The lights are on

I recently attended an event celebrating scholarships for students interested in studying science. The after-dinner speaker was U.S. Supreme Court Justice Anthony Kennedy. Having listened to many after-dinner speeches over the years and having delivered a few myself, I admit my expectations were modest. My generalization is that evening speakers frequently are too long, often boring, full of platitudes, and almost never memorable. Certainly my faculty, ophthalmologist colleagues, and innocent but tolerant spouse probably have found it difficult to remain conscious during a few of my evening homilies. When a member of the audience, I often find myself eagerly awaiting the phrases that signal the speaker is approaching the finale, with the subsequent race for the exit and drive home.

But this speech was different. Justice Kennedy spoke about the fact that a decade or two ago, photos of Asia from space revealed mostly darkness, unlike the well-lit night skies of Europe and North America. Pilots described flying for hours without seeing lights below. Now photographs show lights across most of Asia (with the exception of North Korea) and the Indian subcontinent. The lights of the earth can be seen online at http://visibleearth.nasa.gov/view_rec.php?id=12101/.

But these newly lit cities represent only a visible sign of the dramatically changing world. "In 3 years," said Justice Kennedy, "90% of all the engineers in the world will live in China and India."

Personally, I applaud the rising standards of living for hundreds of millions of people that these observations imply. My preference would be that one day, all countries in the world would enjoy prosperity as reflected by lights at night and young men and women graduating from engineering and other professional schools (perhaps as a result of studying at night, made possible by the aforementioned lights). It is disappointing that some countries, such as North Korea, still remain literally in the dark. Admittedly, the rapidly increasing demands for energy sources and the negative environmental impact of "unclean" energy will need to be addressed as the electrification of additional cities continues.

My other impression is that innovation and progress track along with education. What that suggests to me is if 90% of the world's engineers will be living in China and India, then it is only a matter of time before 90% of the new products and discoveries come from those countries. And that applies to discoveries in medicine (and ophthalmology) as well.

Finally, I believe that visible evidence of development around the world should encourage Americans to redouble their efforts to help improve the lives of people in other countries and build friendships with the populations of these nations. One admirable example of this is the work of the Chinese American Ophthalmological Society (CAOS). This organization, working with academic programs in China, has helped lead efforts to elevate the level of ophthalmic education in that country. The work of CAOS has included translating the basic and clinical science curriculum manuals of the American Academy of Ophthalmology (AAO) into Chinese for free distribution to residents and practitioners in that country (kudos to Allergan for underwriting the program). CAOS also helps bring ophthalmic leaders from China to the United States for the AAO annual meeting. Aside from the clearly positive impact of this work on the level of ophthalmic care in China, these efforts also forge friendships and send the message that we Americans wish the Chinese people well.

The world we leave our children will be better if people around the world see themselves as benefiting from the knowledge and help of their counterparts in other countries. I hope that American physicians, as exemplified by CAOS, will help set the standard in achieving this goal.

Peter J. McDonnell, MD is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of Ophthalmology Times. He can be reached at 727 Maumenee Building, 600 N. Wolfe St., Baltimore, MD 21287-9278 Phone: 443/287-1511 Fax: 443/287-1514 E-mail: pmcdonn1@jhmi.edu