Sometimes I sits and thinks
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It’s summer on the North Coast of America. Here I sits once again, accompanied by my Aussies Sasha and Bohdi, thinking.
Whenever someone asked me what I would do if the medicine thing didn’t work out, I always gave the same answer: I’d be a writer. As a young man, I was a voracious reader, pretty much any and all genres. I read enough to realize that it would be highly likely that I would starve writing what might be called “literature”; even “literary science fiction” seemed to be a bit presumptuous. But maybe, if I worked really hard at it, maybe I could make it as a columnist on the sports pages.
And so I devoured the columns of New England and New York sportswriters. Dave Anderson and Ira Berkow of The New York Times. Bob Ryan and Leigh Montville of The Boston Globe. And the writer who most inspired me, indeed the inspiration for “Sometimes I Sits and Thinks,” the wonderful Bill Reynolds of my hometown Providence Journal. My Mom and I would pass his Saturday column — “For What It’s Worth” — back and forth, discussing both his insights and his unique writing style (he wrote his comments to “Bunky,” his everyday Providence buddy). We loved Fall River Dreams, his book about a kid from the wrong side of the tracks who made it all the way to the NBA. Reynolds passed away July 13 at the age of 78. As I sits here, dogs at my side, I’m thinking about Bill.
- Every dry eye disease (DED) doc is a genius in the summer months. At least those of us who live in northern climes. Come the winter, we all become dullards, barely competent. It’s much more fun being a DED doc in the summer.
- Summer quiz: Bill Reynolds and Eric Donnenfeld share this activity in common. (Answer below.)
- As you read this, I am gearing up to write my annual September anti-inflammatory review. I will doubtless have all kinds of stuff to say about the impact of generic cyclosporine, pharmacy benefit managers, and how cool it is to have Mark Cuban hanging around. Still, I am weeks or so away from starting to write. Who knows what kind of mischief Brent Saunders will have gotten into by then?!
- Seriously, Brent Saunders is the gift that just keeps on giving to writers like me.
- Speaking of cyclosporine, CyclASol got approved as Vevye (cyclosporine ophthalmic solution 0.1%, Novaliq). I’ve lost count of how many times I’ve been asked if we need another branded cyclosporine on the market. We have Restasis (cyclosporine ophthalmic emulsion 0.05%, Allergan) and Cequa (cyclosporine ophthalmic solution 0.09%, Sun Pharmaceutical) and four generics now; I’m going with no, we do not. Remember There’s Something About Mary? Vevye is officially the “ Brett Favre ... ver ... rer” of eye care. I have no idea how to pronounce it.
- Harrow has been on the hunt, and no one there asked me about the cyclosporine market. It announced the acquisition of Vevye on July 19 on the heels of its July 18 announcement that it had acquired Santen’s eye care portfolio. Big week. Big pivot for a cash-only compounder. Wonder what else it has in mind.
- Is it just me, or is it kinda funny/weird that the only company other than Brent Saunders, er, Bausch + Lomb making any waves is Harrow?
- Wasn’t it just a few months ago that Viatris was announcing its intention to be a “major player” in eye care pharma? There’s been an awful lot of stuff on the market that looked like a nice fit there.
- And where’s Alcon while all of this has been going on? It feels like Ferris Bueller’s Day Off. You know, that scene with the teacher doing roll call. “Alcon ... Alcon ... .” There is no truth to the rumor that Texas Rangers were investigating a missing persons report regarding the business development folks over in Fort Worth.
- Summer reading tip: Bill Reynolds was famous in Rhode Island for reading and promoting the books he liked. I considered suggesting a novel about Rhode Island written by a Rhode Islander (City on Fire by Don Winslow), but since I’m thinking about Bill, here’s one he suggested that my Mom and I really enjoyed, Live by Night by Bostonian Dennis Lehane. The whole series is just great summer reading.
- I think of Joe Coughlin every time I drink rum.
- It’s exceedingly rare to have not one, not two, but three unique first-in-class medications arriving on the scene at the same time in a single specialty. But here we are, on the cusp of three FDA approvals for medications to treat dry eye and meibomian gland dysfunction over a period of 3 scant months. This is cause for celebration if TP-03 (lotilaner ophthalmic solution 0.25%) from Tarsus and reproxalap from Aldeyra follow Miebo (perfluorohexyloctane ophthalmic solution, Bausch + Lomb) into the market. I can’t recall anything like it in my 33 years of practice.
- B+L is ramping up to educate us all about Miebo. It sure looks like that’s going to include in-person meetings where more experienced DED docs share the science behind what I’m convinced is going to be a transformative treatment. That’s right, no Zoom or Teams nonsense, but old-school, in-real-life, shake hands and break bread commune with your colleagues-type meetings. I can’t wait.
- We get all kinds of unscheduled, unsolicited visits from representatives from companies with products used to diagnose and treat DED. Don’t get me wrong, I am truly and sincerely delighted to see so much investment in our space bringing new options to our clinics. But maybe we can dial down the hyperbole (“This instrument has made literally every other dry eye treatment obsolete”) and sales speak (“There’s a 6-month backlog on orders; the boat is sailing away from you”) juuusst a bit, eh?
- Quiz answer: Both Bill Reynolds (Brown) and Eric Donnenfeld (Dartmouth) played Ivy League college basketball.
- Been here a bit, the dogs and I, sittin’ and thinkin’. It’s funny — the smoke from the Canadian wildfires has been pretty intense. Really tough on dry eye sufferers. Sasha, Bohdi and I have been out here on the porch for quite a while, and the sun is setting. It’s getting a bit chilly as we enjoy a brilliant red sunset through the haze. Time to call it a night, Bunky.
Fair winds and following seas, Mr. Reynolds. I sits and thinks because, well, just because. But I write about it, I’m a words guy, because of men and women like you. Rest in peace.
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