Dr. Joseph I. Maguire, a vitreoretinal surgeon at Mid-Atlantic Retina and Wills Eye Hospital and one of my fellowship attendings and role models, passed away over the Thanksgiving weekend after a long battle with cancer. I wanted to write this post not only to honor a man who meant so much to many, but also to pay tribute to a few of the lessons he taught me and countless fellows and residents over the years at Wills (as an aside, the name, Straight from the Cutter’s Mouth, was actually inspired by Dr. Maguire’s love for idioms):
1) Take time: In his own practice and in his teachings, Dr. Maguire emphasized the importance of taking the necessary time to sit down with patients and explain. Explain what is going on, why it is happening, and what the goals of therapy are. I remember once presenting to him a patient with a diabetic tractional retinal detachment from the fellow clinic. Dr. Maguire, despite being very busy in his own private clinic, took the time to sit down with this patient to go over her blood sugar and insulin regimen, emphasizing the impact that her systemic disease was having not just on her vision, but also her life as a whole. That experience has always stuck with me and since then, I always try to make enough time for my initial encounters with patients suffering from significant diabetic eye disease.
2) Be a doctor, not just an eye specialist: Dr. Maguire had almost an encyclopedic knowledge of systemic diseases with retinal findings, whether it was Purtscher-like retinopathy or crystalline retinopathy. It reflected in his day to day patient care; he took thorough, comprehensive medical histories that put me, as the fellow working in his clinic, to shame on more than one occasion. As he liked to say to me, ‘the ‘MD’ stands for ‘medical doctor’ for a reason’.
3) Movement equals error: One of Dr. Maguire’s favorite expressions in the operating room was ‘movement equals error’. It was his caution for the excited, rapidly improving surgical fellow that being an efficient and skilled surgeon is not about how fast you move while operating, but about preparing and planning in advance, understanding surgical principles, and avoiding wasted movement. There were surgical specifics that I personally learned first from him, like how to imbricate sutures on a scleral buckle or the concept of ‘oar-locking’ instruments in vitrectomy cannula, but the concept that moving faster is not better will stick with all of his former fellows.
4) Give feedback: Dr. Maguire gave direct, honest, and constructive feedback frequently to me and I appreciated every bit of it. Early on in fellowship I remember doing (what I thought was) a thorough retinal examination on a patient with new floaters on call and finding no issues. Dr. Maguire saw the patient two days later in follow-up and found a retinal tear. He picked up the phone and called me, not to berate me or scold me, but to simply tell me what he had found and where so I could learn. Giving feedback seems like a simple thing to do, but for many of us it can be difficult to tell someone to improve in a compassionate enough way to avoid hurt feelings. He also would give positive feedback unsolicited. When he once called me after a long day in the OR together, I assumed it would be about a patient-related medication prescription or paperwork that I had forgotten to fill out. Instead, he simply told me that I had done a great job and that he was very proud of me. We cannot forget to let our trainees and colleagues know when they are doing well.
5) Pick up the phone: The examples in #4 above were classic Dr. Maguire because he was ‘old school,’ and he picked up the phone and called you when he needed to talk. We live in the digital age of text messages, Instagram DMs, and retweets, but so much can be misconstrued when sent in a few words without any sense of inflection or context. If a conversation is important, pick up the phone. Two minutes of talking can get a lot more across than fifteen minutes of back and forth cryptic emojis. 🤨
6) Be loyal to your team: No one would stand up for his fellows, residents, and staff more than Dr. Maguire. No matter what his schedule commitments were like, he always came to fellow presentations and conferences. He was generous to all those around him; in fact, the last time I saw him in person he quietly picked up the check for fifteen former and current fellows out for lunch after a reunion in Philadelphia. I also remember once there was a patient being extremely rude to one of the front desk staff. Before anyone else could intervene, Dr. Maguire arrived at the scene and quietly but concisely reminded the patient his responsibility as a patient of the practice to be as respectful to the staff as he would be to any of the doctors. Being loyal to the people around you is not only the right thing to do, but it inspires loyalty back that will build priceless relationships and an A+ working environment.
7) Be honest: I remember as a fellow writing a research paper with several attending surgeons including Dr. Maguire as a co-author. When I emailed a draft to him, he called me (see point #5 above!) and asked to not be listed as an author, not because he was not keen in supporting me, but because he felt that he had not contributed enough to merit a spot on the authorship docket. While I explained and eventually convinced him that the research would have been impossible without his help, I was always struck about how principled he was about academic honesty that his initial instinct was to call and ask not to be included. Let’s all be honest with ourselves, because in the end it is more important we respect the person we see in the mirror every morning than to have a couple extra lines on a CV.
8) Be a good person: Dr. Maguire was an exceptional doctor and surgeon, but more than that, he was one of the best people I have ever met. The first word that comes to mind when his colleagues and fellows think of him is ‘gentleman.’ He was respectful and kind to everyone,without any ulterior motives. It was simply the way he was built.
I will miss him tremendously and I know I am not alone among my friends and family from Wills. I feel for his family, and I hope that they can take solace that Dr. Maguire was regarded by all who worked with him as an amazing husband, father, doctor, surgeon, mentor, role model, and friend. RIP Dr. M. We all love you.