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  • Michael J. Hogan, MD: 1907-1976

    In a life filled with many accomplishments, two by Dr. Michael J. Hogan stand out as major contributions to the field of ophthalmology.

    Along with a few other department chairs at the time, Mike Hogan emphasized the concept that ophthalmic management should be based on a thorough knowledge of pathology. Among a small cadre of full-time academic ophthalmologists, he helped develop the modern concept of an ophthalmology department with both a strong basic science component and excellence in clinical training and care.

    Dr. Hogan was born in Kemmerer, Wyo. in 1907 and grew up in Wyoming and Utah. He received a bachelor's degree in 1930 from the University of Utah, where he was an athlete on the swim team. After earning a medical degree from Cornell University in 1932 and following his residency in general surgery at Bellevue Hospital in New York City in 1935, he entered a general practice in San Diego. There he met his future wife, Vera Merrill, whose father was an ophthalmologist and who inspired Mike to enter an ophthalmology residency program chaired by Dr. Frederick Cordes at the University of California San Francisco.

    Following fellowships at the Illinois Eye and Ear Infirmary in Chicago (1940-41) and Columbia University's Institute of Ophthalmology in New York City (1941), he returned to California to private practice and a clinical instructor position at the University of California San Francisco.

    From 1943 to 1946, he served in the Navy as a lieutenant commander. Subsequently he was awarded the first full-time academic appointment in the Department of Ophthalmology at UCSF. Dr. Cordes, the first chair of the department, had supported himself through his private practice and received just $1 a year for his service in organizing and running the department.

    Dr. Hogan became the first director of the Francis I. Proctor Foundation, an independently funded research section of the ophthalmology department and became interested in uveitis and particularly toxoplasmosis, publishing numerous articles related to ocular inflammation. One was a classic article on toxoplasmosis, which became the subject of his American Ophthalmological Society thesis. He served from 1947 to 1959.

    At UCSF, he was one of the founders of the uveitis survey clinic, which compiled data on the history, physical findings and laboratory investigations of more than 5,000 patients with uveitis. Free of any charges, he solicited eyes from anywhere in the world for microscopic examination, including postmortem eyes and eyes enucleated because of complications from uveitis.

    These uveitis patient survey clinic study data contributed to a better understanding of ocular inflammation and incidentally revealed that several eyes that had been treated for uveitis actually also had harbored retinoblastomas or other intraocular tumors. In 1967and 1968, he spent a sabbatical year in Rome, studying uveitis and especially Behcet’s disease.

    Dr. Hogan’ primary interest in academic ophthalmology was the discipline of ocular pathology and oncology. He had started the eye pathology laboratory at UCSF and was its director from 1946 to 1959. Then, in 1959, he succeeded Dr. Cordes as the chair of the Department of Ophthalmology, a position he held until 1975.

    Although not a founder of the Verhoeff Society, (now the Verhoeff-Zimmerman Society), which was founded in 1945 by T. E. Sanders, John McLean and Benjamin Rones, he was one of its earliest and most influential members. He made sure that all of his former students and colleagues who had an interest in eye pathology became members of this leading and oldest ocular pathology society. These colleagues included Levon Garron, William Spencer, Edward Howes and J. Brooks Crawford.

    Dr. Hogan was one of the early adopters of the electron microscope for the study of eye pathology. He and one of his electron microscope technicians, George Alvarado, and Joan Weddell, a talented medical illustrator, published a book, “Histology of the Human Eye” in 1971, which became a classic. Subsequently, Dr. Alvarado went to medical school, became a resident in ophthalmology under Dr. Hogan and then became a prominent and internationally famous glaucoma specialist in the Department of Ophthalmology at UCSF.

    Drs. Hogan and Lorenz Zimmerman expanded and edited the second edition of "Ocular Pathology," which was essentially a new textbook rather than just a new edition. Dr. Zimmerman lived with Dr. Hogan in Mill Valley while they worked on this project. At the time, and for many years, theirs was the most important and influential book on the subject of ocular pathology.

    In 1953, Dr. Hogan became one of the first to recognize the benign nature of an optic disc melanocytoma, tumors which were not named nor described until 1962 by Drs. Garron and Zimmerman. He was also one of the first to treat primary ocular melanosis with local excision rather than exenteration, the conventional treatment at the time. Dr. Brooks Crawford conducted an extensive follow up of these patients for his AOS thesis and Dr. Devron Char, one of Dr. Hogan’s former residents who became an emminent ocular oncologist, continued the care of these patients after Dr. Hogan's death.

    During World War II, then-new and expanding shipyards in the region of San Francisco were building liberty ships – transport ships – for the war effort and hired many workers with little or no previous training in welding. The yards operated 24 hours a day, and welders shared goggles and masks with those who worked on previous shifts, leading to an epidemic of keratoconjunctivitis (EKC).

    Patients were seen by Joseph W. Crawford, who was an ophthalmology consultant for Bethlehem Steel. Dr. Hogan evaluated the patients at the Proctor Foundation. He and Dr. Crawford published an article, which was reproduced later as a "landmark article" in the August 2018 edition of American Journal of Ophthalmology. Dr. Crawford used some of this material for his AOS thesis. Thus, Dr. Hogan directly or indirectly contributed to the AOS theses for both a father (Joseph W. Crawford) and son (J. Brooks Crawford).

    Dr. Hogan was a member of the American Medical Association Board of Trustees and on the Board of Directors of the American Board of Ophthalmology, the Association for Research in Ophthalmology, the Heed Ophthalmic Foundation and the National Society for the Prevention of Blindness. He was president of the Northern California Society to Prevent Blindness.

    He was a member of the American Ophthalmological Society and a recipient of their highest award, the Howe medal. He also received the Proctor Gold Medal, the Knapp Prize, The Bowman Medal and the Outstanding Civilian Service Medal from the Surgeon General. He was a gifted, articulate and prolific writer and served on the editorial boards of The American Journal of Ophthalmology, Investigative Ophthalmology, and the Archives of Ophthalmology (now JAMA Ophthalmology).

    The American Journal of Ophthalmology dedicated a special issue to him in 1975. As might be expected of an ophthalmic pathologist, clinician and oncologist, his extensive list of publications included inflammatory conditions, anatomy and tumors of all parts of the eye and orbit.

    As chair of the Department of Ophthalmology at UCSF, he nourished his residents with knowledge, enthusiasm, compassion, humor and a special interest in their family lives and well-being. Every year he and his devoted and gracious wife, Vera, would invite residents to his home for a barbecue, hiking on Mount Tamalpais and swimming in his pool. He was easy-going, tolerant and never in my experience showed anger or frustration. His friends and colleagues called him "Uncle Mike." To relax, he loved to watch B westerns (cowboys, Indians and outlaws), quite a contrast from his broad cultural, intellectual and academic pursuits.

    The author is indebted to Fraser Muirhead, MD, and Devron Char, MD, for suggestions about this article and to the obituary written by G. Richard O'Connor, MD, for many of the facts about Dr. Hogan's life.