Challenges in Ophthalmology with April Steinert

Even busy physicians should make themselves a priority

Trex Topping talks about a stroke he suffered in 2017 and the lessons he has learned during his recovery.

A sudden tropical storm was blowing through Cane Garden Bay on July 21, 2017, at 5:30 a.m. The rain outside produced a loud, steady drumbeat against the hull of their 40-foot chartered catamaran. They had set sail days before to cruise the British Virgin Islands in celebration of their 50th wedding anniversary. My friend, Trex Topping, had recently retired from his successful retina practice at Ophthalmic Consultants of Boston. With the storm raging outside, Judy, Trex’s wife, asked if he was awake and if he could hear the pelting rain. When Trex turned toward her to speak, his words were coming out jumbled. Judy also quickly noticed that he was unable to move the left side of his body. Judy raced to wake their older son, Quentin, who was also sailing with them along with his young family. Quentin immediately recognized his dad’s symptoms and said, “Mom, dad has had a stroke!”

Quentin motored the boat to shore where emergency services were waiting for them. They lowered a metal basket onto the stern of their vessel, and Trex was loaded in as precious cargo. They lifted the basket off the boat and carefully transported him to a waiting ambulance. Peebles, the new hospital on Tortola, is the only real hospital in the BVI. There he was stabilized, his assessment was completed, and it was determined that it was too late for tissue plasminogen activator and that he had suffered a right middle cerebral artery occlusion secondary to a broken plaque.

It did not take long for the family to decide it was necessary to transfer Trex to Mass General Hospital in Boston as soon as possible. And so the search for rapid air transport began. A medical Learjet (and for those in the market to charter a flight from Boston to the BVI, it is a mere $66,000 one way!) was the only option. For those who have an Amex Platinum card, you will be relieved to learn that because Trex used his card to charter the boat, Amex paid for the plane travel. In full. (And no, I do not have any financial interest in Amex, only a newfound appreciation for its travel insurance.)

While Trex was at a rehab facility, the family discovered that he had not had a physical exam in more than 7 years. As Trex told me this, I immediately thought back to something he had told me as we began our conversation; he is presently writing an article entitled, “Good Doctor, Bad Patient.” Trex had dedicated his life to caring for his patients, but not caring for himself. A common affliction among physicians.

As Judy puttered around the kitchen behind us clearing up lunch, Trex stressed to me that he and Judy have always enjoyed a close relationship as “partners and playmates,” but that she is now also his “savior.” I also learned that over their 50 years together, they had been keeping a list of places to visit and things to do once Trex was retired. However, as often happens, life had other plans.

Trex told me that he is still “crawling out of the abyss.” Although he is now legally blind (left homonymous hemianopsia), he walks with a cane with someone close by and spends his days shuttling to and from multiple therapy sessions. Despite these new present-day challenges, he has preserved his sharp sense of humor and is finding hope and light each day in the things he used to take for granted. Every accomplishment, no matter how small, whether building his walking distance with a cane, relearning how to move his arm, or sitting and chatting with friends, is now treasured. He and Judy recently traveled to St. Martin where they rented a home, found a caregiver and enjoyed time away from their usual occupational and physical therapy routine.

When asked if he had any pearls of wisdom regarding his new life circumstances and challenges, Trex said that choosing a life partner carefully and making one’s health a priority are the most significant lessons he has learned. He loved practicing medicine and caring for his patients, but taking time out for himself and having an annual exam might have changed everything. No matter how busy your practice may be, make yourself a priority. Your loved ones will thank you.

“The first wealth is health.” – Ralph Waldo Emerson

Disclosure: Steinert reports no relevant financial disclosures.

A sudden tropical storm was blowing through Cane Garden Bay on July 21, 2017, at 5:30 a.m. The rain outside produced a loud, steady drumbeat against the hull of their 40-foot chartered catamaran. They had set sail days before to cruise the British Virgin Islands in celebration of their 50th wedding anniversary. My friend, Trex Topping, had recently retired from his successful retina practice at Ophthalmic Consultants of Boston. With the storm raging outside, Judy, Trex’s wife, asked if he was awake and if he could hear the pelting rain. When Trex turned toward her to speak, his words were coming out jumbled. Judy also quickly noticed that he was unable to move the left side of his body. Judy raced to wake their older son, Quentin, who was also sailing with them along with his young family. Quentin immediately recognized his dad’s symptoms and said, “Mom, dad has had a stroke!”

Quentin motored the boat to shore where emergency services were waiting for them. They lowered a metal basket onto the stern of their vessel, and Trex was loaded in as precious cargo. They lifted the basket off the boat and carefully transported him to a waiting ambulance. Peebles, the new hospital on Tortola, is the only real hospital in the BVI. There he was stabilized, his assessment was completed, and it was determined that it was too late for tissue plasminogen activator and that he had suffered a right middle cerebral artery occlusion secondary to a broken plaque.

It did not take long for the family to decide it was necessary to transfer Trex to Mass General Hospital in Boston as soon as possible. And so the search for rapid air transport began. A medical Learjet (and for those in the market to charter a flight from Boston to the BVI, it is a mere $66,000 one way!) was the only option. For those who have an Amex Platinum card, you will be relieved to learn that because Trex used his card to charter the boat, Amex paid for the plane travel. In full. (And no, I do not have any financial interest in Amex, only a newfound appreciation for its travel insurance.)

While Trex was at a rehab facility, the family discovered that he had not had a physical exam in more than 7 years. As Trex told me this, I immediately thought back to something he had told me as we began our conversation; he is presently writing an article entitled, “Good Doctor, Bad Patient.” Trex had dedicated his life to caring for his patients, but not caring for himself. A common affliction among physicians.

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As Judy puttered around the kitchen behind us clearing up lunch, Trex stressed to me that he and Judy have always enjoyed a close relationship as “partners and playmates,” but that she is now also his “savior.” I also learned that over their 50 years together, they had been keeping a list of places to visit and things to do once Trex was retired. However, as often happens, life had other plans.

Trex told me that he is still “crawling out of the abyss.” Although he is now legally blind (left homonymous hemianopsia), he walks with a cane with someone close by and spends his days shuttling to and from multiple therapy sessions. Despite these new present-day challenges, he has preserved his sharp sense of humor and is finding hope and light each day in the things he used to take for granted. Every accomplishment, no matter how small, whether building his walking distance with a cane, relearning how to move his arm, or sitting and chatting with friends, is now treasured. He and Judy recently traveled to St. Martin where they rented a home, found a caregiver and enjoyed time away from their usual occupational and physical therapy routine.

When asked if he had any pearls of wisdom regarding his new life circumstances and challenges, Trex said that choosing a life partner carefully and making one’s health a priority are the most significant lessons he has learned. He loved practicing medicine and caring for his patients, but taking time out for himself and having an annual exam might have changed everything. No matter how busy your practice may be, make yourself a priority. Your loved ones will thank you.

“The first wealth is health.” – Ralph Waldo Emerson

Disclosure: Steinert reports no relevant financial disclosures.