A new life for Dr Leigh Spielberg, vitreoretinal surgeon

One evening, I received a call from Ghent University Hospital in Belgium. Prof Bart Leroy, an internationally renowned ophthalmic geneticist and chairperson of the department, was on the line.

“We have a lot of interesting pathology. All the standard retinal problems, and more. Trauma. Rare genetic disorders. Retinopathy of prematurity. Coats' disease. We currently have a very good and very experienced consultant in Fanny Nerinckx, but there’s too much work for just one surgeon. We want someone here full-time,” he told me.

It was a very attractive offer. Marc Veckeneer, another highly experienced retinal surgeon who had trained countless fellows in Rotterdam, was interested in joining the team on a part-time basis, on the condition that there would be a junior vitreoretinal surgeon (me) there full-time, to ensure proper pre- and postoperative management as well as emergency care.

Prof Leroy had my undivided attention. Ghent, a beautiful medieval city located halfway between Brussels and Bruges, is a great place to live. The city itself has everything: museums, restaurants, stores, and entertainment. It’s close to both the Belgian coastline and the Flemish Ardennes, a hilly region full of good mountain-biking trails. It also has leafy suburbs just a few miles from the city centre.

A STORIED HISTORY

The ophthalmology department in Ghent University Hospital has a strong and storied history. Charles Schepens, the Belgian retinal specialist and father of modern retinal surgery, went to medical school at Ghent University, trained at Moorfields, and then moved to Boston to invent the binocular indirect ophthalmoscope and found both the Schepens Eye Research Institute and The Retina Society. Prof Jules François, a previous department chairperson, won so many international ophthalmology honours that a new one was named after him.

After I spent more than five years at the Rotterdam Eye Hospital, I had gotten used to working in a well-known institution. Ghent was something I wanted to be a part of. The department was rebuilding. Many ophthalmologists in Belgium choose to enter private practice rather than join the staff of a university, for various reasons, but Prof Leroy had attracted the interest of several young doctors and it looked promising. Both Dr Nerinckx and Dr Veckeneer had expressed their interest in helping to rebuild and were willing to help guide my transition from fellow to full-fledged vitreoretinal specialist.

SPECIFIC REQUESTS

I was in a position to make some specific requests. I wanted to have at least one, and preferably two full days of dedicated vitreoretinal surgery. If possible, I also wanted a half-day of cataract surgery to maintain the phaco skills I had spent so much time and effort developing.

Lastly, I was interested in doing a half-day of medical retina, in conjunction with one of the medical retina specialists, for two reasons. Firstly, I had always been interested in retina as a single specialty, as it is practised in the US: both medical and surgical retina treated by one doctor. In much of Europe, these sub-disciplines are divided, which causes a certain disconnect between the two. This leads to confusion and misunderstanding with cases when the two fields have to collaborate, such as non-clearing vitreous haemorrhage due to neovascularisation; submacular haemorrhage due to macular degeneration; proliferative diabetic retinopathy; and persistent diabetic macular oedema with epiretinal traction.

This could all be arranged.

“But are you willing to train residents in cataract surgery?” asked Prof Leroy.

“Yes,” I replied, somewhat surprised at the confidence he had in my freshly minted skills. “Will you supervise their clinics?” he continued. “Yes, no problem,” I said. “OK then, I think we have a deal. Come down to Ghent sometime and I’ll show you around. I think you’ll like what you see,” he replied.

After a few meetings with Prof Leroy, Dr Nerinckx and Dr Veckeneer in Antwerp and at EURETINA in Nice, I decided that this was a team I could work with and could trust. Prof Leroy is past-president of EVER and also leads the genetic ophthalmology clinics at the Children’s Hospital of Philadelphia, the cradle of ocular gene therapy. Dr Nerinckx has vast experience with difficult paediatric cases, and Dr Veckeneer had trained more than a dozen retinal surgery fellows.

Once my wife, a dermatologist, had found a job in Ghent, I made the decision to sign with the University Hospital. We found a great school for Philippa and Raphael, and a house nearby. We were all set.

Spread over two cold winter days, we emptied our house in Rotterdam, locked the door behind us, said goodbye to friends, neighbours and colleagues, and moved our family south to Belgium, where we would start a new life.

Dr Leigh Spielberg is a vitreoretinal and cataract surgeon at Ghent University Hospital, Belgium