EyeNet Magazine

History Can Teach but Will We Learn?
By Richard P. Mills, MD, MPH, Chief Medical Editor, EyeNet

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When one of my daughters was a tween, I took her with me on a business trip to Japan. One day, we visited the war memorial in Hiroshima, together with about a thousand Japanese, many of them schoolchildren. In Japan, a visit here is part of the school curriculum, and many classes travel long distances on trains and buses to attend. I must confess I was feeling angst that my countrymen had dropped the A-bomb here. I was also worried that animosity toward us, the only Caucasians in the building, would be palpable. On the contrary, we were greeted warmly. The children and their teachers explained that the purpose of their visit to the memorial was to learn the horrors that ensue from war, and each student would carry that memory forward to ensure that such a thing could never happen again. Not a single exhibit attempted to vilify the American perpetrators of the atomic bombing. It wasn’t about who did it; it was about what circumstances led to it.

A similar lesson of history is taught at the sites of the Holocaust, and at Holocaust museums in many countries. The lesson is not to be wary of a strong Germany, nor for Germans to feel guilt for those who died in the gas chambers, nor for the rest of us to feel excessive shame for our predecessors. The take-home message is that people should strive to ensure that such horrors never recur. Genocide still occurs in some parts of the world, but hopefully the ongoing awareness of the Holocaust is helping to reduce its prevalence.

On a much smaller scale, there are history lessons in ophthalmology. Some of them are hidden from our view in sealed records of courts, of medical disciplinary boards, and of the Academy’s Ethics Committee. It’s hard to learn a lesson if all you get to hear is the conclusion that Dr. X did something wrong and was disciplined for it. But occasionally a remarkably complete record of a series of events offers an opportunity to learn a lesson from history. Such a saga is told in a new book Waking Up Blind1 that appeared late last year, written by Atlanta ophthalmologist Tom Harbin, MD. For an ophthalmologist, it’s a gripping read, and one I found hard to put down. It chronicles two decades of events, from 1976 to 1997, within and around the department of ophthalmology at Emory University. While the book uses the real names of the participants, most of whom I know, I found myself focusing elsewhere than on their personal weaknesses, strengths and personalities. For me, the lesson is that the culture of quality improvement to which we all aspire as individuals and as institutions is so easily subverted by an alternative culture of silence, cover-up and deceit. In such a culture, and in this book, there are no winners and losers; no participant emerges as a hero.

I debated to myself for a while about whether to let sleeping dogs lie; many of the people named in the book have rebounded to successful careers elsewhere. Many also carry some personal scars. I do apologize if my mention of Dr. Harbin’s book in this column causes them additional angst. But like a German attending the Holocaust Museum and my daughter and I at the Hiroshima War Memorial, a little extra angst for them is a small price to pay for a history lesson learned well by the rest of us.

1 Harbin, T. Waking Up Blind: Lawsuits Over Eye Surgery (Minneapolis: Langdon Street Press, 2009).


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