C. Thomas Dow, MD: Reflections on Residency and Beyond

Alumni News // News // Oct 01 2019

C. Thomas Dow, MD

It’s interesting to consider the career path that a young ophthalmology resident might take. Will they become a master of cataract surgery? Will they decide to further specialize in uveitis or retina? Will research inspire them? Which patient populations will capture their interest: adults, children, urban, rural, international?

C. Thomas Dow, MD, did not limit himself to just one of these categories. Dr. Dow recently sat down with the DOVS team to share some memories of his time at UW-Madison.

Education · Training

Dow earned his bachelor of science degree in microbiology from UW-Madison in 1970, followed by a medical degree at the UW School of Medicine in 1974. His internship year was spent at Bronson Methodist Hospital in Kalamazoo, Michigan. He then returned to Madison for his ophthalmology residency with the University of Wisconsin Hospital and Clinics, which he completed in 1978.

When asked about his time in medical school and residency, Dow easily recalls rich memories. He recollects a second-year medical school ophthalmology class with Guillermo de Venecia, MD, the first full-time professor in the department. Dr. de Venecia’s lab was down the hall from the second-year medical lab. Dow remembers that while waiting for his roommate to finish lab work twice a week, de Venecia would cruise through and shoot the breeze with students, creating an air of ease and relatability. De Venecia invited Dow to his lab, where Dow became fairly knowledgeable about his novel clinical pathologic correlation research. He notes that de Venecia was also very generous with clinical knowledge, once demonstrating to Dow the proper way to use an indirect ophthalmoscope.

When reflecting on the faculty, Dow notes Drs. Bresnick, Brightbill, Dortzbach, Kushner, Appen, and Allen as influential teachers during his residency. He recalls Dr. Allen’s teaching approach, which encouraged being open to many ways of thinking and different techniques. “Allen would get out his book of ophthalmic surgery and say ‘today we’ll do [surgery] this way, and the next time we’ll try it the next way.’ He wanted you to get the experience.”

Dow reminiscences about starting on the retina service, and points out that he knew how to do a scleral buckle before he knew how to refract. He felt that the faculty expressed confidence in the residents, which, to Dow, created a strong sense of comradery between the residents and faculty.

When asked how he approached learning surgical techniques, Dow notes that he was just happy to assimilate what was being done around him. “Fred Brightbill was one of top cornea people in the country, he had a wonderful cornea book out. You try to take bits and pieces to take your own expectations of how to do [surgery] and plug in the things that you learn from different people. Certainly, Fred was a terrific surgeon, as was pretty much everyone that I worked with there.”

Throughout our conversation, Dow seemed energized as he discussed his time with his educators. “Department Chairs Dinny Davis and Dan Albert each had a way,” Dow reminisced, “one word of encouragement from either would light a fire. Sometimes we forget the effect we can have on a young person.”

Career · International

After his residency, Dow established the Chippewa Valley Eye Clinic in Eau Claire, Wisconsin, in 1978. Dow grew the practice, eventually adding doctors and clinic locations in Menomonie and Rice Lake, in addition to outreach locations around the region. He performed the first corneal transplant in Eau Claire, the first retinal reattachment surgery in Eau Claire, and convinced Sacred Heart Hospital to purchase its first Argon Laser.

His mentor de Venecia had started charity work in the Philippines in 1978 and formed the Free Rural Eye Clinic to offer free cataract eye surgery to patients who could not otherwise afford the procedure. When de Venecia called Dow to see if he was interested in volunteering across the ocean, Dow says there was no way he could say no. He had young children at the time, but he went right before Christmas.

                     Dr. C. Thomas Dow and Suzanne Dow in the Philippines.

Dow recalls operating in six different hospitals on his first trip to the Philippines. It took hours to get started, so it was a great accomplishment when de Venecia built a permanent outpatient surgical center in Dagupan to center his Free Rural Eye Clinic program in 2000. At that point they could perform six surgeries before breakfast. They operated on 46 cases in one record day, changing 46 lives. Overall, Dow completed 16 mission trips to the Philippines, performing 250 to 300 surgeries per visit. He has fond memories of each trip.

He had, however, curiosities beyond his clinical and international interests.

Research Interests

The series of successful enterprises that Dow built has allowed him to explore two areas of research that have long interested him, a bacterium and an enzyme.

The bacterium, Mycobacterim avium ss. Paratuberculosis (MAP), is responsible for Johne’s disease, an inflammatory bowel disease of ruminant animals and the suspected cause of the similar human ailment, Crohn’s disease. Dow’s interest in the role of this bacteria in human autoimmune disease also includes study of Type 1 diabetes and Hashimoto’s thyroiditis.  Dr. Dow recently was asked to co-edit a special edition of Medical Microbiology: Mycobacterial infections and Autoimmune Diseases. He views this as a culmination of 20 years of work in this area

Telomerase, an enzyme that maintains the ends of our cells’ chromosomes, started to intrigue him as an investment. Dow eventually partnered with a company to test a telomerase supplement with an age-related macular degeneration population. More recently, he saw a CNN report about researchers who were investigating if the detection of Alzheimer’s could be done with an eye test. As he puts it, “any ophthalmologist would be intrigued by that.” Research initiated at the University of Southern California Cedars-Sinai Medical Center found that if you could identify and score amyloid proteins in the retina, it mimicked what was happening in the brain. Dow is now involved in studies to develop this kind of testing. The detection of amyloid in the eye “should become to Alzheimer’s what the cholesterol testing is to heart disease. In the future, people will want to know their retinal amyloid score.”

His new treatment center, Mindful Diagnostics & Therapeutics, puts him squarely in the world of cognitive decline. The center focuses on the MEND (metabolic enhancement for neurodegeneration) protocol. It’s a big data approach to address the contributors to cognitive decline: serum chemistries, diet, exercise, sleep and stress reduction.

Additional Accomplishments

Dow served as the second president of the UW Ophthalmology Alumni Association, following Alice McPherson, MD, the first female resident of the department. Dow also served on the UW McPherson Eye Research Institute’s first Advisory Board from August, 2007 -April, 2010.

In 2007, he received the DOVS Distinguished Alumni Award. Peter Holm, MD, president of the Alumni Association at the time, prepared the presentation of the award. Part of Dr. Holm’s homework involved asking Suzanne Dow about her husband. Suzanne described him this way: “He is passionate about his patients, his community projects, and is the most optimistic person I know. He is a guy who sees the big picture and acts on it.”

It is fascinating to consider the trajectory of Dow’s career, from private practice to cataract surgery in the Philippines to the research of diagnosing dementia by looking at the eye. “Who knows where your career will point you, especially towards the end when you have the experience and a broad knowledge base,” Dow concluded.