department with his arrival. To compatriots. He once told me this:
quote Dr. Denis O’Day, the chair- “In the days when we didn’t know
man of ophthalmology at that time, much about many retinal diseases,
“The image that will forever endure photos and [fluorescein angiog-
for me is the one I saw every week. raphy] were done often at every
It is of a man sitting, surrounded by visit trying to figure out what the
Gass family: John & Carlton (Top colleagues, residents, students and patient’s diagnosis could be.”
row) Media, Margy Ann, Donald fellows. All are peering at photo-
During a fluorescein conference
Gass & Dean (bottom row). graphs of the retina and the conver- 11
when such a patient was presented,OPHTHALMIC HISTORY
J. Donald M. Gass, MD
and the presenter went on showing
several fundus photographs and
fluorescein images done at multiple
times, up jumped Dr. Gass with a
fluorescent green Halloween mask
over his face and announced, “And
then the patient began to look
like this.” Such was his humor. In
another episode, while walking
through the gift shop, he found
a stick with a voodoo toy/skull
attached to one end. He bought this
and stuck it under his lab coat and
went to grand rounds. When the
patients with unknown diagnoses
were presented, two older ophthal- Margy Ann Gass and Donald M. Gass at their home in Nashville.
mologists at Bascom Palmer often
said that they had a similar patient park while playing softball at Bas- and accolade that is known in
and that the patient went on a com Palmer. The Baltimore Orioles ophthalmology and retina.
cruise or an exotic trip or had some were his favorite team. Many Mon-
obscure treatment and were cured. day lunches were spent discussing Dr. Gass was diagnosed with
The next time they said something weekend sports events ranging pancreatic cancer in June 2003, and
similar, Dr. Gass stood up with his from basketball to football and golf. his clinical practice had to be halted
He loved Michael Jordan and Tiger prematurely. In spite of the ravages
Woods for their capabilities and of the illness and the effects of che-
Whatever he was achievements. As a fellow, I was motherapy, he continued writing,
invited to his home in Nashville for rendering his thoughts and opinions
doing he immersed every major sporting event – Super of cases that colleagues from across
the country and the world sent him
himself completely Bowl Sunday, college football finals
and many others where we watched and attending teaching fluorescein
conferences. His enthusiasm for a
and enjoyed every the game eating dinner and play-
ing Super Bowl pool for minimal new case, a novel finding or writ-
minute of it. To stakes, along with his daughter’s ing a letter to the editor about an
article was unchanged; all of which
family and grandkids. He was a
quote his son John great cook and enjoyed barbecuing he did during this period. He made
and using slow smoking cooker. I it to the Academy’s annual meet-
Gass, “One could see spent many weekend evenings at ing in New Orleans in November
their home enjoying the hospital- 2004, where he was bestowed the
the twinkle in his ity of Margy Ann and Dr. Gass. Laureate award. Sadly, soon after,
his health took a downturn, and
eye and a satisfied Dr. Gass was a special gentle- he passed away on Feb. 26, 2005.
man with multifaceted skills and
smile in his face for abilities. He contributed much to It is an honor to write about a
man who was unusually brilliant
a job well done.” science and medicine at the same
time devoting time to his fam- and truly generous in many ways;
ily and pursuing his favorite past he had great knowledge and skills
voodoo stick and said that when times. Whatever he was doing and freely shared his thoughts and
he had a similar case, his voodoo he immersed himself completely opinions. Most of all, he was a
doctor friend sent him this special and enjoyed every minute of it. healer and a teacher who made each
stick and asked him to perform a To quote his son John Gass, “One one of us a better doctor, a better
dance that cured the patient. His could see the twinkle in his eye teacher and a better human being.
eyes filled with laughter and enjoy- and a satisfied smile in his face
Editor’s Note: We are grateful
ment recalling those moments. for a job well done.” More than
to our History of Ophthalmol-
anything else, Dr. Gass contrib-
Dr. Gass enjoyed sports, both ogy editor, Daniel M. Albert, MD,
uted most to our knowledge and
playing and watching. He was MS, and his editorial assistant,
understanding of medical retinal
known to hit the ball outside the Ms. Jane Shull, who contributed
diseases. He won every award 12
to the editing of this article.OPHTHALMIC HISTORY
Algernon B. Reese, MD: A 5-foot-9 where he received a degree from
the University of Vienna. In the
Giant in Ophthalmic Oncology fall of 1926 he returned to New
in the 20th Century York as planned, where he joined
the private practice of his uncle,
By David H. Abramson, MD, FACS but the plans soon fell apart.
A
lgernon B. Reese, MD, After graduating from David- In October 1926, just months after
dominated the world son College in North Carolina in starting, his Uncle Robert, then 61,
of ophthalmology in 1917 and Harvard Medical School died unexpectedly. Dr. Reese took
the 20th century, but his legacy in 1921, he did a surgical intern- over the busy Manhattan practice.
lasts in the 21st century. ship at the Roosevelt Hospital in He was adept at running the prac-
New York (1922-23) followed by tice and from then on, according
Dr. Reese believed in staying busy, a residency at the New York Eye to one of his later associates, he
working hard, always perfecting and Ear Infirmary in 1924-25. never stopped. For the rest of his
whatever he did, sharing thoughts professional life he merged a private
and experience and being open In those days, the science of midtown practice with hospital
always to new ideas and approaches. ophthalmology was pathology. Dr. appointments/obligations/titles and
When he died at age 85 in 1981, Reese had developed an interest a very active surgical practice, all
everyone in ophthalmology knew in pathology (his uncle’s plan had while doing his own pathology. He
him (or of him). His obituary in included studying pathology with joined the New York Eye and Ear
The New York Times emphasized the “greats”) so he spent six months Infirmary, serving as chief of clinic
his contributions, career and some in Boston with Verhoeff, followed by and pathologist until 1932. He then
of his most famous patients (no a year with Ernst Fuchs in Vienna, joined the staff at Columbia for a
HIPAA then), including actors John year, then resigned to become chief
Wayne, Bob Hope and Paul Muni; of the eye clinic at Cornell, where he
Chinese leader Chiang Kai-shek; became associated with Memorial
Edward VIII and Wallis Simp- Hospital, now Memorial Sloan
son, the Duke and Duchess Kettering Cancer Center.
of Windsor; baseball
legend Babe Ruth; At Memorial he met
composer George the head and neck
Gershwin and surgeon, Hayes
novelist Ernest Martin, MD, and
Hemingway. together they
began explor-
In some ways, ing the use of
Dr. Reese’s life radiation for
was planned retinoblas-
for him, but toma. Radia-
despite the tion had been
planning, first reported
it didn’t go to work in
exactly as envi- retinoblas-
sioned. He was toma treatment
born and raised about 30 years
in North Carolina earlier, but tech-
where his father niques were crude
was a pharmacist. His and there were no
uncle, Robert G. Reese, physics to help gauge
MD, was an ophthalmolo- the dose to deliver. Often,
gist in New York. Algernon dosage was determined
always wanted to be a physician only by “skin tolerance.”
but lacked the money for medical
school so his family made a “deal” At the time, radiation sources
Portrait of Dr. Algernon B. Reese,
with his uncle: His uncle would loan and energy gave a higher dose to
circa mid-1930’s. Reproduced
them money for the cost of medi- the skin than to the eye and had
with permission granted by the
cal school in return for Dr. Reese a large penumbra, causing signifi-
Historical Society of Western
joining him in practice in New cant local toxicity. Although some
Virginia. 13
York when he completed training. patients were cured, few eyes sur-OPHTHALMIC HISTORY
Algernon B. Reese, MD
vived and even fewer survived with
vision. With Dr. Hayes Martin, Dr.
Reese learned how to modify the
beam and aim it to lessen toxicity
to structures, and to measure dose,
improving success rates for saving
eyes, eyesight and for a few — resto-
ration to normal vision. Drs. Reese
and Martin not only performed the
radiation treatments themselves,
often they also served as anesthesi-
ologists for their pediatric patients.
In 1931, Dr. Reese resigned from
the New York Eye and Ear Infir-
mary and Cornell positions to begin
a lifelong association with Colum-
bia University College of Physicians
and Surgeons and the Eye Institute, Algernon B. Reese knew from a young age that he wanted to be a
where he rose to professor of oph- physician. Image and permission to reproduce provided by Algernon B.
thalmology and director of eye Reese III.
pathology. At Columbia he estab-
lished the first clinic dedicated to
retinoblastoma and each week in thalmoscope. Bethke documented Columbia’s mandatory retire-
a basement room, he would exam- many of Dr. Reese’s cases and his ment age of 65 for surgery
ine children under anesthesia. illustrations fill his famous text- required Dr. Reese to cease per-
book on tumors. Later, I had the forming surgery in 1962. I entered
Dr. Reese’s fame grew. Patients opportunity to appreciate how the Eye Institute in 1970. In
and visiting physicians came, he accurate these drawings were. those days the entering residents
soon realized how difficult it was began the residency in a rotat-
for families to come and stay in While writing a treatise on retino- ing fashion: each on four months
New York for exams and treat- blastoma, I came across the record after the other. I was assigned
ment. At his own expense, he of a patient whose retinoblastoma the extra year. Fortunately, D.
purchased a townhouse near the had been successfully treated with Jackson Coleman, MD, kindly
hospital, where families could stay diathermy by Charles Perera, MD, invited me to join his pioneering
while in New York. The families and illustrated by Bethke. I exam- work on ultrasound for a year.
were never charged for lodg- ined that patient 50 years after his
ing, and his friends would clean previous treatment and — using Dr. Coleman encouraged me
and maintain the townhouse. modern ophthalmic imaging — I to explore what was afoot in the
was able to photograph the eye and Eye Institute, and I met, Rob-
He would split his time between ora seratta. When I compared my ert M. Ellsworth, MD, who was
his private office and Colum- photos with Bethke’s illustrations pursuing Dr. Reese’s retinoblas-
bia Presbyterian where he did 50 years later, I realized that he toma work. One day, I walked
his retinoblastoma work. While had depicted the ora precisely as it past an open, unmarked door.
he was a true pioneer, he was was … not as the usual “sawtooth” There — stooped over a micro-
always open to new ideas. filled in by most other illustrators. scope — was an older man. He
said he was working on a book.
It must be remembered that Even though Dr. Reese had great
Dr. Reese did almost all of his confidence in his skills, knowl- “It’s about tumors of the eye,”
melanoma and retinoblastoma edge and abilities, he was always he said. He was searching slides
work with the direct ophthalmo- open to new things. For example, for material to use for the third
scope in a time when there was he immediately realized the ben- and final edition of his legend-
no ophthalmic photography. At efits of the newly designed indi- ary book, to which I still refer,
Columbia, he worked with a medi- rect ophthalmoscope. Dr. Reese “Tumors of the Eye.” I told him
cal illustrator, Emil “Gus” Bethke, was in his 60’s when it became about our work with ultrasound
whom he taught how to use the popular in the U.S., he quickly in the diagnosis of ocular tumors.
slit lamp, gonioscope and oph- learned and perfected its use. 14OPHTHALMIC HISTORY
Algernon B. Reese, MD
“Would you like to write a chap-
ter for my book?” he asked. I was
stunned! He did not know me nor
anything about ultrasound, but
immediately recognized ultra-
sound’s potential value to the work.
“I don’t know anything
about tumors,” I said.
To which he replied:
“You’ll learn!”
He taught me about tumors and I
taught him about ultrasound. When Pictured from left to right: Dr. Ellsworth, Dr. Reese and Dr. Abramson.
his book was finally published, I Image source and permission to reproduce by author, David H.
was shocked that he acknowledged Abramson, MD, FACS.
me for my contribution to his book.
Prior to the use of radiation edged sword and that more children
Dr. Reese received many honors for retinoblastoma, the standard were dying from the second cancers
and awards in our field and lectured practice was to remove almost all than from the retinoblastoma itself.
extensively. He always worked to eyes with retinoblastoma including Reese immediately appreciated the
make organizations better and to bilateral enucleations. For most of dire consequences of radiation.
help his fellow physicians. He was the 20th century, the only way to
a charter member of the Verhoeff save an eye with advanced disease There was a nonophthalmic
Society, president of the American (and vitreous seeds) was radiation. side to Dr. Reese, too. In college
Academy of Ophthalmology and Children’s lives were saved, eyes he played basketball and was the
Otolaryngology in 1955, chairman of were saved and vision was often team captain. Throughout his life
the AMA Section of Ophthalmology saved. In fact, retinoblastoma is the he enjoyed tennis, hiking and water
in 1966-67, president of the American only solid tumor of childhood that sports. In his later years he took
Ophthalmological Society (AOS) in can be cured with radiation alone! up golf with enthusiasm and used
1960 and chairman of the American home movies to help his swing.
Board of Ophthalmology in 1960. Dr. Reese had perfected the
techniques, established the dose, Perhaps because of his time spent
He sponsored countless Ameri- fractionation and portals and in Europe he appreciated good
can and international fellows, delivered some of it himself, but in food, wine, dancing — and then
published more than 200 peer 1955 he reported that — years after there was bridge! He loved bridge,
reviewed papers and published his treatment — two of his patients read books on it, studied it and
first book, “Tumors of the Eye” had developed fatal cancers in the played regularly. He hosted parties
in 1951. Dr. Reese never sat on radiation field. In 1972, he and Bob for the staff at the Eye Institute and
his laurels. He revised and repub- Ellsworth, MD, encouraged me to included a yearly golf tournament.
lished the book again in 1963 spend time at the Armed Forces He was a southern gentleman who
and the last edition — the one to Institute of Pathology (AFIP), with never cursed, never boasted, was
which I contributed — in 1977. Lorenz Zimmerman, MD, explor- polite and respectful of all people.
ing these curious second cancers.
Although Dr. Reese is best And yes, he completely repaid
remembered for his work on As a result, we realized that chil- his uncle’s widow for the loan he
uveal melanoma and retinoblas- dren with retinoblastoma had a received for medical school.
toma, he was a prolific surgeon genetic defect (this was more than 10
who had extensive experience I stand on the shoulders of this
years before the gene was sequenced),
with surface ocular malignan- giant who made me look taller.
which made them prone to develop-
cies, periocular malignancies, ing subsequent cancers (we called Editor’s Note: We are grateful
orbital tumors and a fascination “second cancers”). We also identi- to our History of Ophthalmol-
with PHPV (PFV). Interestingly fied the exquisite sensitivity these ogy editor, Daniel M. Albert, MD,
his AOS thesis was “Peripapil- children experienced to the harm- MS, and his editorial assistant,
lary Detachment of the Retina ful effects of radiation. In effect, we Ms. Jane Shull, who contributed
Accompanying Papilledema.” His showed that radiation was a double- to the editing of this article. 15
Jackson Lecture was on PHPV.BOOK REVIEWS
What We’re Reading This Winter 2021
Book Review Editor, Thomas S. Harbin, MD, MBA
S
enior ophthalmologists Pettus Bridge in Selma, Ala.,
share the best of what they’re where he was beaten and taken
reading this Winter. Share to the hospital with a concussion.
what you’re reading and send But he and the others returned
your review to scope@aao.org. two weeks later and completed
the march from Selma to Mont-
gomery (54 miles) in three days.
It is hard to imagine what it
must be like to allow another per-
son to beat you without retaliat-
ing and to even convince yourself
that you love that person. But
that is what Lewis and many oth- Being Mortal
ers like him did repeatedly. He By Atul Gawande
was jailed 40 times, five during Reviewed by Alfredo
his time in Congress, where he A. Sadun, MD, PhD
I am afraid of dying. And why
not? I’m 70 and need to come to
It is hard to imagine terms with that eventuality.
what it must be like When I was younger, the
issues of life and death had deep
to allow another philosophical and psychological
implications that I felt were over-
His Truth is Marching On:
John Lewis and the Power of Hope person to beat you whelming. Now, as I’ve learned
more about life, it’s less about
By Jon Meacham
Reviewed by M. Bruce without retaliating these theoretical concerns and
more about the ugly process.
Shields, MD
The tumultuous year of 2020
and to even This New York Times bestseller
by practicing general surgeon Atul
will go down in history for many
reasons. One of those will be the
convince yourself Gawande, MD, MPH, argues the
point we’ve often heard: Qual-
passing of the civil rights icon and
longtime U.S. congressman Rep.
that you love that ity of life should take priority
over quantity of life. He offers
John Lewis, on July 17, 2020. person. But that models for assisting the infirm
and the elderly, but more impor-
The significance of his contribu-
tions to racial justice in the twen- is what Lewis and tantly, demonstrates that a per-
son’s last months can be elevated
tieth and twenty-first centuries
makes this account of his life by many others like to maintain value and dignity.
Pulitzer Prize-winning author
Jon Meacham one of the most him did repeatedly. The first half of “Being Mortal”
important books of the year. was good, but it was largely sociol-
ogy. It asked what’s wrong with
Lewis was an advocate of non- our society and health care systems
violence, a philosophy he learned served with distinction for 34 and what remedies could be con-
from Martin Luther King Jr. and years. In 2011, he received the sidered to better handle the chal-
others. He also aspired to be a Presidential Medal of Freedom. lenges of people too old and too
minister. As a child on his fam- sick to take care of themselves. But
If and when our country achieves
ily’s Alabama tenant farm, he it was the second half of the book
true racial equality, it will be to the
preached to the chickens. In fact, that was profound as it ranged
credit of men like Lewis. For those
his first act of nonviolence was from philosophical to practical.
who hope for that day, I highly
refusing to eat them. At age 25, The anecdotal stories were deeply
recommend Meacham’s book.
he participated in the march over moving but also grounded in evi- 16BOOK REVIEWS
What We’re Reading With his opening three-page let-
ter the longest poem, the remaining
dence. I was surprised to find the short poems are divided into four
answers to some problems that I sections corresponding to Midwest-
had pondered much of my life. ern seasons, beginning with those
appropriate for Winter and ending
For example, Gawande described with Autumn. Those familiar with
the difference between trans- Kooser’s work will recognize his
actional loyalty (which is bad, skill at connecting the ordinary
at least in excess) and loyalty to events of daily life to the sublime.
something grander than ourselves
(church, community, country, His observations of a dead vole or
idea). “Loyalty to causes that have a field mouse struggling in the tal-
nothing to do with self-interest ons of a red hawk will lead to medi-
…” is its own reward. And this tations on the transitory nature
gives life meaning, even when of existence. A neighbor watering
confronting the pain and loneli- her petunias can remind read-
ness of the final months of termi- ers of the beauty available in any
Red Stilts of the mundane moments which,
nal illness. Gawande argues that By Ted Kooser
the key to facing our mortality when connected, form our lives.
Reviewed by J. Kemper
is to have a voice in facing it. Campbell, MD
Orson Welles famously said,
“You are born alone, and you die
At 81, Pulitzer Prize-win- As the sights, sounds
ning poet Ted Kooser seems as
alone.” This need not be true in the
physical sense. The dying can and
firmly rooted in the Nebraska and ambiance of
landscape as the Bohemian
should feel their family connected Alps in which he resides. a summer night in
and condensing around them. Yet
maybe it is true in the deeper spiri- Despite his recent second retire- a small town are
tual sense. You can hold hands, ment from his teaching position
but at the end of the day, only at the University of Nebraska carefully assembled,
one of you is gone, so it can’t be
a completely shared experience.
and as editor of his syndicated
newspaper column, “American the reader discovers
There is inherent loneliness in dying
Life in Poetry,” he continues to
write daily. His 15th book of
that the scene has
but that can be partly mitigated. As
Woody Allen said, “It’s not death I
poetry, “Red Stilts,” demonstrates been conjured
that poets, like fine wines, con-
fear. It’s the dying.” Gawande did
a masterful job explaining how we
tinue to improve with age. entirely from the
dread the loss of dignity, of control, Poetry, perhaps more than poet’s nostalgia for
of no longer being the author of our any type of written communica-
own narrative — that’s all worth fear- tion, relies upon that invisible an imaginary time.
ing. But much can be done to address bond formed between author and
this. And having read the book, I audience. The emotions evoked
think I’ll do a better job talking to by the poet in each reader are An old man’s mind, as this
my seriously ill patients. I’ll stop to unique and result in a shared reviewer can verify, is able to
ask them what they hope for, what intimacy between the two. recreate vanished scenes with
they fear, and what their priorities a miraculous clarity. The foot-
are. These are the three key ques- Fittingly, this book begins with a prints left in the morning snow
tions for us to ask of them. And for letter from the poet to his readers. by a father seventy years ago will
us to ask our family members and, As the sights, sounds and ambi- remain untouched by the sunlight
most importantly, to ask ourselves. ance of a summer night in a small and a long gone, familiar Sherwin-
town are carefully assembled, the Williams signboard retains its
This is a good read for all, but reader discovers that the scene has brilliant red hue. Rummaging
especially for those who have fam- been conjured entirely from the through Kooser’s memories is like
ily approaching their last decade poet’s nostalgia for an imaginary visiting an antique store in which
and especially for physicians who time. Fortunately, as his childhood every corner yields a fresh delight.
may be called upon to help with footsteps fade into the night, he
difficult decisions. But it is also a leaves the hint of his future return. As one of the truly accessible
guide and comfort for ourselves. poets, Ted Kooser is the ideal com- 17You can also read
