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Steve Charles, MD: surgeon, engineer, inventor
Hard work has paid off for Steve Charles, whose efforts have led to the development of 15 surgical techniques, 40 surgical tools and countless clinical discoveries.
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In the Charles family, hard work was not a choice — it was a way of life.
“My father was a college professor and designer, my uncle was a cancer surgeon, my grandfather was cancer surgeon. My other grandfather was a mechanical engineer,” said Steve Charles, MD, with a smile.
“All of these men worked 18-hour days, 7 days a week — just like I do.”
As a child, Steve was surrounded by cultured and creative minds, exercising their intellect, teaching, writing and showing him the value of hard work and education.
“I was always with my parents’ friends, who were professors and creative types. In first grade, I met Frank Lloyd Wright and Buckminster Fuller,” he said.
However, it wasn’t until his maternal grandfather — an auto-engine designer — took him on a trip to his factory, that a dream of being a designer, inventor and innovator took flight.
“I would go to his factory with all my drawing instruments and be ready to design. As a boy, I really thought that I was an engineer,” he laughed.
The youngster’s dreams led him to major in engineering in college, but he soon realized a career as an engineer could not completely fulfill his desires.
“I didn’t want to sit in a room all day and do calculations at a drawing board. I wanted to be more creative, to have direct contact with people,” Dr. Charles said. During this time, guidance from a college faculty advisor set him on his path.
“He said ‘Go to medical school and work hard in medicine. Then you’ll know what problems to fix with your engineering skills,’” Dr. Charles said. “But, he added, ‘Don’t let your engineering skills slip. Work doubly hard so that you can keep both talents up throughout your life.”’
This is just what Steve Charles did.
A precocious start
In 1969, Dr. Charles received his doctorate from the University of Miami School of Medicine. He went on to perform his residency at Bascom-Palmer Eye Institute in ophthalmology, but he had settled on that specialty long before.
“I selected ophthalmology within a month of entering medical school, and I never wavered on that decision. The microsurgical aspect attracted me,” he said.
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During medical school he spent every free moment working at the Bascom Palmer Eye Institute. “There I had the good fortune of working with Dr. Edward Norton. He was a fabulous leader who encouraged me to work on technology for medicine,” Dr. Charles said.
While working at the institute, Dr. Charles focused his energies on the anterior chamber. In 1968, he identified the cause of the fixed, dilated pupil in angle-closure glaucoma. This was followed by the uncovering of an afferent pupillary defect during retinal rivalry in amblyopia.
After junior year in medical school his interest shifted to the retina. While working as an intern and fellow at the Jackson Memorial Hospital in Miami in 1970, Dr. Charles went on to detect and document the presence of early receptor potential in detached retinas. At this time, he also determined the role of exposure to ambient illumination in the degeneration of photoreceptors of a detached retina.
After his residency, Dr. Charles spent 2 years in a fellowship in retina-vitreous at the National Eye Institute in Bethesda, Md., and worked with biomedical engineers at the National Institutes of Health.
“I learned things from the engineers as I kept up my own engineering skills. I also taught myself electrical engineering,” Dr. Charles said.
Because of his specialization in vitreoretinal surgery, Dr. Charles became a retinal consultant to the National Navy Medical Center while in Maryland.
“It was during these years that I developed some of the vitreoretinal surgical techniques that I am most proud of,” Dr. Charles said.
In 1973 and 1974, Dr. Charles developed the techniques of internal fluid/gas exchange, internal drainage of subretinal fluid, endophotocoagulation, linear suction and scissors segmentation of epiretinal membranes.
In all, he has developed more that 15 surgical techniques for vitreoretinal surgery and authored three editions of his textbook, Vitreous Microsurgery.
Developing ophthalmic tools
It was in these early years that Dr. Charles began to develop relationships with industry manufacturers and small businesses, which helped him move his ideas and inventions into operating rooms around the world.
“I sought out ethical and effective companies that I felt safe working with. Many of the companies were acquired by Alcon — the company that I am proud to work with today,” Dr. Charles said.
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These relationships were formed while Dr. Charles was entering private practice in 1975. Today, his practice has become the Charles Retina Institute, in Memphis, Tenn., where he resides.
Dr. Charles approaches work in his practice from egalitarian perspective. This philosophy extends to all aspects of his life.
“I don’t believe in a feudal system. To me, everyone is equal. I listen and learn from nurses, scrub technicians, manufacturers and engineers. These people are important because they tell me what the real problems are,” Dr. Charles said.
By listening to all voices, Dr. Charles said, he is able to design products that make surgical procedures run more smoothly, with more efficient and effective results.
“It’s essential to listen to the feedback from novice surgeons. Things need to work for them as well as for highly skilled surgeons,” Dr. Charles said.
Surgeons from around the world have come to call on Dr. Charles. In his lifetime, he has welcomed 1,200 visiting doctors to observe surgery and learn his techniques. He has taught and performed surgery in more than 25 countries and is licensed to practice in 10 states.
“In my travels, I am constantly challenged by the questions and the feedback that I am given by all types of surgeons. It’s these ideas that help me to constantly improve the products that I design,” he said.
Ideas that are generated in the operating room are physically shaped in Dr. Charles’ personal machine shop. Some of the surgical products and modular systems he has designed include the Accurus from Alcon (a systems integration unit), the MicroVit vitrectomy system, many scissors and forceps, microvitreoretinal blades and disposable lymphatic cutters.
In total, Dr. Charles has developed more than 40 tools for ophthalmic surgery, not including his most recent inventions with MicroDexterity Systems, a company he founded. He has been issued 15 patents.
Dexterity enhancement
MicroDexterity Systems is a company that Dr. Charles established in 1996. MicroDexterity tools are machines designed to enhance the surgeon’s dexterity while performing surgery.
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“Our robotics smooth out a shaky hand, scale down the motion and allow you to perform surgery with your hands more precisely,” Dr. Charles explained. “It’s kind of like power steering for your car, or anti-skid breaks and active traction control.”
Dr. Charles’ impetus for investigating this type of device came in 1976, when Dr. Charles’ father died of a brain tumor.
“During that time, I learned that it is very hard for doctors to dissect tumors and aneurysms. My father’s death hinted to me that maybe he would like me to work on a solution for that problem,” he explained.
Dr. Charles started working on dexterity enhancement robots more than 10 years ago. This year, his prototypes will be deployed in neurosurgical operating rooms throughout the country.
“Our product is called MicroDex. It’s a single system that supports tools, drills and machinery for skull-based neurosurgery, surgical spine and ossicular chain replacement in your ear,” Dr. Charles said.
Dr. Charles said he did not develop these microdexterity enhancement systems specifically for ophthalmology, but they could be useful for vitreoretinal surgery in the future.
The robotics work has found additional applications in hazardous material handling for the Department of Energy and automatic transmission assembly for Ford Motor Co. The risk of harm to factory and plant workers has been reduced, Dr. Charles said, by modifying and upscaling the dexterity systems to handle larger tasks.
Free time, free care
Instead of spending money and time on personal pleasures like exorbitant vacations and expensive toys for grown-ups, Dr. Charles chooses to apply his resources to providing free surgical services and developing new technologies.
“I try to focus my time and my energy on helping people and developing easier ways of performing surgery,” he said.
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In following the path of his uncle and godfather before him, Dr. Charles offers free care to those who cannot afford to pay for it. He has performed millions of dollars worth of free surgery.
“Last year, I did 1.5 million dollars of free surgery. This is something I believe very strongly in doing and will do for the rest of my life,” he said. “I don’t believe in letting someone go that needs care.”
In order to keep up his rigorous schedule of 18-hour days, 7 days a week, Dr. Charles follows a strict health and fitness regimen.
“I work out every other morning for 2 hours to sustain my energy during the week,” he said. “This is something that I’ve practiced religiously over the past 15 years.”
His diet is primarily fruit, vegetables and fish.
“I abide by a healthy lifestyle because I think you are responsible for your own health. There is a huge amount of illness caused by patient behavior,” he said.
While his endeavors leave little time in the daily schedule for activity other than work and exercise, Dr. Charles makes sure he always has time to spend with his family.
“I have three beautiful daughters and two grandchildren whom I spend my free time with,” he said.
In keeping with the Charles family tradition, all three daughters are hard workers. His two oldest daughters have followed in their father’s medical footsteps and become doctors. His youngest daughter, a recent college graduate, has also followed in her father’s footsteps by focusing on a career that demands her creative talents; she is a musician, composer and graphic artist.
What lies ahead
For Dr. Charles, the future looks much like the past: hard work and the development of more ideas will fill the foreseeable future. He said he never tires of his hectic schedule or his 18-hour days.
“I love what I do. It’s fun, and it enables me to exercise my greatest interests — engineering and medicine. I love creating things, developing instruments and helping people,” Dr. Charles said.
He plans to continue to study the “complex and complicated” anatomy of the posterior chamber, to continue to teach his surgical methods to surgeons worldwide, to explore new approaches in science, to write, to design and, most important, to be creative.
For Your Information:
- Steve Charles, MD, can be reached at the Charles Retina Institute, 6401 Poplar Avenue, Suite 190, Memphis, TN 38119; (901) 767-4499; fax: (901) 761-0727; e-mail: scharles@att.net; Web site: www.charles-retina.com. Dr. Charles has no direct financial interest in any products mentioned in this article. He is a paid consultant for Alcon.