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Young Ophthalmologists
Against All Odds: Lessons from Three Heroically Persistent Ophthalmologists
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Have you ever considered asking yourself, “What would keep me from practicing ophthalmology?” Take a moment to reflect on this. Very few would contest that obtaining a residency in ophthalmology is highly competitive, requiring approximately a decade of your time, and placing demands on your personal life.

In addition to excellent grades, superb board exam scores and influential letters of reference, there exists a prerequisite of good fortune in order to succeed. Now, introduce into this equation an international catastrophe spanning six years of active warfare and genocide preceded by decades of economic hardships, political imprisonment and forced migrations.

The devastation of World War II affected millions of individuals but cannot be fully appreciated simply by reviewing statistics. The Academy’s Museum of Vision was established in 1980, and aims to preserve and promote ophthalmic heritage through its interactive website. Of particular interest is “The Eyes of War” exhibit that presents the experiences of wartime ophthalmologists and how unexpected circumstances guided their careers.

By exploring these personal accounts, we can attempt to understand the struggles of an entire generation and how this contributed to our current practice of ophthalmology. (In fact, all of the mentioned ophthalmologists eventually became involved with the Academy.) As we read forward through these outstanding stories, let us ask ourselves, “At what cost would I become an ophthalmologist?”

How Airplane Canopy Injuries Inspired the IOL Inventor
From adversity springs innovation. This was evident in the case of Nicholas Harold Lloyd Ridley, MD, a British ophthalmologist who, in 1939, served in the Emergency Medical Service at Moorfields Eye Hospital. Dr. Ridley treated Royal Air Force (RAF) pilots, many of whom suffered eye injuries from airplane canopies, which were composed of polymethyl methacrylate (PMMA). Interestingly, Dr. Ridley observed that these PMMA fragments were relatively inert and did not show any foreign body rejection.

Before he could further pursue this, he was sent to serve in the Royal Army Medical Corp in Ghana, India, Burma and the Pacific Theater. In spite of these responsibilities, Dr. Ridley continued to push the envelope and investigated vision-threatening conditions of the developing world, including onchocerciasis and nutritional amblyopia. Upon return to London, he further investigated PMMA for use in cataract surgery and eventually developed the world’s first intraocular lens (IOL) – a groundbreaking milestone in the history of ophthalmology.

The Eye M.D. Who Had to Learn Chinese for His Studies
Discrimination and ethnic persecution were the central themes of World War II. In 1939, when Nazi Germany annexed Austria, Rudolf Bock, MD, was attending medical school in Vienna. Due to their partly Jewish ancestry, his family was subjected to the unjust “Final Solution” policies of the Third Reich, and rightly feared for their lives. Despite being only four exams away from graduating, Dr. Bock was forced to quit medical school, but his passion for medicine remained undeterred.

Detail of Rudolf Bock's revocation of Austrian citizenship
Detail of Rudolf Bock's revocation
of Austrian citizenship

After obtaining false travel documents, Dr. Bock fled Austria for Imperial Japan and continued applying to medical schools in the Far East. He was able to secure admission at Peiping (Beijing) Union Medical College in China. Despite the medium of instruction being Mandarin, Dr. Bock boldly faced the challenges of a new language and culture, completed medical school and began training in ophthalmology.

However, this was now December 1941 and, following the Pearl Harbor attacks, the war had expanded to the Pacific Theatre. The Japanese invasion of China resulted in Dr. Bock’s hospital being closed, and he supported himself by opening a small clinic in the Chinese countryside.

After the war ended, he returned to a different Europe, one where his community was destroyed and his life would never be the same. Rather than succumbing to the devastating reality of losing his family and spending many years abroad as a refugee, Dr. Bock remained determined to practice ophthalmology. He re-enrolled in medical school, completed multiple exams (some for the third time!), and, in 1951, immigrated to the United States to practice ophthalmology

One of the passports used by Dr. Schepens during the war
ID paper for Jacques Perot-Spengler, aka Charles
Schepens, 1942.

The Spy Who Fathered Modern Retinal Surgery
Can you list how many ophthalmologists have been awarded the French Legion of Honor? The career of Charles Schepens, MD, has been hallmarked with multiple accolades. He is credited as being the “the father of modern retinal surgery” and was chosen by the American Society of Cataract and Refractive Surgery as one of the most influential ophthalmologists of the 20th century.

Dr. Schepens, a native of Belgium, was a practicing ophthalmologist when German Panzer tanks invaded Belgium on May 10, 1940. Despite Belgian forces surrendering, the Resistance effort continued and Dr. Schepens allowed them to use his office to conduct meetings. However, his life was in danger and he secretly crossed the border into France.

In Paris, friends of Dr. Schepens helped him forge a new identity as “Jacques Perot-Spengler,” a local businessman, and he was able to contact other members of the Belgian Resistance in exile. During his time as an operative of the Belgian Resistance, Dr. Schepens helped hundreds of people and countless classified documents cross between France and Spain.

Unfortunately, on July 21, 1943, the German Gestapo found "Jacques Perot-Spengler," and Dr. Schepens fled to England where he was eventually reunited with his family. Following World War II, Dr. Schepens immigrated to the United States and established the World’s first retina service and vitreoretinal disease fellowship at the Massachusetts Eye and Ear Infirmary.

Their Lessons Learned
As I reflect upon these courageous tales of valor, I fondly recall an insightful quote that has provided me with motivation over the years: “He who knows only his own generation remains always a child.” With the advent of premium and toric IOLs, I wonder if Dr. Ridley ever imagined that his contributions would be paramount to future generations of cataract surgeons.

Dr. Bock faced harassment in the land of his birth, but was given the opportunity to continue his medical education in a foreign land. In my opinion, this is a beautiful example of unity amongst the international medical community. As young ophthalmologists, we should learn from this benevolence and strive to collaborate with our international colleagues.

Creativity is paramount in advancing research and design, and Dr. Schepens’ ability to create multiple roles for himself is admirable. Is it any wonder that his autobiography is titled The Surgeon and the Shepherd: Two Resistance Heroes in Vichy France?

Hence, as we proceed forward in our careers, let us willfully admire and be inspired by these great pioneers of ophthalmology. Lest we forget, their sacrifices both on and off the battlefield have gracefully bestowed upon us the privilege of providing our patients with the best possible quality of vision. Now let us ask ourselves, “How do we plan on contributing to the future of our noble profession?”

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Hemang Pandya, MDAbout the author: Hemang K. Pandya, MD, is a resident at the Kresge Eye Institute at Wayne State University, Detroit, Mich. His professional interests include health literacy, medical ethics and vitreoretinal research. In his spare time, he enjoys wildlife photography, snowboarding and visiting UNESCO World Heritage Sites.

 
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