ACADEMY TRADITION V. CHANGE

There is nothing unique about our Academy in this regard: human beings are resistant to change. Change forces us to abandon our “tried and true” ways and move into a new zone of uncertainty where the outcome appears to be unclear. Uncertainty makes us uncomfortable. There is the tendency for us to abandon the new initiative without giving it a fair trial and to retreat to our old familiar habits, even if they are less effective than the proposed change.

Nevertheless, it is clear that change is inevitable. This has been well documented since ancient time as Heraclitus in 513 B.C. observed, “There is nothing permanent except change.” We all recognize that our Academy must change in order to grow and remain relevant to our profession. So how do we reconcile this conflict between the certainty of change and our comfort with the status quo?
This reminds us of the old baseball adage: you can’t steal second base with your foot on first. Yet, we can’t be complacent with both feet safely placed on first base. We need to be comfortable taking a lead off first, be vigilant for any attempt to pick us off, and choose wisely and decisively on which pitch to attempt to steal second.

While being respectful of the culture and treasured traditions of our Academy and our profession, we must embrace change that moves our organization and profession forward. One clear example is the decision to move our annual meeting from the time-honored and traditional Academy dates in early or mid-December to the present October/November time frame. There has certainly been some downside to this change, such as the conflict with other local and regional meetings.

But as busy as things might have been for those of us who attended our meeting in Phoenix in October this year, just think how nice it has been to have the last two weekends at home as you and your family prepare for your holiday celebrations. No working on posters and courses over Thanksgiving. No pre-holiday fatigue from just having arrived home this last weekend. Furthermore, since this change was implemented six years ago, our Academy has had five of our most successful meetings. Undoubtedly, this decision has also afforded Happier Holidays for our Academy Fellows, staff, and our families.

Happy Holidays to all, and a very happy, healthy New Year!

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TEMPE THOUGHTS

On the Sunday morning following the Phoenix Academy Meeting, as many of you dashed to Sky Harbor Airport or discovered your stay in Phoenix was extended due to superstorm Sandy, I was strolling across the Mill Street Bridge in Tempe with Jack, Seth, Eric, Ben, Channing, Alexis, and their families, friends, co-workers, and acquaintances. Over 16,000 of us participated in the Arizona Walk for Autism Speaks raising $1.4 million to fight this disorder whose clinical presentation, social challenges, and research prospects were so eloquently summarized to us during our Plenary Session by Drs. Ricki Robinson and David Amaral.

Planes flying overhead caused my thoughts to drift to my Academy Fellows returning home after joining us for another successful meeting. This was our third largest meeting with over 3,000 optometrists and 5,000 total registrants. High quality courses, superb symposia outlining critical clinical thinking to improve patient care, thought provoking clinical case presentations and clinical studies in the poster sessions, papers providing new discoveries in clinical and vision science, and a robust exhibit hall are the essence of our meeting. All of you who contributed to the success of this meeting should be congratulated. Yet, the formal induction of 204 new Fellows of the Academy was the pinnacle of the event. At the banquet we welcomed them into our Fellowship along with their commitment to life long learning and expanding their knowledge to provide improved patient care.

When we turned for the return trip across Tempe Lake, my attention returned to those walking with me. The love and concern of friends, family, and neighbors was evident as all were united in this common case. As I walked with Kyla discussing the new school and program that her son started attending this year, it became clear that she and her husband were firmly dedicated to a long-term commitment to make the best life possible for their son. And while all parents strive to make a good life for their children, the added challenge of having a son with Autism Spectrum Disorder requires a constant and full commitment to that vision.

Then my thoughts and reflections drifted back to my Academy week. What is the level of our commitment to our Academy and our profession? Is it one of convenience that can be disrupted by the first sign of discomfort? Or is it a more robust commitment that can be sustained and enhanced by professional and personal challenges?
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OCTOBER 2012: LOST (AND FOUND) IN TRANSLATION

October is Breast Cancer Awareness Month, so you may have seen a lot of pink signs, t-shirts, and calls for participation and contributions in various venues around your community. I became more aware of the disease than ever last month.

I have invasive lobular carcinoma of the breast. I had my annual, routine mammogram on September 4th followed rapidly by digital mammography, ultrasound, and needle biopsy, was diagnosed September 18th, and had a partial mastectomy and sentinel lymph node biopsy on September 28. I will start either chemotherapy or radiation as soon as I get home from the Academy meeting. Either way, radiation and many years of aromatase inhibitor treatment are on the docket for sure.

I am experiencing the full force of translational research, or what we at the Academy have “visioned” as “Today’s Research, Tomorrow’s Practice” for many years, albeit it in oncology instead of optometry. When my surgical oncologist says, “The 20-year results for lumpectomy and radiation are the same as for mastectomy,” all I can see is someone presenting a survival analysis from a randomized clinical trial or case-control study at a national conference and the hundreds of women who were in that study. When I hear, “Your tumor will be sent for genotyping to help us make the chemotherapy decision,” I envision bench scientists toiling late into the night and on weekends to gather results, write papers, receive grants, and translate their results into the very real life preserver and treatment opportunity I am being offered. My medical oncologist is a true clinician-scientist with a basic science laboratory and an active clinical practice; he probably received the equivalent of an Ezell Fellowship from his professional organization way back when.

When breast cancer survivors on Facebook know their tumors’ estrogen, progesterone, and HER2neu receptor status, it means that doctors have spent countless hours educating their patients about the structure and function of cell receptors and the latest therapies to combat those cells’ growth.

It’s the same in optometry. Maybe the stakes are lower for us compared to oncology, or maybe not, at the end of the day. Patients deeply fear blindness.

Next week in Phoenix, you will stroll through the Exhibit Hall, trying out the latest equipment and comparing new devices across manufacturers. You will take notes furiously during a paper or poster or lecture on a topic that directly affects a patient you saw last week and resolve to call her to update her care when you get home from the Academy meeting. You will listen, rapt, while a colleague in the hallway relates his recent clinical experience before providing your own insights on his patient. You will translate today’s research into tomorrow’s practice, in some way, as soon as you get home.

Now that I’m a bit over the initial shock of diagnosis and surgery, I am doing okay and will welcome your words of support in Phoenix, even as I offer my own to Fellows who have been through this themselves. I just got cleared to resume regular activities postoperatively. I took a beginning watercolor class this weekend. I successfully rode a 25-mile breast cancer awareness bicycle ride Saturday, and I am following my doctors’ recommendations (including, “Don’t fall off your bike”) and living my life with my customary cynicism, joy, negative-energy-you-can-feed-off, sleeplessness, and love.

It has been an unparalleled honor to serve these past two years as the President of your Academy. I wish incoming President, and dear friend, Bernie Dolan, all the best.

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A NEED TO KNOW BASIS

Students have been on my mind lately. I've made school visits to the Illinois College of Optometry, am visiting the School of Optometry at Inter-American University tomorrow, and head to the Indiana University School of Optometry in mid-September. I've had the good fortune to go to Pacific University, SUNY, and the University of Houston during my term as Academy president, and, of course, I work with Ohio State's optometry students every day. These interactions always energize me. Regardless of institution, the students are excited about optometry, overflowing with information and ideas, and seem to have newly discovered our Academy.

Our optometric institutions are our profession’s lifeblood, our future, even our destiny. We all became optometrists at one of them, and they are different in many respects but bond us with their similarities, too.

Recently, I was at a brown bag lunch organized by Fellow and Faculty-Student Liaison Committee Chair, Jeff Walline, for six Ohio State students who competed for and have completed a research rotation, through a grant from the National Eye Institute. Several other US optometric institutions host the same program. The lunch was attended by Fellows (and optometrists/faculty members) Andy Hartwick, Dean VanNasdale, and Don Mutti, too. The conversation turned to how each of the faculty members had decided on graduate school and a career in academia.

Andy related a colorful story that involved tent camping, a poster about the OD/MS program at the University of Waterloo, and undergraduate research observations on the mating habits of beetles. Dean recalled a random email about a retinal imaging training opportunity, and I decided that a PhD might be the best path for me, in part because I thought I might have some leadership chops. Don simply said, “I just needed to know stuff.”

I’ve been thinking about that ever since. Isn’t that why our Academy exists, when all is said and done? Optometrists become Fellows because they … need to know stuff. Students come to the Academy meeting because they… need to know stuff. The American Optometric Foundation (AOF) subsidizes residents, students, and faculty endeavors based on the applicants’ descriptions of their… need to know stuff. Scientists pursue research, conduct experiments, write grants, and publish papers because they…need to know stuff. Editor, Fellow, and Past President Tony Adams dedicates himself to Optometry and Vision Science every month because his readers… need to know stuff.

Our American Academy of Optometry, its Annual Meeting, its journal, and its academic charity all continue to thrive because the optometric profession needs to know stuff to satisfy our innate curiosity about the eye and visual system so that we can take better care of our patients. Come join us. If you’re a candidate, finish up the Fellowship requirements. If you’re a student member, become a Student Fellow. If you’re a scientist non-member (or you know one), take advantage of the free non-member scientist registration opportunity in Phoenix this year by contacting Fellow Shaban Demirel, Chair of the Vision Science Section. If you’re a Fellow, pick a Special Interest Group and become active or find a Section and start that Diplomate process. If you’ve never donated to the AOF to support a young person’s need to know, do so now. Read and/or contribute OVS.

Lastly, this year in Phoenix, there’s a unique opportunity to celebrate the life of one of us who needed to know stuff, every day. Come to this year’s Borish Festschrift, featuring Borish award winners and Borish Ezell fellows, on Saturday, October 27, in Room 122 A-C of the Phoenix Convention Center. Irv would love to know you’re there.

P.S. I thought you might like to know. I biked a 160-mile charity ride, the Pan Massachusetts Challenge, earlier this month. It’s the trip I’ve made every year since 2005, but I suffered a concussion riding it in 2011. I finished the event this year, in record time for me, without visiting the emergency department at Cape Cod Community Hospital.

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WISHING WELL

The House of Delegates at the American Optometric Association’s (AOA) meeting in Chicago in July saw the induction of Ronald L. Hopping, OD, MPH, FAAO, as President of the AOA, accompanied by First Lady Desiree T. Hopping, OD, FAAO. As everyone well knows, he followed in the footsteps of his father, Richard Hopping, OD, FAAO, a past-president of the AOA, to create the first parent-child AOA presidential pairing. Our own Academy can also lay special claim to Dr. Ron. In addition to being a Fellow, he is a Diplomate in the Section on Cornea, Contact Lenses & Refractive Technologies, an achievement of which he is rightfully proud. We are at least that proud of him. Congratulations, Ron!

Following a rousing inaugural parade into the House for Ron that included Texas music and flags and a lot of rompin’, stompin’ cowboy boots, Ron delivered an inspirational speech. In it, he promoted the importance of a vital, healthy, actively-advocating-on-behalf-of-our-profession American Optometric Association. He told the assembled audience that they “drink from wells they did not dig,” while exhorting them to help maintain our profession’s healthy advocate.

Wow, I thought, what a lovely turn of phrase. Did Ron write that? If I’d asked him, I know he would have said, “No, you idiot.” A quick look at the Google Machine yielded this reference, from Deuteronomy 6:11. I love the poetry of the American King James Bible (always have, from childhood), which goes like this, “And houses full of all good things, which you filled not, and wells dug, which you dug not, vineyards and olive trees, which you planted not; when you shall have eaten and be full.

In our lives, we all drink from wells we did not dig, both personally and professionally. (Naturally, there are holes we’ve dug ourselves into, but that’s a story for another day.) Our own Academy house is beautiful and well stocked with good things. Your AAO housekeepers, in the form of valued staff and dedicated volunteers, including the hardest working Board of Directors in show business, are busy planning the Annual Meeting in Phoenix where you will all eat olives and drink wine and intellectually fulfill yourselves. Come join us, AOA President Ron Hopping and his Board of Trustees, and 5,000+ of your closest friends at Academy 2012 Phoenix.

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BURNING MAN

If the timing of these monthly columns seems irregular (early in the month one time, “just under the wire” other times), it’s because I truly wait for inspiration before I write. This month it was getting late in the game, so I hoped my recent travels—to Los Angeles, Reno, and Chicago—might provide the spark of an idea. As I left Columbus early last Thursday, I overheard a conversation between a 7-year-old girl and her slightly older brother. They were debating whether the fluid a plane was discharging was fuel or water. The self-assured girl asserted, “I know it’s gasoline because I can smell it. I have a very good smelling technique.” Cute story but no possible Academy analogy, and, although surprising my daughter later that day in Los Angeles for her 27th birthday was fun, it didn’t really supply any Academy “ah ha!” moment either.

I then advanced (as opposed to going on a “retreat” or “retreating”) to Verdi, Nevada with Optometry and Vision Science (OVS) Managing Editor, Kurt Zadnik, and Fellow/Past Academy President/Past AOF President/Current Editor of OVS Tony Adams. In between strategizing about our journal, we visited a construction site where Tony’s son, Lindsay Adams, is part of a team that is building a life-sized shipwreck for what he called Burning Man.

Burning Man began in 1986 and is now an annual, week-long event that occurs just before Labor Day in the Nevada desert. It clearly occupies the region, as we were in an antique shop on Saturday where the proprietress pointed out a tie-dyed dress, whispering that “it would be perfect to wear to Burning Man.” Poor Lindsay, as he had to put up with my interrogation at dinner that night, along the lines of “What exactly is Burning Man?” It’s described officially as “part of an experimental community [that] challenges its members to express themselves and rely on themselves to a degree that is not normally encountered in one's day-to-day life. The result of this experiment is Black Rock City, home to the Burning Man event.” Further, “Burning Man is a kind of Petri dish. Theme camps cling in fertile clusters to its latticework of streets, artworks tumble out of it, like pollen on the air. These nodes of interaction mutate, grow, and reproduce their kind, only to effervesce and spread across five continents.” Some of Burning Man’s guiding principles are radical inclusion; gifting; radical self-expression; communal effort; participation; and immediacy (as in “No idea can substitute for this experience.”) Lindsay embellished that website definition with descriptions of a five-mile radius, well-mapped city in the desert where 50,000 people pay an average of $400 per ticket and live for a week, relying on non-motorized vehicles for transportation. No money is exchanged at Burning Man, but bartering is endorsed and encouraged. He said outsiders have stereotyped the event as hippie-ish but asserted that the only thing in excess in Black Rock City is hugging.

So, how does this relate to our Academy? We form an annual, transient community too, for the better part of a week. This year it’s even in the desert! We don’t call it “Academy City”, but we could. We gift in the form of buying each other dinners and drinks, and we bestow the gifts of our knowledge and experience. We park our cars at our home airports and take taxicabs instead of riding bicycles. We hug—a lot—both physically and intellectually. We embrace: inclusion, sitting side-by-side with optometry students; self-expression in our scientific presentations, lectures, and symposia; communal effort in our extensive volunteer structure; and a deeply-held belief that our reach is international and that nothing substitutes for the immediacy of the professional and personal experience of our Academy’s Annual Meeting. You won’t get it by reading about it. You have to be there. As I imagine the Burning Man participants at the end of an exhausting, hot, dehydrating, energizing, enriching week, we too leave our Academy’s Annual Meeting each year recharged and, across the years, fundamentally changed as optometrists, vision scientists, and human beings.

To register for Academy Phoenix 2012, head to the registration webpage.

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TRY SOMETHING NEW

I apologize for how late in the month you're receiving this installment, but I spent the second half of the month on the longest real vacation of my life in Italy and France. I know what you're thinking, "I'm glad she got to do that, but how will she relate that experience this month to our Academy?"

The experience has reminded me, fondly, of the international meetings of the 1990s and 2000s, but that's not the connection I'm proposing. Instead, it's Try Something New. Kurt (Zadnik, managing Editor of Optometry and Vision Science since 1996) and I traveled with old friends (well, ones we've known a long time, not nonagenarians) who planned the trip. All four of us have had to be willing to Try Something New. I'm not much of a sightseer, but Michangelo's David in the Florence Accademia changed how I think about museums, forever. Our friends don't much like feeling like tourists, so taking a goofy pizza making class was a (fun) stretch for them.

As you make your plans for Academy Phoenix 2012, think about stretching yourself. If you always attend glaucoma lectures, for example, think about hitting the glaucoma posters in the Scientific Program too. If you never miss a certain speaker's annual lecture on keratoconus but realize you could tell all his anecdotes because you've heard it so often, try a new, young speaker on a similar topic. If you avoid binocular vision-related sessions of every variety because you just never liked the topic in optometry school, dip your toes in the waters of the Binocular Vision, Pediatric, and Perceptual Optometry's symposium. Branch out. Try Something New.

There's one problem with my proposal. Adult learners want to master a new skill quickly. We want to know everything the teacher knows in an hour or two. We have a hard time giving anything novel a chance. I read something recently that posited that a real expert spends most of her time trying to master a new skill rather than practicing one already mastered (or is that "mistressed"?)

As we moved from Italy to France last week, I got it into my head that I was going to start a watercolor travelogue of little pictures or images from our trek. The obsessive search for materials began. I bought pencils, an eraser, and marker in Florence. I gestured in vain at a "peints" sign outside a shop at the foot of Mont Ventoux in France. We tried to find a shop near Avignon in Provence that a local described. Finally, in a grocery store, I bought a child's paint set, much to the relief of my traveling companions who were tired of hearing me whine. I sat out on the patio of our lodging in Tavel and sketched and painted a little wine glass filled with the local rose, a local wine label logo, and a tiny bunch of grapes that were imprinted on a cork left on the table. (Go to the Academy's Facebook page now to view my effort.

See? They're amateurish. I have to keep trying and practice. They're not the Sistine Chapel, but I did Try Something New.

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