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Up Front | May 2002

5 Questions with Howard V. Gimbel, MD

Thirty-year veteran, Dr. Howard “Gadget” Gimbel, shares his perspectives on optimizing care.

What is the current focus of your research? I am focusing on preventing or delaying ocular diseases in western societies. For generations, we have believed that age-related conditions, such as macular degeneration and cataracts, had no relationship to lifestyle. Although genetic factors are predominant, there is evidence that a healthy lifestyle can delay or prevent some degenerative conditions. As more people are living healthy, productive lives into their 90s, preserving functional eyesight for those years is very important. We have placed emphasis on epidemiological evidence for these relationships, but more clinical and basic scientific research must be conducted to learn more about them.

How has working in developing countries broadened your view of ophthalmology? My work in developing countries has made me aware that preventing ocular diseases is a very important aspect of ophthalmology worldwide. Also, some of the things we take for granted, such as the removal of cataracts when they interfere with our lifestyles, are not privileges enjoyed by many people who cannot access such care because other life-threatening illnesses may take precedence over lifestyle enhancement conditions. I have been impressed with the commitment of surgeons all over the world to strive for excellence in patient care. My most remarkable international experience was during a trip to Thailand for lectures and demonstrative surgery at Chulalongkorn Hospital. The hosts were gracious, and the young surgeons were eager to develop their skills.

How did you receive the nickname “Gadget” Gimbel? I received the name because of my confidence with, and acquisition of, diagnostic equipment for the office and operating room. I remember obtaining the first A-scan ultrasound in Canada during the early days of IOL implantation, and how exciting it was to be able to select lens powers and target emmetropia. I could foresee the expectations of patients wanting a surgical correction of ametropia not only with cataract surgery, but also by other means, and we have certainly seen this in the development of refractive surgery.

What is unique about the way you run your facility in Calgary? The increasing demand for cataract surgery without hospitalization, or requiring thick glasses and contacts motivated me to develop an out-of-hospital surgical center. In our facility, we were able to innovate in the areas of patient and family experience, as well as surgical techniques and technology. We realized that allowing the family to stay with the patient throughout the entire treatment or surgical experience was very effective in reducing anxiety. The family can watch the operation through a glass wall and a monitor while staff members explain every aspect of the procedure.

What advice can you offer the next generation of ophthalmologists? My advice is to take seriously the responsibility of a physician to help patients prevent disease and injury, as well as the importance of preserving his or her own health. At times, physicians neglect taking care of their own bodies because of their commitment to their practices and patients, but they should lead by example in promoting healthy, well-balanced lifestyles. I encourage surgical ophthalmologists to investigate the relationship between their lifestyle and the health of their nervous system and motor skills, and to form habits that will allow them to be at their best for every surgical encounter, just as athletes must discipline themselves to be at their best for every competition.

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