A Zoom Conversation With Richard Sogg, MD, on the Occasion of His 90th Birthday, August 2020

Great Conversations Section Editors: Meagan D. Seay, DO Rachel Calix, MD A Zoom Conversation With Richard Sogg, MD, on the Occasion of His 90th Birthday, August 2020 Downloaded from http://journals.lww.com/jneuro-ophthalmology by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdgGj2MwlZLeI= on 05/04/2022 J onathan Trobe (J): Dick, some years back at a Frank Walsh meeting, after a case was presented involving an 85-year-old patient, you jumped up to the microphone and said, “Oh to be 85 again!” Richard Sogg (D): Yes, that sounds like me. J: How old were you then? D: 86. J: Are you the oldest neuro-ophthalmologist on the planet? D: Yes, by a month. J: Who else is in your company? D: David Knox (former faculty ophthalmologist at the Wilmer Eye Institute, Johns Hopkins University). J: David Knox told me that he is older. D: Not true. I straightened him out. It’s a lot more fun to be the oldest than the second oldest. J: Do you feel your age? D: When you get older, there are two things that go: your eyesight and your hearing. But now that I have had my left lens exchanged for an IOL, it’s 20/20. It was about 20/100. My eye surgeon said that I had “a third world cataract.” I waited until I was seeing flares during night driving, and I was having trouble reading music. Misjudging a natural sign from a double sharp can be confusing. J: What about hearing? Do you need a hearing aid? FIG. 1. Left to right: Valerie Biousse, Richard Sogg, Nancy Newman, and Anna Newman. Trobe: J Neuro-Ophthalmol 2021; 41: e1-e5 FIG. 2. Left to right: Richard Sogg and Barry Skarf. D: Only for hearing. Stanford Ophthalmology grand rounds talked me into getting one. My comment was always “Could you repeat that for the hearing-impaired?” So I finally got a hearing aid five years ago. FIG. 3. Richard Sogg. e1 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. Great Conversations FIG. 4. Richard Sogg playing piano in September 2020. J: Dick, you are also famous as a pianist—especially for Jonathan Horton (cello) and Valerie Purvin (violin), with whom you have played so many duets. D: I love making music with musicians and especially with neuro-ophthalmologists. J: When was the last time you played with Jonathan? D: Three or four weeks ago. I was playing up to the moment I went into surgery. They advised me not to bring my piano to the OR. A very famous pianist named Gary Graffman wrote an autobiography called “I Really Should Be Practicing.” And that’s true, I really should be practicing. Instead, I’m talking to you. FIG. 5. Richard Sogg performing with Tom Carlow. e2 J: Gary Graffman developed writer’s cramp and that stopped his career. D: Yes, the other famous pianist that developed writer’s cramp was the guy from San Francisco. J: Leon Fleisher. D: They had a famous picture in Life Magazine where they were playing duets, each with one hand. Fleisher, through the magic of Botox, got his playing back and started playing with both hands, but Graffman still only plays with his left hand. J: What duets are you working on now with Jonathan Horton? D: Beethoven’s Cello Sonata Opus 69 in A major. I’ve played all five cello sonatas. I’ve concertized on the first and the fifth, but the third has the most beautiful melody. It’s very difficult for cellos, and it has many difficult problems for the piano. J: How does the cello melody go? D: (sings the melody). J: What about the piano melody? D: Well, we both get that melody. We trade off. J: You said you have concertized. D: I’ll tell you about the most impressive concert I was ever in. That was when I was a senior at Harvard College in 1952. I soloed with the Boston Symphony. The piece was one that they’d never heard before and probably will never hear again, by Ralph Vaughan Williams, called “Fantasia on the Old 104th Psalm Tune” for piano, organ, chorus, and orchestra. J: How did you get that gig? Isn’t that like getting the Nobel Prize? D: No, it’s a lot better. J: Who was conducting? D: G. Wallace Woodworth, who was also the music director of the Harvard Glee Club. He was substituting for Charles Munch, who was then the BSO music director and FIG. 6. Richard Sogg entertaining NANOS colleagues. Trobe: J Neuro-Ophthalmol 2021; 41: e1-e5 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. Great Conversations FIG. 7. Richard Sogg performing with Valerie Purvin. was on sabbatical. I was the accompanist of the Harvard Glee Club, and I had played the Vaughan Williams piece with the Harvard Radcliffe Orchestra under Woodworth. One day he said, “How would you like to play it with the BSO?” I think I probably stopped breathing. That offer just doesn’t happen twice. J: Have you soloed with other orchestras since that time? D: Yes, several times with the San Jose Symphony, where I was the keyboard specialist, and many concertos with local orchestras. I play a concert called Soirée Musicale once a year in my home. Our group has been in business for about forty years. I arrange the program. But if I can just play with one other person, that’s fine with me. J: Can you still play the way you did years ago? D: In some ways not as well, but in other ways, surprisingly better. Being a musician is much harder than being a physician. When you practice medicine, you eventually get it right. In music, you never get it right. Pablo Casals was practicing like a fiend when he was 92. People asked him “You’ve been playing for 80 years, why are you still practicing?” He said, “I still see some progress.” And so it is never, never right. The audience may think it’s right. Your family, who knows the pieces, knows it’s not right, and you know it’s not right, but you keep plugging away. J: Do you have a piano at home? D: I have two Steinways. J: Why do you have two pianos? D: I always wanted to play two-piano music. I bought the second piano from a pediatrician in 1988. It was only 2 years old. My other piano is 100 years old. I got it when I was in high school. I am going to play two-piano pieces with Patricia Stroh, the curator of the Ira F. Brilliant Center for Beethoven Studies. She doesn’t like to read new stuff, so Trobe: J Neuro-Ophthalmol 2021; 41: e1-e5 I am giving her a whole month to learn the Mozart sonata in D major, K 448. J: When you aren’t playing music, what are you doing? D: I wake up at 7:30 AM. I walk down the hill, get the newspaper, read some of it, eat a not-too-dangerous breakfast, and listen to National Public Radio. I practice in the evenings. I go hiking. I use walking sticks, but don’t tell anyone. When I was 70, I ran my first marathon and at age 71, my second marathon. After that, I ran a number of half marathons and then I said, “I don’t need this anymore.” J: Dick, let us go back a bit. Where were you born? D: In Cleveland, Ohio. My father played the piano. The pieces he played, he played his way. My maternal grandfather was from Russia—a singer. He sang the “Libiamo” chorus from Act One of Verdi’s “La Traviata” in Russian. My mother had an aunt who was a dancer. On my father’s side, an aunt played the piano for silent movies. My parents heard me sing and they each said, “Maybe he ought to get lessons.” I was six years old. J: They recognized that you had a musical gift. D: Well, they had an unrealistic expectation of how far I would go. I began to believe it. That’s a big mistake. We were living in San Francisco in 1943. I was 13 years old and studying with Anna Clement, the head of the piano department at the San Francisco Conservatory of Music. She was convinced that I was going to follow Leon Fleisher, who was just a year or two ahead of me. That year, I gave my debut recital at the San Francisco Conservatory of Music. But that was the only solo recital I’ve given outside of my home. J: What do you remember about that recital? D: I remember every piece that I was assigned. I played five Chopin preludes, a Bach English Suite, and Beethoven’s 2nd Piano Concerto with my teacher playing the orchestra part. The cadenza she chose was written by the very famous French composer Camille Saint-Saëns. No one knows that cadenza. My mother got the score. She did not know how to write music, but she wrote out every note. I still have that copy. My father had just been to Hawaii as an army doctor, but he returned a week before the recital. He stood up, and my mother said there was not a dry eye in the house. I played a Chopin prelude in B minor in his honor. That piece has been my. J: Signature? D: Right. J: After the recital, were you not propelled into a musical career? D: Yes and no. I studied at the Cleveland Institute of Music with four different teachers. I’d study for a year, they’d go into the army. I’d study for another year, they’d go into the army. I did not practice the way I had when I was in San Francisco, and that’s a failing. J: Dick, what is your ethnic origin? D: I’m Jewish on my parents’ side. J: And on your side? D: That too. e3 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. Great Conversations FIG. 8. Left to right: Deborah Friedman, Richard Sogg, and Valerie Purvin. J: Did you leave Judaism behind? D: No. My paternal grandparents were very orthodox. My maternal grandparents kept kosher. I was doing religious things, but I didn’t want to become a rabbi because you have to write a sermon every week, and I couldn’t do that. Eventually, as a neuro-ophthalmologist at Stanford, I gave a different talk every week. I said, “Wait a minute. I wasn’t going to be doing this.” J: So from Cleveland, you went to Harvard College. What did you major in there? D: That’s one of my problems in life. I never could figure out what I would major in, and that’s why I’m a neuro-ophthalmologist. Music at Harvard in 1948-1952 was all theory. I was not interested. Also I knew a guy who was a music major and didn’t like it. Harvard had a field called “biochemical sciences.” J: Did your father influence you? D: Yes, he was a general practitioner. When I was 8 or 9 years old, I asked him, “What if I don’t go into medicine? What if I become a garbage collector?” And his answer was, “If you’re a good garbage collector, that’s all that’s important.” J: You graduated in biochemical sciences. And then straight to medical school? D: Yes. But I had a tutor named Ivan Frantz who did stuff with cholesterol in rabbit aortas at Mass General (Massachusetts General Hospital) and who told me “Maybe you should go to the New England Conservatory of Music and not to medical school.” J: But you went to Harvard Medical School. D: Yes, accepted in March 1952. J: What happened to you at Harvard Medical School? D: I was not the greatest student there, but I was doing music. I played all the shows. I was a music director, and it was like being in the Glee Club. It was a terrific experience—great friends, really brilliant people. I learned the Mozart clarinet concerto with one of my classmates who was a clarinetist. You’d think they’d be teaching you histology, but no, I had to learn the clarinet concerto. So, you see, I never dropped music. I played a concert grand piano in the common room. If you look at the last edition of the Harvard Medical School Alumni e4 Bulletin, you’ll see what Howard Rubenstein said, “I used to hear Richard Sogg play in the common room in Vanderbilt Hall, and I was elevated.” J: What came after graduation? DS: David Glendenning Cogan came to our Harvard College Pre-Med Society along with David Donaldson. They showed their 3D dissection of the eyes. There was something about Cogan—inspiring, humble. Anyone who spent any time with him had to be inspired. And the other person who inspired me was Abraham Pollin. He gave a lecture on how a study of the eyes can teach you about systemic disease. Another guy who was influential, but didn’t get me to go into his field, was a professor of radiology—Richard Schatzki of the “Schatzki esophageal ring.” He was from Germany and he owned two grand pianos. His son Stefan was in my class and would drive me to his family’s house in Belmont, and he would go and study like a fiend, and I would be playing two pianos there with his father. J: Did you give a thought to radiology? D: Yes. It was radiology, ophthalmology, radiology, and ophthalmology. I had a long talk with my uncle, who was a radiologist. I said, “You know, the only thing I don’t like about radiology is that there’s not much patient contact.” He said, “You’ll get over it.” J: But then you chose ophthalmology, why? D: You can be a pediatrician and a geriatrician. You can be an internist and a surgeon. J: After you graduated from Harvard Medical School, what then? D: I got married right at the time of medical school graduation. My wife had been a sophomore at Radcliffe. Her father was a general practitioner at Newton Wellesley Hospital. They had season tickets to the Boston Symphony. Then I went as an intern to Cleveland Metropolitan Hospital and into my ophthalmology residency at (Case) Western Reserve. They sent their residents to the Mass Eye and Ear Basic and Clinical Science Course, where I met Dr. Cogan again. I got interested in neuro-ophthalmology. At the end of my three years of ophthalmology residency, I took a year of neurology. J: What happened next? D: I had to tell the Berry Plan that I’m available for military service. They said, “you’re too well trained for us.” So I decided to take a neuro-ophthalmology fellowship. The only two people I knew were Frank Walsh and David Cogan. So I applied to each of them. Walsh said, “You can work on my neuro-anatomy atlas.” I wasn’t interested in working on an atlas. I wanted to see patients. So I went to see Cogan, but his fellowship had been filled. Walsh and Cogan mentioned a doctor in San Francisco—William Fletcher Hoyt. I didn’t know who he was, and I can assure you he didn’t know who I was. But somehow I got the fellowship. J. Were you the only fellow? Trobe: J Neuro-Ophthalmol 2021; 41: e1-e5 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. Great Conversations D: I was his first fellow! The happiest people were the UCSF ophthalmology residents. When they went on the neuro-ophthalmology rotation, they were incinerated. Here was this guy to take the cruelty off their backs. They loved that I was there. From an educational point of view, it was the best year of my life. J: But the fellowship was hard going? D: Yes. Dr. Hoyt would say, “certainly you’ve read so and so’s article in the Journal of Neurology, Neurosurgery, and Psychiatry.” I had never heard of the authors, and I had never heard of the journal. Ever since that time, I have known that any sentence that starts with “Certainly you’ve heard of.” is the beginning of spontaneous keloids. J: During your fellowship, you wrote some papers with Dr. Hoyt. D: Yes, but I had had some publications before that. My first paper was in the Anais Brasileiros de Ginecologia in Portuguese on pulmonary hyaline membrane disease. How can that be your first paper? That doesn’t get you into the executive washroom. My second paper was in JAMA Ophthalmology—a case report on Moebius Syndrome. That was a legitimate paper. I didn’t write many papers, but I did get close many times. Dr. Hoyt gave me the diagnosis of “agraphia malignans.” J: But didn’t you write a paper together on spastic paretic facial contracture? D: Yes, I was the senior author. Dr. Hoyt might have modified my language a bit. He would say, “How could you write that sentence?” But it still gets quoted. J: Which other publications are you most proud of? D: A paper that dealt with the complications of radiation to the brain. I could have written more papers. Every time someone is introduced as a guest speaker at Stanford—and I’m sure at every academic institution—it is with “He has written 400 papers in peer-reviewed journals.” They would never say that about me. But I still go to Stanford ophthalmology grand rounds. There’s always some guy from some weird place like Ann Arbor and I can say something funny. Or I can say something that no one in that room knows about because I started at Stanford in 1962. None of them were even alive! When they’re talking about all the stuff that they’re doing now, I may say, “I’ve got news for you, we did that at Stanford 60 years ago.” J: Did you go directly to Stanford from your fellowship? D: Well, I tried other places. Do you remember the yellow textbook of ophthalmology by Cook, Vaughan, and Trobe: J Neuro-Ophthalmol 2021; 41: e1-e5 Asbury? Well, Vaughan and Cook needed a neuroophthalmologist in their private practice in San Jose. But I only lasted one year there. Then I went into solo practice and later a combination of solo practice and Stanford faculty. J: When did you retire from the Stanford faculty? D: In 2003, but I continued seeing patients in private practice until a few years ago. J: As you look back, how do you think neuroophthalmology has changed? D: The newcomers do not have the luxury of talking to just two patients in an afternoon. Lawton Smith would say, “They scheduled three patients for today. They overbooked me.” The thing that is still good about neuroophthalmology, though, is solving a problem that has eluded other people, sometimes very good ophthalmologists. J: Dick, you still go to the annual Walsh-NANOS meeting. How long have you been going? D: I went to the second Walsh meeting, something like 45 years ago. In those days, the meeting was held in Baltimore. J: One of the things that amazes me about this interview is your incredibly lively recall. I’m imagining that the notes on the piano are there for you. Can you play the music by heart? D: I do, but I don’t risk it. Here is a true confession. When I was 16 years old, my parents and I were at the University of Chicago in a common room, seeing some of my father’s army buddies, and they asked me to play the piano. I played the Brahms Rhapsody in G minor, which I had studied. I knew every single note, no problem. I got lost. And that was an earth-shaking event for me because I was strongly considering going into medicine. I said to myself, “In medicine, you have to know everything. You cannot forget anything.” J: At age 90, what do you see ahead? Playing music, hiking, and attending virtual grand rounds at Stanford? D: If they hold it, I’ll sign up. Jonathan D. Trobe, MD Departments of Neurology, Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan e5 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited.