Please share with us your background.

“Never forget where you’re from,” are my mom’s words that I still hold close to my heart. My humble beginnings were on a family farm about 10 miles west of where I consider to be the middle of nowhere. In rural Minnesota, we farmed corn and soybeans, raised hogs, and put up a lot of hay over the years. Farming with my dad was the most formative part of my childhood, with so many stories remembered and forgotten and so many lessons learned, including how to rethread the knotter on a baler and tie a square knot, the importance of community, how to build something that lasts, and what a full day of work actually looks like. There were a lot of things I didn’t have growing up, but with a caring set of parents, I had what mattered most.

At some point between hearing The Rest of the Story from Paul Harvey and listening to Chuck Swindoll at night, I grew up. In small-town Minnesota, sports were everything (and, most importantly, got you off the farm). I gravitated toward running, and while I retired at the ripe age of 19 (right before running became cool), it ingrained in me an important trait: being comfortable with being uncomfortable. It is evident in running that improvement requires discomfort, and lots of it. At the time, I didn’t understand how transcendent that was.

I obtained my undergraduate degree at South Dakota State University (go Jacks) and ventured down to the University of Iowa for medical school. My school experience challenged and changed my thoughts and beliefs, and it shaped me into who I am today. I married my college sweetheart, Shanna, before heading to the University of North Carolina for ophthalmology residency. While there, David Fleischman, MD, MS, FACS, taught me how to be a good doctor by caring about the things that matter most. I completed a cornea fellowship at Duke University—coincidentally as an avid Tar Heels fan during Mike “Coach K” Krzyzewski’s final season with the men’s basketball team. Over 4 years, I cut my teeth treating the patients of North Carolina, and for that I will be forever indebted to the great state.

Following residency, Shanna and I moved back home to good ol’ South Dakota, where we now live with our two beautiful children, two loyal Vizlas, and a garden.

What drew you to ophthalmology and, specifically, to your field of interest

August 25, 2011, was the first time I crossed paths with ophthalmology. I was shadowing an anesthesiologist and had just finished observing a bypass surgery (because as a premed student I, of course, thought I was going to be a cardiothoracic surgeon). I saw “Berdahl” on the OR board and recognized the name. John Berdahl, MD, and I both graduated from THE Hills-Beaver Creek High School. At that point, he was in the early stages of his career—about where I am now. I watched my first cataract surgery while being quizzed by Dr. Berdahl:

“How thick do you think this capsule is?”
“Boy, I have no idea.”
“Well, how thick do you think a piece of paper is?”
“I don’t know, 100 microns?”
“Right! So, how thick do you think this capsule is?”
“I don’t know, maybe like 5 to 10 microns?”
“That’s actually right,” and the rest is history. (Sometimes it’s better to be lucky than good.)

Throughout medical school at University of Iowa, ophthalmology was the specialty I measured everything against—nothing else came close. Vision is such a precious gift, and it is an honor to help the world see better. If I was going to dedicate my life’s work to the best specialty in medicine, why stop there? It only made sense to commit to the best subspecialty of cornea. I wanted to be a bulletproof anterior segment surgeon, and a cornea fellowship lends itself to that. I was also in awe of eye banking as one of the greatest medical advancements of the past century. The way our society comes together to make tissue donation possible instills in me so much hope for our future. Selfishly, the opportunity to be the surgeon who delivers that gift to the patient is the highest of highs.

Please describe your current position.

I’m a surgeon at the greatest practice on earth: Vance Thompson Vision. We work collaboratively with optometrists in our community and within our practice to deliver our version of the best surgical eye care possible. I perform refractive, cataract, cornea and glaucoma surgery at our Sioux Falls, South Dakota, and Alexandria, Minnesota, locations.

Who are your mentors?

Other than my parents, a man named Tom Goehle is probably the third most influential person in my life. He challenged me and helped grow my determination and faith more than anyone over the years.

Professionally, all the surgeons at our practice serve as each other’s mentors one way or another. Iron sharpens iron, and we’re always making each other better. Specifically, Dr. Berdahl has poured a lot of effort into mentoring me over the past decade. Terry Kim, MD, became a close mentor during my time at Duke, and Missy Daluvoy, MD, and Lloyd Williams, MD, PhD, are still the first people I reach out to when I get stuck on a case.

What has been the most memorable experience of your career thus far?

My most memorable experience is performing my dad’s cataract surgery a few months into practice. Closely following are the tough cases that I get to be a part of—I love practicing medicine to my fullest ability and helping people in my community in the process.

What are some new technological advances that you have found particularly exciting? Which advances in the pipeline are you most enthusiastic or curious about?

My colleagues and I have been fortunate to participate in studies for injectable endothelial cells and other drugs to treat endothelial cell loss. I love how our field takes something wildly successful like endothelial keratoplasty and strives to make it even better. Onward and upward!

The generations before us shined a light on global cataract blindness, and while the problem isn’t resolved, great progress has been made. I think corneal blindness and glaucoma-related blindness are areas where my generation stands to make an impact. Many advances in glaucoma could help in the developing world, including MIGS and IOP-lowering goggles (the first surgery-free, drug-free treatment for glaucoma). I’ve also seen some early but potentially impactful advances in cornea, such as a drop to treat keratoconus and a steroid-free endothelial transplant option.

Ultimately, I think one of the most impactful advances in ophthalmology we’ll see in the next decade will be the FDA approval of MELT, a fentanyl-free, IV-free form of sublingual sedation for ocular surgery. I’ve seen first hand how opioids can ruin people’s lives, families, and communities. The less we rely on opioids like fentanyl, the less we expose our patients to them, and the less risk there is of drug diversion. What a simple yet profound impact we can have!

What is the focus of some of your research?

Most of us in ophthalmology are scientists at our cores. It’s unfortunate that many in the field sour on the idea of research because an experience in their training years centered on doing scut work to answer someone else’s questions and filling their CV. At its core, research is about being curious. It’s about having a meaningful question, using the scientific method to answer it, and hopefully helping people in the process.

My first big stint in research involved working with data from the AstigmatismFix database, an online tool designed to assist surgeons in achieving optimal alignment of previously implanted toric IOLs. It was an honor to make an impact so early in my career. Recently, I’ve worked on the AstigmatismFix calculator to include toric implantable collamer lenses; it will be interesting to see the impact we can make by looking at these data.

I’ve also had the opportunity to be the principal investigator for a few FDA clinical trials and a subinvestigator/implanting surgeon for a handful of others. I can’t say enough positive things about our research team. I’ve learned so much from them in my first couple years of participating in clinical trials.

What is a typical day in your life? What keeps you busy, fulfilled, and passionate?

My alarm goes off between 5:00 and 6:00 AM, and I enjoy coffee and a book before I make breakfast for my kids. I’d venture to say that my typical day at the clinic would be considered atypical for most. Generally, the patients I see alongside our amazing optometrists are more complex in nature, and I’m the second (or third or fourth) provider weighing in. As an ophthalmologist, I don’t have to look far to find fulfillment. Our patients entrust us with their most valued sense, and delivering on that trust in a time of vulnerability is sacred. I love this profession, and I love making Vance Thompson Vision a rewarding place to work for our team. A great patient experience starts with a great team experience, and I’m learning more about this every day.

I have a 4-year-old and a 2-year-old, so my evenings are filled with watching Inside Out for the 745th time (I still tear up every time Bing Bong jumps off that wagon), giving underdogs, and refining my Magna-Tiles skills. It’s a great day when we get a family walk/ruck in and even better if I get a workout in after the kids are in bed (Peloton stretches and yoga FTW). I go to bed between 9:00 and 10:00 PM because, after jumping on the Oura smart ring train, I’ve learned just how important it is to get adequate sleep. Someday I’ll revisit the idea of hobbies, but currently, I wouldn’t have it any other way.

What advice can you offer to individuals who are just now choosing their career paths after finishing residency or fellowship?

As I mentioned, I attended University of Iowa for medical school, University of North Carolina for residency, and Duke University for cornea fellowship. Looking back, there was a point in time when I considered each of those one of my greatest failures. I believed my story was supposed to include the Mayo Clinic for medical school, University of Iowa for residency, and Vance Thompson Vision for fellowship. Life is 10% what happens to you and 90% how you react. I think my actual path resulted in the best version of my professional self, and now, looking back, I wouldn’t have written it any other way. Don’t be afraid to fail. If you’re not failing, you’re not setting a high enough bar for yourself. “What was my last failure?” is a question I often ask myself in reflection, and the answer is usually the instance from which I recently grew most. Take big swings and learn from the big misses.

Tell us about an innovative procedure you are performing or a new imaging/diagnostic tool that has improved your practice.

Something I’ve leaned into after fellowship is the visual rehabilitation of keratoconus patients. In my first year of practice, I took on the nuances of topography-guided PRK. This past year, I started performing cornea tissue addition keratoplasty, or CTAK. It’s still early, but I’ve been very impressed with the results. I love mixing and matching these with other technologies, such as an EVO ICL (STAAR Surgical), Apthera IOL (Bausch + Lomb), or Light Adjustable Lens (RxSight), to achieve patients’ goals. I treat every keratoconus patient as a refractive patient and lay out their options for seeing the world more clearly.

Regarding imaging, I couldn’t imagine practicing without epithelial mapping. There are many times when an epi-map has pointed me toward superficial keratectomy for a patient who is unhappy with their quality of vision but shows a pristine stainless cornea on the slit-lamp exam. The next steps are often an IOL exchange or a scleral contact lens, and these have been some of my happiest patients. Epithelial mapping is also a must-have for my refractive evaluations. I can’t wait for an all-in-one (or even a most-in-one) imaging device to reduce the work-up burden for patients and my team.