What you leave behind is not what is engraved in stone, but what is woven into the lives of others.
— Pericles, Greek statesman (c. 469 – 429 BCE)
Charles L. Schepens, MD, was a very special man who was molded by his times, yet simultaneously shaped them.
By dint of the way he lived, Dr. Schepens exemplified leadership and heroism during a very dark period in the history of the world, traits which he manifested repeatedly later in life to markedly improve our field of ophthalmology. We can all marvel at the history he created through the power of his life1 and his story should serve as inspiration.
Born in 1912 just 30 km from the French border in Mouscron, Belgium, Dr. Schepens was the youngest of six children. He was ostensibly destined for a career in medicine, as his father was a family practitioner who died when Dr. Schepens was only 7. His three older brothers became physicians, and his two sisters were nurses. Interestingly, his first passion was mathematics, likely influenced by Jesuit teachers at Notre Dame de la Paix boarding school in Namur, Belgium. Nonetheless, he pursued medical studies at the University of Ghent, and after a student fellowship in the world-renowned Institute of Pharmacodynamics, headed by Nobel Prize winner Corneille Heymans, he graduated in 1936.
Charles Schepens married Marie-Germaine Van der Eecken, an accomplished artist known to all as “Cette” (Figures 1 & 2). Dr. Schepens chose the field of ophthalmology, although he carried with him a penchant for mathematics that was critical to some of his major contributions to medicine. Remarkably, these important developments in the history of ophthalmology might never have happened, were it not for the extraordinary ways in which Dr. Schepens responded to the events of a horrifying time in the world.
Dr. Schepens began ophthalmology training in Brussels under Léon Hambresin, MD. While working at the prestigious Eye Institute of Professor H. Weve in Utrecht, Holland, his training was interrupted in 1940 by the sudden and unexpected German invasion, a violation of Belgium’s neutrality. A member of the medical corps of the Belgian Air Force, Dr. Schepens’ heroism during the war has been well-chronicled,2 but is worthy of brief consideration.
When the Air Corps was disbanded, he joined the Resistance, fighting the Nazi German occupation. For two years his medical office in Brussels functioned as a mail drop for the transfer of secret documents. After two arrests by the Gestapo and alerted to another, he escaped to France where he took the pseudonym Jacques Perot and acquired an abandoned sawmill in Mendive, located in France’s South Pyrénée mountains. Dr. Schepens not only transformed the mill into a viable business entity, but also a major conduit for the underground rescue of military and political personnel, as well as enabling other activities of the resistance to Nazi German occupation. Resolute to overcome hardship and prevail over the enemy invaders, Dr. Schepens became successful in this new endeavor.
When France (rather belatedly) acknowledged these achievements near the end of his life, Dr. Schepens at age 94 was awarded la Légion d’Honneur. It is the highest French order of merit (both military and civil), established in 1802 by Napoleon Bonaparte. In a 2004 interview for the Boston Globe, Dr. Schepens reflected that “It was a wonderful life, you know,” referring to the time he spent in the French Pyrénées with his wife Cette and their two young children Claire and Luc. Indeed, despite the dangers, he might well have lived his entire life there had it not been for another major intrusion caused by the war. Nearly caught again by the German Gestapo in July 1943, Dr. Schepens fled to England. He took this forced move to resume his work as an ophthalmologist.
At Moorfield’s Eye Hospital in London, Schepens worked with Ida Mann and began his lifelong quest to improve the care of those afflicted with retinal disease. His initial major achievement, in 1945, was the development of the world’s first binocular indirect ophthalmoscope (Figure 3). There is a story, perhaps apocryphal, that the prototype was made from pieces of metal he found in the rubble of a German buzz bomb that had struck Moorfield’s. That prototype is currently housed in the Smithsonian National Museum of American History in Washington, D.C. (Figure 4).
But the prospects to continue this work in England were not good, and in his words, “There was nothing left in Belgium to go back to.” So in 1947 Schepens moved his family to Boston, where he was welcomed to the Howe Laboratory by David G. Cogan, MD. With the approval of E. B. Dunphy, MD, head of the Massachusetts Eye & Ear Infirmary, Dr. Schepens began what would ultimately become the world’s first retina service. In 2003, Dr. Schepens was heralded by his native Belgium when during an international symposium he received the key to the city, awarded by the mayor of Bruges and was inscribed in the city’s archive (Figure 5). In attendance were Professors Jean-Jacques DeLaey, Wallace Foulds, Gabriel Coscas, Peter Kroll and Ingrid Kreissig; Alice McPherson, MD; and other notable members of the international ophthalmic community (Figure 6).
Like so many immigrants to America, Dr. Schepens came with little but was determined to leave his mark. As the author of four books and 360 publications, recipient of every notable award bestowed upon an ophthalmologist, founder and first president of the Retina Society, Inaugural Laureate of the American Academy of Ophthalmology, and attainer of countless other achievements, it would seem that Dr. Schepens has indeed made every mark. His indirect ophthalmoscope is now used routinely throughout the world, and in France, it is referred to by many as “le Schepens.” It is laudable, however, that he appreciated and often recognized the contributions of those who went before him.
Dr. Schepens was always quick to credit Hermann von Helmholtz, Jules Gonin, Marc Amsler, Henricus Jacobus Marie Weve, Hermenegildo Arruga and others. His childhood friend Oleg Pomerantzeff, who fled the Russian revolution in 1910 to immigrate to Belgium, attended the same Jesuit boarding school in Namur, Belgium and became an engineer. In 1962, Dr. Schepens invited him to Boston, where he was instrumental in perfecting a newer version of a binocular indirect ophthalmoscope designed to utilize the center of the pupil to illuminate the fundus and capture reflected light from the peripheral pupil.
Dr. Schepens was also very proud of his relationships with the more than 200 fellows whom he trained, including notables such as Federico Grignolo from Genoa, Italy (his first fellow), Bob Brockhurst, Ed Norton, Harvey Lincoff, Bill Tasman, Alice McPherson, Ray Margherio, Morton Cox and many other renowned ophthalmologists. As a teacher of teachers, Dr. Schepens eventually taught indirect ophthalmoscopy and modern retinal surgery to everyone in the world. According to Harvey Lincoff, “Blindness from retinal detachment that was frequent before the emergence of Jules Gonin in 1929 has become rare since the emergence of Charles Schepens in 1950.” 3
The markedly improved success rates in retinal reattachment that were realized as a result of “le Schepens” and a series of other developments in Boston for retinal detachment surgery reaffirmed Dr. Schepens’ belief that better therapies can only be attained through improved basic science understanding of disease processes and, correspondingly, enhanced diagnostics aided by advances in technology. This conviction led to the creation of the Eye Research Institute of Retina Foundation, which has diversified, expanded and now bears his name. The Schepens Eye Research Institute at Harvard has been and will likely remain the largest independent institute for eye research in the world, a living legacy to the basic biomedical and clinical eye research Dr. Schepens thought so important.
Through this great institute, legions of American and international eye researchers and surgeons can trace their professional roots, either directly or indirectly via their teachers, to Dr. Schepens. He has been quoted as saying: “I am most satisfied that this type of work is not dying with me, thanks to the training program and the people who continue the tradition. I think it is wonderful to be proud of people who are younger than you and who will survive you and know that you had something to do with the fact that they are so successful, and the knowledge has been passed on.”
The personal attributes of courage and resolute determination that were forged during his days as a leader in the resistance to German occupation not only played a significant role in his paramount contributions to ophthalmology but were also evident in his approach to patients. Any of his fellows can attest to the incredible determination he displayed while painstakingly performing surgery for many hours, even in his later years. Indeed, Dr. Schepens was a tireless worker who saw adversity as a challenge to overcome. Though he demanded much from his colleagues and co-workers, he was even more demanding of himself. Apart from his daily swim in the waters of Nahant, north of Boston, Schepens had no major hobbies and remained primarily committed to the significance of his work. Cette, his wonderful wife of 69 years, spoke longingly of the time when “One day I’ll have him for me. Right now, he’s for the world.”
However, in his 95th year of life, Dr. Schepens was still working until just before his death. Thus, it would appear that Cette’s wishes were sadly never realized. But rest assured, madame, your sacrifice is appreciated on a daily basis by millions of grateful patients and their doctors throughout the entire world.
During his life, Dr. Schepens appeared outwardly as a simple, unassuming man. His demeanor concealed the great depths within, but to Dr. Schepens, cars were simply vehicles of transportation, not symbols of status. As his back increasingly caused him chronic pain, he left driving to Cette, who used a grey Chevrolet sedan for the daily commute between Nahant and Boston.
“A bed is a bed”, as he said, so he always stayed at the Holiday Inn, eschewing fancier accommodations. But in 1999, he was selected by his peers as one of the 10 Most Influential Ophthalmologists of the 20th Century for his innovations and inventions that have so greatly improved ophthalmology. The self-effacing grace and wry, whimsical way in which Dr. Schepens often confronted important events were perfectly embodied when Dr. Schepens was awarded the highest honor bestowed in American ophthalmology: the Laureate of the American Academy of Ophthalmology.
On June 24, 2006, a service was held at the Memorial Church of Harvard University in Cambridge, Mass., to honor Dr. Schepens. Though ostensibly the event was organized to commemorate his passing, it was, in truth, to honor his 94 years of vibrant life, for a great man’s death is made significant by the power of his life.
In the words of one attendee and former student, “[Dr.] Schepens had an unlimited amount of kinetic energy and seemed always focused, engaged, passionate, and driven. His logical thought processes, attention to detail, and formidable intellect are legendary. He was quite engaging, and never forgot anything about anyone he ever met. In his presence, you could feel the energy he radiated — the fire of so many things to do and questions to be answered. This energy was contagious and gave him the ability to inspire others with his passion and enthusiasm. He created in us a sense of the importance of the projects in which we were involved.” 4
Indeed, the many who follow in his footsteps (Figure 7) are a fitting legacy for the man who was molded by his times but was still able to shape them.
1. Sebag J: Charles L. Schepens – the power of his life. Graefe’s Arch Clin Exp Ophthalmol 244:771-2, 2006
2. Ostrum M: The Surgeon and the Shepherd. Bison Books, 2011 ISBN-109780803236417
3. Lincoff H: The evolution of retinal surgery – a personal story. Arch Ophthalmol 127(7):923-928, 2009
4. Abelson MB: A tribute to Charles L. Schepens, MD. Rev Ophthalmol June 13, 2006