A mid-career switch to ophthalmology is worthwhile

Bruce Springsteen, Shaquille O'Neal, and I grew up in New Jersey. Bruce played at a dance at my high school (obviously this was before he made it big). The three of us eventually moved on to California; then Shaq and I recently returned to the East coast. We don't really keep in touch.

While growing up in New Jersey, I had a friend, "Joe." Recently I thought about Joe after attending an event for ophthalmology department chairmen from around the country.

These are sometimes somber events, where we discuss and sometimes lament issues like declining reimbursement, dean's taxes, etc. Many department chairmen are worrywarts, concerned about their faculty and staff and about making payroll.

The other chairmen at my table were angry about this, with one chairman accusing the speaker of not caring about the scientists whose careers would be "ruined" by the funding limitation.

Why the funding rates are dropping is its own story, but my basic point is that department chairmen spend a fair amount of time worrying, feeling that no one understands or cares about the challenges faced by academic departments, and not wanting to let their people down.

Possibly many of you who run large practices have a similar experience, as you worry about making payroll and providing for your families.

Sometimes it is easy to get discouraged, or even a little angry. And that is when I think about "Joe."

Joe was a friendly, bright, and athletic guy, who attended a prestigious East coast university (let's call it "Yale"). After college, Joe went to work on Wall Street and married a beautiful, kind woman (let's call her "Peg"), while my career path took me to medical school, internship, etc.

One day, during my residency, Joe came down to Baltimore and we went out for crabs and beer. Joe mentioned that his division had done well the past year, resulting in a year-end bonus that exceeded, by a factor of 10, my annual salary as a resident! After I told him how happy I was that he was doing so well, he told me that he was envious of me.

His career "was all about money," he said, while mine "was all about helping people." He was pondering giving it up and going to medical school. In the frank and open style of communication that endears me to so many, I told Joe that he was "a stupid idiot."

A few years later, Joe calls and tells me that he is accepted at Penn State medical school! Now with a few kids, and well on his way to accumulating great wealth on Wall Street, Joe throws it all away to start a new career in medicine as a tuition-paying medical student. Peggy is 100% supportive.

After considering a career as an orthopedic surgeon, Joe chooses a residency in ophthalmology. Today he is now in practice, and is happy, content, and glad to be helping his patients.

Sometimes I fall into the trap of focusing on problems, threats, obstacles, my residents, and things I think are "unfair." People tell me it was a mistake to go into medicine, or into ophthalmology. They say that there's a lot more money to be made in business by bright, hard-working people.

Having friends like Joe helps me remember why, in fact, I'm an awfully lucky person to be an ophthalmologist. I hope you have a pal or two like Joe, and still appreciate how we ophthalmologists can help people every day.

Note to Joe: Let me know when you are coming to Baltimore. We will get some crabs and beer. Shaq and Bruce-you guys would be welcome to join us.

Peter J. McDonnell, MD is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of Ophthalmology Times. He can be reached at 727 Maumenee Building, 600 North Wolfe St., Baltimore, MD 21287-9278. Phone: 443/287-1511 Fax: 443/287-1514 E-mail: pmcdonn1@jhmi.edu
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