"For me, ophthalmology is the best career in medicine," says Dr. Paul Murphy, Saskatoon Health Region's Department Head of Ophthalmology.
The 27-year-veteran initially thought he wanted to be a geologist, then a pathologist like his father, before an 'Aha' moment led him to ophthalmology – the study and treatment of disorders and diseases of the eye.
Dr. Paul Murphy
It happened when he was a medical student listening to a lecture on cataract surgery at the University of Saskatchewan. During the presentation, Dr. Murphy remembers seeing slides that showed a surgeon making an incision in the eyeball, removing the yellow lens caused by the cataracts and inserting a lens implant that would allow the patient to see clearly again.
"I remember being blown away," Dr. Murphy says, a hint of awe still present in his voice nearly three decades later. "I always thought that if you opened the eye, it would just shrivel to nothing, and here was the surgeon opening the eye, taking out a cataract, sewing it back up – and these people were seeing. That was my 'Aha' moment – when I sat there saying, 'That's what I want to do.'
"I was lucky to have that moment and then be able to attain it," he adds.
For the entire span of his career, Dr. Murphy has worked at the Eye Care Centre, located at Saskatoon City Hospital. In a typical week, the good-humored physician sees between 150-175 patients – about two-thirds of those appointments are consultations and the rest are treatment related, involving cataract or glaucoma surgery or laser treatments. He also makes time two afternoons each week for administrative duties related to his role as department head.
"I tried to dodge the department head role for as long as I could," he says with a lighthearted chuckle. "Now that I'm in it, I find it really interesting."
Dr. Murphy's specialty is glaucoma – eye diseases that damage the optic nerve carrying information from the eye to the brain. Since 1994, he has been the director of the Glaucoma Clinic at the Eye Care Centre.
"Glaucoma is one of the leading causes of preventable blindness worldwide and in Canada," he says. "It's a so-called 'sneak thief of sight' because it sneaks up on you – most people with early glaucoma have no idea they're losing their vision. Unfortunately, once vision is lost due to glaucoma, it's permanent, so the idea is to prevent further damage or loss of vision from occurring. We do that with various different drops, pills, lasers and surgeries, and it ends up being a life-long follow-up."
This means Dr. Murphy has known some of his patients for up to 25 years.
"The thing I like most about my job is the patients," he says. "It's really gratifying to know that I've followed someone for 20 years – I really get to know them, share in their trials and tribulations, and through all of that, I hope I can maintain their vision, and they can continue to enjoy life."
Dr. Murphy recalls one patient in particular who was in her eighties when he first started seeing her because of macular degeneration – loss of vision in the centre of the visual field caused by damage to the retina.
"Her central visual acuity was so profoundly affected she could barely make out the big 'E' on the eye chart," he explains. "But instead of feeling sorry for herself because of her poor vision, she was going around the building she lived in – by now she was in her nineties – helping all the other 'old' people. Most of these people probably saw better than her, but she was the one helping them. It was really inspiring."
He remembers another patient – a war bride who had been in Canada for many years.
"We got to talking one time about various things, including what beer a person likes, and she came in the next time, looking both ways, saying, 'I don't think I should really do this, but I brought you a little present,'" he says of the bottle of Guinness she pulled from a brown paper bag tucked neatly in her purse.
"That was always something I got when she came for an appointment," he says, laughing at the memory.
One of the most interesting patient cases he remembers was a young boy who came in with a wooden stake impaled in his eye-socket – he had fallen on it accidently while playing with a friend.
"We all assumed he would lose his eye," he recalls. "In the operating room, we gently removed this wooden stake from his orbit, and low and behold, it had just pushed his eyeball up and out of the way – his eyeball was intact. We packed the wound and a couple of weeks later his sight was perfect. He went from worst-case scenario – losing his eye – to regaining his sight.
"Vision is such a precious thing," he adds. "Time and again, patients will sit in my chair and say, 'I could lose an arm. I could lose a leg. Take my hearing away, but I do not want to go blind. I want to see.' That really hammers home how important people's vision is to them."
Dr. Murphy shares his passion for ophthalmology with the residents that he mentors.
"I feel that I need to 'pay-it-forward' for the training I received, so for the past 27 years, I've been quite involved in the residency training program," says the former director of the program, which has been around for more than 50 years.
"The residents always ask difficult questions and keep you on your toes," he says. "When you see a resident who can perform a cataract surgery, and you know that when they graduate they're going to be a great surgeon, it's really gratifying to know you've been part of that."
But Dr. Murphy says the thing he is most proud of is his family – his wife, a psychiatrist, of 29 years and their five boys, who range in age from 18 to 24.
After having five boys in six years, he says, "one of the greatest days of our lives was throwing away the diaper pails!
"To have seen these five little rugrats grow into these fine young men who've all done well, and to hear other people say, 'your son is such a polite young man,' makes you feel like you've done something correct in bringing them up," he says affectionately of his sons.