A Job for Life
Sitting Down With… Carol Shields, Chief of the Ocular Oncology Service at Wills Eye Hospital and Professor of Ophthalmology at Thomas Jefferson University, Philadelphia, PA, USA.
What led you to ocular oncology?
When I came to Wills Eye Hospital as a resident in 1984, I enjoyed all aspects of ophthalmology. With every rotation, I fell in love with a new field. Then I got to ocular oncology. It seemed like an orphan subspecialty; it didn’t have much interest, and very few people were working in it. I saw a potential to make a big difference. I did some research on tumors of the caruncle, retinoblastoma and uveal melanoma, and found it was my calling.
What are you working on right now?
We’re doing the first ever prospective study to assess injectable nanoparticles for the treatment of melanoma. The study is taking place in eight centers throughout the United States, and we’re about to invite European centers to participate. If the trials are successful, this will be a novel non-radiation treatment for melanoma.
What drives you?
A lot of who I am goes back to my childhood. Even as a kid, I liked to do meaningful things. I enjoyed reading books about science, and participating in team sports – and so did my brothers and sisters. I am one of eight kids and most of my siblings are now physicians or lawyers. I put it down to my parents. My dad was a very dedicated internist with an interest in cardiology. He didn’t have a big salary but he had a big impact on his kids. He created a sense of wellbeing in each of us – everything we did was important to him – and it was the same for my mom. She was a registered nurse but took time off to raise us. It was her peace and organization and my dad’s support that allowed me to develop into a research physician and to believe in myself.
What is it like working with your husband?
Jerry is actually the one who trained me in ocular oncology, and I am enormously indebted to him. He has a gentle way about him. He takes his time to show you what happens if you do it right, and what happens if you do it wrong. He was – and is – a wonderful teacher.
Does medicine run in your family?
Of our seven kids, five have gone into medicine. We had hoped they would choose ophthalmology or ocular oncology, but you have to let them do their own thing!
What is the next big step in ocular oncology?
Better treatments for ocular melanoma. It’s been a long and winding road to raise awareness that melanomas need to be treated when they are small – not medium or large. Our plan is to teach people how to identify small melanomas when they’re the same size as a nevus. We are already seeing a trend towards referral of smaller melanomas, but I want us to reach a point where all patients with small pigmented lesions are seen by an ocular oncologist. When you’re dealing with something as serious as melanoma that could lead to metastasis and death, you need an expert opinion.
Are you making any progress?
We’ve started a HIPAA-protected website – OORCA.org – where doctors can submit an image or OCT scan for interpretation whether it’s a nevus or melanoma. It stands for Ocular Oncology Reading Center of America. If a patient has a pigmented lesion they want us to look at, we ask that they send it to OORCA.org or [email protected].
How do you find the time?
I receive emails every day regarding unusual intraocular tumors, or questions on management. My answers are generally short and sweet – sometimes just one sentence. But for a doctor who is really struggling with a case, one sentence might be all they need. I’ve seen virtually every eye cancer known to humankind so I figure my input could help out. So far this year, I have answered 373 email consults.
You’ve had a great career.
And I’m not done yet! I think I have a good 15 years left. Believe it or not, I’ve been in the field 34 years and I’m still at my first job. I never even signed a contract, I just started working. I didn’t know my salary, vacation days, or benefits. That’s pretty different from today’s world. We put in a lot of work over the years, our patients have tremendously benefited, and our reward is their satisfaction.
What is your proudest achievement?
My professional success is thanks to the help of my associates, fellows, residents, and medical students. My success is a result of strong teamwork. Aside from that, I am most proud of my family. My husband has been a role model in ocular oncology. He has lived his life honestly, worked hard, and shared his knowledge. My children are now young adults. They are good to their friends, take care of each other, and love their parents – they are our happiness and our legacy.
Carol Shields is Chief of the Ocular Oncology Service at Wills Eye Hospital and Professor of Ophthalmology at Thomas Jefferson University in Philadelphia, USA