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Bascom Palmer Eye Institute 50th Anniversary Reunion & Scientific Meeting

1967 Residents at Bascom Palmer Eye Institute.

1967 Residents at Bascom Palmer Eye Institute.

John P. Shock, M.D., F 71

Fellow, 1971

How my BPEI training impacted my life.

John P. ShockOne of Dr. Norton’s greatest talents was his ability to clearly articulate his extraordinary vision and to inspire those around him to buy in and think outside the box. His uncanny ability to get the right people on the bus and in the right seats was a trademark of his genius. In fact, he invented “good to great” long before Jim Collins and his researchers put a label on it. The “great spirit in the sky” dropped a small but potent acorn on Miami in the late 50s from which sprung a mighty oak whose offspring have played a highly significant role in transforming ophthalmology worldwide.

Frankly, I cannot get enough of the stories about the Bascom Palmer’s evolution and how proud everyone is to have been associated with this great institution. Each of us has our own unique memories depending upon when we were there, but more importantly, most of us were permanently and substantially transformed for the better in one way or another.

I happened to be at the BPEI in its formative years when the Founders were causing the giant “flywheel” to spin with ever increasing momentum. It was early in 1970 that I became a retinal fellow and spent most of the next 12 months working with Ed Norton, Victor Curtin and Don Gass. Near the end of my fellowship I spent a few weeks each with Doug Anderson, Joel Glaser and Dick Forster. It was the first year on faculty for Joel and Dick, and we became friends shortly after I arrived. I had had substantial retinal surgical experience during my residency at Walter Reed where Froncie Gutman was attending as we were receiving casualties straight from the battlefield in Viet Nam. Since it was my goal to join the faculty of one of the Army’s ophthalmology training programs after I finished my fellowship, I was anxious to learn all I could while at the BPEI. I thought working with other faculty would be an opportunity of a lifetime, and it was! The “Big Three” willingly endorsed my unusual request for which I will always be grateful. What made this move easier was that there was an extra retinal fellow, and neither Doug, Joe, or Dick had clinical fellows at the time.

Prior to going to BPEI, I performed my residency at Walter Reed Army Medical Center after attending West Point as an undergraduate and Duke Medical School for my M.D. So how does one place a value on the different levels of formal education and training? Why subconsciously do we seem to value one level above the others when consciously we know all levels are important and are very necessary to move our life forward? Is it related to the skills we obtain, the relationships we make, or the philosophical attitudes we develop? Is it the time in life when one begins to visualize obtainable goals which heretofore you did not think were possible? Whatever the reasons, I must say that my time at the BPEI was transforming and had a significant and lasting impact on my life. Specifically, it broadened my views, enriched my knowledge at multiple levels, and encouraged me to go further than I ever dreamed was possible.

In 1970, the positive atmosphere at the Institute was contagious. It seemed as if every other week some new discovery was being made, and papers and textbooks were being written and published at a furious pace. The faculty was in great demand on the teaching circuit, and there were always well-known ophthalmologists and others dropping by to “drink the water”. It was simply a fabulous time for learning and for building self-confidence. Examples were everywhere. Bob Macemer and Jean Marie were building the first VISC, and Robert was performing his first posterior vitrectomies. Don Gass was describing a new retinal disease every month and “wowing” everyone with his ability to recall in detail every patient’s retina he had ever seen. Lawton Smith and John Flynn were continually providing all fellows with pearls of wisdom, and I had the opportunity to operate with three of the world’s best retinal surgeons. In addition, I carefully watched Dr. Norton’s unique skill in dealing and working with people. He was intellectually honest, wise, perceptive, friendly, engaging, and most people loved working with him. He quickly bonded with those whom he perceived could help him make a difference. When it came to raising money, he was in a league of his own, and although he did not teach you how to do it, his ability to develop relationships was plainly there for everyone to see if you were looking.

I was the first fellow at the Bascom Palmer Eye Institute who had done an ophthalmology residency in the military, so when I finished my fellowship, I was obligated to return to active duty. My first assignment was on the faculty at Letterman Army Medical Center in San Francisco. Full of confidence from the BPEI, I was fortunate early in my career to develop the technique of phacofragmentation and irrigation of cataracts, an ultrasonic method primarily used for removing cataracts through the pars plana during posterior vitrectomy. For seven years Larry Weregland and I gave over 50 training courses in the use of the technique to ophthalmologists from around the world at the University of California in San Francisco, and for ten years I did a similar course at the American Academy of Ophthalmology Annual Meeting with the assistance of Harry Flynn and John Clarkson who presented the vitrectomy portion.

John P. Shock in labThe phacofragmenter was the first to use a bent needle configuration to generate torsional vibration and the first to use piso electric crystals in the hand piece to generate the ultrasonic energy with reduced handle heat. Both of these innovations exist today in present phacoemulsification equipment. I also introduced the double barrel irrigation aspiration needle with a .3 mm. side port for aspirating lens cortex. Until that time cortical material was aspirated through an 18 or 20 gauge needle. I also was the first to report that repeated freeze-thaw would soften a lens nucleus and destroy the lens epithelial cells. This was named phacocryolysis, and it was reported just before the introduction of the YAG laser for posterior capsulotomy so it never became a practice procedure. I also helped to revive the large incision extracapsular cataract technique using the operating microscope which I presented at the Bob Welch Meeting at Miami Beach in 1971 or 1972.

In 1979 after retiring from the military as a Colonel and Chief of Ophthalmology at Brooke Army Medical Center in San Antonio, I became the Professor and Chairman of Ophthalmology at the University of Arkansas for Medical Sciences in Little Rock. This was a big title for directing a program with one full-time faculty and department offices in an un-renovated chemistry laboratory. I chose to go to Little Rock primarily because it offered some of the same opportunities for growing a program that existed when Ed Norton and Victor Curtin came to the University of Miami. During the next 30 years we grew the department from 2 to 25 full-time faculty, raised over $65 million in philanthropic gifts, and built and equipped the free-standing ten floor Harvey & Bernice Jones Eye Institute and the Pat Walker Tower. We also substantially increased the size of Arkansas Children’s Hospital Eye Clinic and the VA Eye Clinic. In subsequent years we established the Pat & Willard Walker Eye Research Center, the Arkansas Lions Eye Bank & Laboratory, and the Ophthalmic Medical Technology Program and have assisted in the training of over 100 ophthalmology residents. We recently raised an additional $5.5 million to open the Leland and Betty Tollett Retinal and Ocular Genetics Center. From 2000-2002 I served as the Dean of the College of Medicine, and from 2002-2009 I served as Executive Vice Chancellor of UAMS while remaining Chair of Ophthalmology and Director of the Jones Eye Institute.

Nationally, I served on the ACGME Residency Review Committee for Ophthalmology for six years and was the Committee Chair from 1993-1996. I was elected to the Board of Trustees of the Association of University Professors of Ophthalmology and served one term as its President. From 2003-2009 I served on the Central Arkansas Radiation Therapy Institute Board (CARTI) and was Chairman of the Board from 2007-2009.

I have received several awards and honors to include the University of Arkansas appointment as Distinguished Professor in 2007. In 2000, I was awarded the Chancellor’s Meritorious Award, in 1999, the College of Medicine Distinguished Service Award, Alumnus of the Year at two institutions, and the American Academy of Ophthalmology Guest of Honor Award in 2010. In 1994, the John P. Shock, M.D. Endowed Chair was established with a $1 million gift from Mrs. Bernice Young Jones. Additionally, we have raised money to establish six other endowed academic chairs as well as endowments for education, research and patient care. While Dean of the Medical School I helped to raise a $48 million gift to build the Jackson T. Stephens Spine Institute. I have been supported in all of these endeavors by Nancy, my wife of 52 years, and our sons, Jeff and Brad, a multitude of wonderful faculty and staff, and a group of distinguished citizens who have a passion for giving.