Saturday, March 14, 2015

The early steps I become an eye doctor

Plenty of people around me wear glasses. Both my parents are myopic, as are all my siblings. (Interestingly, none of my 4 grandparents were myopic, but this is a topic for another day) I'm not sure, but perhaps this constant reminder of our bodily imperfections was the beginning of an interest in the eye and vision.

My paternal grandmother had cataract surgery back in the 60s, and in those days the norm was large incision ICCE followed by thick aphakic glasses. I was always amazed that she could see through those glasses, which looked pretty much like the magnifying glasses we played with to focus light and make small burns with sunlight. Sadly, in her later years, her vision dimmed as her corneas became swollen from aphakic bullous keratopathy.

However, I hadn't exactly set my mind on ophthalmology at the time I set off to Melbourne for medical school. My eventual career goal was actually quite fuzzy at the time, and medicine was relatively reassuring as a stable career which I was familiar with through my father's occupation. I knew it could be a very satisfying job as well.

Where I stayed-49, Haines Street, North Melbourne. It was a 15 minute walk to the medical faculty at Melbourne University

As a medical student, I initially found it quite discouraging to study ophthalmology. We had all of 2 weeks attached to an eye unit. When the doctors looked at the eye, we could not usually see what they were looking at. And they were not very interested to show us how to use the instruments.

slit lamp microscope
How does the doctor focus the slit lamp microscope??-One of the many mysteries I faced while watching eye doctors at work as a medical student...

John Llewellyn Colvin
John Colvin, Ophthalmology teacher extraordinaire
In my clinical years I heard about John Colvin's lectures on Saturday mornings, and started attending them, if only to ensure that I had a basic competency in ophthalmology when I graduated. I was grateful for his handouts, and for making a pretty mysterious subject understandable. I was also fascinated by his aviation anecdotes, and he kept us awake by the use of the bugle and gong. It was a highlight of my medical school years.

By my final year of medical school I started to seriously entertain thoughts of specialising in ophthalmology as a career. My father was pretty encouraging in this respect as well. Studying for and winning the RANZCO Ophthalmology prize for Victoria in my final year of medical school more or less sealed my decision to embark on this as a career.

Most people would prefer staying in one place for their career, however, I became a bit of a nomad after graduating from Melbourne University in 1997. Medical school was followed by House Officer posts in Stoke-on-Trent and Glasgow, the United Kingdom. While in Glasgow, I started applying for and going to interviews for Senior House Officer (SHO) posts in ophthalmology. I got an offer from Northampton, which resulted in an overnight drive from Glasgow to Northampton at the end of February 1998. Along the way, I dropped my wife off at St Mary's Hospital in Manchester, where she had obtained a job in obstetrics and gynaecology. Yes, we made our minds up pretty quickly about our areas of specialization!

It was one long night's driving for me, with the sum total of our possessions packed in the car boot

At Northampton, I was introduced to Mr Pierre Hein, who took me through my first ECCEs (extracapsular cataract extractions-punctuated by cigar and coffee breaks in between cases, when sagely advice would be given), and Mr Ian Fearnley, who introduced me to phacoemulsification cataract surgery. Mr Atkinson had a 'photo clinic', where cases with prominent clinical features were present and we, the junior doctors were given grillings...

There were moments of excitement unrelated to ophthalmology too-Michael Schumacher broke both his legs at Silverstone that year (1999) when his F1 car speared into the barriers. He was airlifted to where else but...Northampton General Hospital! Sadly, I was not able to penetrate the barriers to have a good chat with him-it was one of the rare occasions where I thought of doing orthopaedic surgery instead...

The nomadic lifestyle continued, with interesting sojourns to Windsor (watching Concorde fly overhead was a truly earsplitting experience), followed by the major part of my Basic Specialist Training at Manchester Royal Eye Hospital.

But finally, with the impending birth of our eldest daughter, we sought to return to Singapore, where we had my in-laws to help take care of the baby, and easier access to domestic help.


  1. Hi, Just to let you know, Pierre died recently.
    Best wishes, James Kirwan...if you are in Singapore you will know several of my colleagues...

    1. Hi Jim, thanks very much for letting me know. I'll always remember Pierre, even though I was only at Northampton for the 6 months. I'm currently in private practice in Singapore, and yes, I think I know most of the eye people of our vintage or older. I found I couldn't keep up with the younger ones after leaving institutional practice though...