Between the Blinks #006

Four Years Later

Today’s edition of Between the Blinks is going to be a little different, and probably a little longer than usual. I’ll apologize for that upfront, but this is one of those subjects where I have a lot to say, and trying to shorten it just for the sake of keeping to our usual format didn’t feel right.

Four years (and one day) ago, we lost Dr. Arthur Epstein. It’s strange how four years can simultaneously feel like yesterday and a lifetime ago. So much has happened since then, both personally and professionally, yet there are conversations with Art that I can still hear as clearly as if they happened last week.

When I look at where I am today and how I ended up doing what I do, there’s really no way to tell that story without talking about him. When I was a fourth-year optometry student, my first rotation was at Phoenix Eye Care. At the time, the practice was run by Dr. Epstein and his wife, Dr. Shannon Steinhauser, along with an associate most of you probably already know, Dr. Cory Lappin.

When I showed up, I was a kid. I knew very little other than that I was about to spend three months learning from one of the best dry eye doctors in the world, if not the best. I knew what an opportunity I had in front of me, although I’m not sure I fully appreciated at the time just how much those three months would end up shaping my life.

Before arriving in Arizona, Art and I had exchanged a few emails. We very quickly figured out that we had a similar sense of humor, which meant we were able to give each other a hard time pretty much immediately. Sometimes relentlessly.

I landed in Phoenix on a Friday and sent Art an email asking what time he wanted me to come in Monday morning. I also made sure to let him know how disappointed I was that he hadn’t been waiting for me at the airport wearing limo gloves and a chauffeur’s hat, holding a sign with my name on it. I told him I’d let it slide this time. That was the kind of relationship we had already established, so I didn’t think anything of it.

Then I got this response:

My heart sank.

Here I was, a student who hadn’t even started his first rotation yet, and I was convinced I had already managed to screw something up. But tucked into some pretty serious news was that line from Art. Even from the hospital, he made sure there was a joke waiting for me. As worried and embarrassed as I was, reading it also gave me a little bit of relief.

I spent the next week or two working directly with Cory and eventually learned more about what Art was going through. I won’t get into those details here, but before long, Art was back in the office and apparently very serious about fulfilling his promise to make my life a living hell. What followed was basically three months of dry eye bootcamp.

Art had very little interest in letting me settle for being good. The patients coming into that practice had often already been everywhere else, tried everything else, and were showing up because they needed someone willing to look a little harder. He wanted me to understand the responsibility that came with taking care of those patients. One thing he told me has stuck with me ever since: if I was going to take dry eye seriously, I needed to commit to it 100%.

At the time, I was a student trying to absorb as much as I possibly could. I don’t think either of us could have known where that advice would eventually take me. Years later, I would build a practice entirely around treating dry eye and ocular surface disease. I’d spend my days treating the same kinds of complicated patients he taught me not to give up on. A lot has happened between that first day at Phoenix Eye Care and where I am now, but there’s a pretty straight line connecting the two. I wish I could thank him for that again.

I’m sure a lot of people reading this have their own Art story. For some, it was probably one of those four-hour phone calls where you asked one question and walked away with enough information and advice to fill a notebook. For someone else, it might have been getting his very blunt opinion about a medication, product, device, or treatment you were excited about. Whether you wanted to hear it or not, Art was going to tell you what he thought. That was Art. He gave 100% on both sides of the coin.

For a long time, I liked thinking of Art as my dry eye mentor. There’s a part of you that wants to believe the relationship you had with someone like him was uniquely yours, and in some ways, of course, it was. But the truth is that I wasn’t the only one who got that version of Art. He gave himself to everyone.

He answered the phone. He shared what he knew. He challenged people when he thought they could be better. He gave advice, opinions, criticism, encouragement, and probably a healthy amount of shit to more doctors than I could ever count. Four years later, you can still see pieces of him in the way so many people around our profession practice, teach, and think about dry eye.

There’s one story that I think puts into perspective just how much respect Art had earned from the profession. In 2021, Newsweek published its first ranking of America’s best optometrists. The rankings incorporated recommendations from other eye-care professionals around the country, and when the list came out, the name sitting at number one was Arthur B. Epstein.

I remember asking him about it. You could tell there was a part of him that was proud, as he absolutely deserved to be, but Art wasn’t about to sit there and tell me how great he was. His response was much more on brand. He said to me, “It’s all politics.” That was it.

Unfortunately, if you go looking for that list today, you’ll notice something strange. It starts at number two. After Art passed away, his name was removed from the online list. I actually reached out to Newsweek about it because it bothered me that someone could earn that recognition from his peers and then seemingly disappear from the record. I was told that the list was intended to display active doctors, and because Art was no longer practicing, his name would not be restored. I understand the reasoning. I still don’t particularly like it.

So, for anyone who finds that list today and wonders why the 2021 Newsweek ranking of America’s Best Optometrists begins with number two, there’s your answer. Number one was Dr. Arthur B. Epstein. A website may no longer show his name there, but those of us who knew him certainly haven’t forgotten it.

And when I think about everything I have to thank Art for, there’s another part of this story that still feels a little surreal to me. The practice he left behind is now the practice I own.

The same place where I showed up as a fourth-year student knowing next to nothing, where Art put me through three months of dry eye bootcamp and made it very clear that “good” wasn’t going to cut it, eventually became the foundation for what I’m doing today. There are days when I’m seeing patients and I stop to think about how strange that full-circle moment really is.

I still remember getting the call with the news that he had passed. Cory and I spoke on the phone for a few hours, walking down memory lane about our shared mentor. After that call, I quickly searched my phone for my last contact from Art.

At least once a month, I go back and listen to the final voicemail Art ever left me. I’ve never deleted it, and I don’t think I ever will. In that voicemail, Art was hopeful. He was happy. He talked about looking forward to my return to Phoenix and the opportunity for us to work alongside each other. He told me how important it was to work with people you genuinely enjoy working with. At the time, it was just a voicemail from someone I cared about talking about what we were going to do next. Neither of us knew it would be the last one.

Listening to it now is difficult, but I’m incredibly grateful that I still have it. There’s something about actually hearing his voice that brings me right back to that time. For a few minutes, the plans are still the plans. He’s still looking forward to what comes next, and I’m still the young doctor who is eventually going to make his way back to Phoenix to work alongside him. We never got the opportunity to do that the way we had planned, but in a strange way, I did make it back.

I’m here in Phoenix. I’m taking care of dry eye patients every day. And the practice Art had built, the place where he first taught me what it meant to take this disease seriously, is now mine to carry forward.

There are a lot of people who helped me get where I am today, and I’ll never pretend I did any of this alone. But there is absolutely no version of my story that looks the same without Arthur Epstein in it. I just wish he could see where it all ended up.

Note: If you have an Art story of your own, I’d genuinely love to hear it. Send me an email, or if you’re going to be at Academy in Anaheim this week, come find me and tell me in person. I have a feeling there are a lot of stories out there worth keeping alive.

One Last Blink

Rest in peace, Art. We all love you, and we miss you dearly.

See you next week.

Andrew Zagelbaum, OD