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  • Pearls for My Younger Colleagues

    There are many things that we all learn from life, aka as the school of hard knocks. I hope that I am still learning!

    Having said that, I have a few things that I would like to share with my younger colleagues embarking on careers in ophthalmology. These things are not in order of importance; they are in the order that they occurred to me in writing this article.

    Marguerite B. McDonald, MD
    1. Your colleagues are not mind readers; tell them what you want and expect. You might think that it is obvious: everyone must surely know that you want to be president of this organization or be on that committee. They don’t. Numerous prestigious organizations are actually looking for interested participants and will be thrilled to hear of your interest. Many of your colleagues may innocently assume that you can’t possibly be interested in the extra responsibility because you have a sick spouse or three small children under the age of 6. They don’t know your story: Perhaps you have a family member who is helping you to care for your sick spouse or that your children have four youthful, healthy grandparents who are eager to help you or a dependable nanny. Remember, most people are so consumed with their own problems/issues, that they don’t actually spend time thinking about your interests, or your candidacy. In a polite but direct way, tell them what you would like.

    1. Learn golf. I surely wish that I had. It is still true that many deals go down on the golf course; MBA students are encouraged to learn to play golf, it is so important. Apparently, there is ample time during a round of golf to chat and get to know one’s partners. I am told that this sport is also a great way to determine one’s character: honesty, ability to deal with disappointment/embarrassment, ability to play by the rules, competitive spirit, graciousness, anger management, and other attributes. Alternatively, it could help to learn tennis since the same may be said about “chat time” and your colleagues’ ability to assess your character.

    2. Learn the basic conversation and “eye exam language” of a language spoken by local culturally distinct groups (Spanish, Yiddish, Italian, etc.). Without fluency in this language, you will spend countless hours trying to find a staff member who can translate for you, and each exam will take twice as long, as translation occurs in both directions. The act of translation also removes a bit of the doctor/patient interaction and bonding. Very important. ’Nuf said.

    3. Learn to suture with your needle holder and fixation forceps; do not ask for a pair of McPhersons. This is critical for cornea specialists, of course, who spend more time suturing than any other subspecialty. But it is of great help to any subspecialty since it takes much more time to ask for McPhersons and then tie the knot than to simply use the needle holder and fixation forceps to tie the knot. I estimate that it has saved me thousands of hours in the operating room because my fellowship director, Dr. Herb Kaufman, insisted that I learn to do this years ago.

    4. The worse the news you have to share, the closer you should sit to the patient. Even with the pandemic, I sit fairly close to patients and often touch their arms. I am even more physical with patients with whom I have bad news to share, i.e., I hold their hands, etc. Patients appreciate it so much; being “hands on” means a great deal to them.

    5. Wear a white lab coat. Studies have shown that patients have more faith in doctors of either gender who are wearing lab coats, but especially women, who still need all the help they can get to be taken seriously.

    6. Women: wear a pantsuit or slacks when you give a talk. Frequently, you will be seated on an elevated stage, with a head table that is not skirted. You will struggle to keep your skirt modestly in place, as the audience’s eyes are at the level of your perineum. You don’t need the added stress of this unfortunate situation. Also, use minimal bracelets, as they will clack and clang on the podium during your talk.

    7. Be kind and respectful to all your colleagues, even that co-resident who flunked the ophthalmology boards three times and required special permission to take them a fourth time. There are some people with school smarts, and some people with street smarts.

    8. A corollary to No. 8: Be kind and respectful to your junior colleagues, including medical students, residents, and fellows.

    9. If you give a talk, thank everyone who helped you with your talk. Be sure to cite — on the slides and from the podium — the authors of any data that you show. Nothing is more upsetting to an investigator than sitting in the audience while one’s data are shown, with no credit given (or worse, the wrong credit). That investigator will hold a grudge that can impact your career for decades to come.

    10. Learn how to be an effective lecturer. Every ophthalmologist will need to give the occasional talk. This skill also prepares one for interviews with the media, should the need arise.

    11. When you enter the exam lane, always introduce your staff member to your patients. Your staff member will appreciate the recognition as a professional, your patients will be more relaxed and comfortable, and you will get a better performance out of everyone.

    12. You are not invisible. People are watching you at all times when you are in public, and now they all have phones with cameras. Outrageous behavior will be documented and will spread like wildfire on social media, where it lives forever. But you knew that!

    13. When you don’t have any idea what to do or how to respond to a situation, do the kindest thing. There is always a kind, elegant, considerate option, even when the other party doesn’t deserve it. It strengthens character; others will notice it.