06.12.2017,
News & Insights, Interviews

Dr. med. Markus Holdt

Markus Holdt moved to Switzerland in 2014. The doctor who looked after the children and families in Essen for many years. It is clear that the Children’s Eye Cancer Foundation will not let him go without looking back.

Mr. Holdt, you are leaving with a smile on your face and a tear in your eye – why?

On the one hand, I’m really looking forward to the new challenge: working in a healthcare system that is supposedly as good for doctors as Switzerland’s and at the same time balancing it with family life – I’m looking forward to that.
I’m also looking forward to slipping into the role of a foreigner, getting to know a different mentality better and redefining myself.
On the other hand, the work in Essen has enriched me enormously.
I have also come to appreciate a great many people in Essen in all areas over the last few years.
Both privately and among colleagues and patients and their families.
It won’t be an easy farewell all round.
The last ten and a half years in Essen have been a very valuable time.

What was special about your work here in Essen?

It was only during my medical studies in Freiburg that I realized that ophthalmology, with its partially surgical and single-organ focus, was the most interesting discipline for me. In 2003, I was very impressed by the interview with Prof. Bornfeld. The special focus on oncology in ophthalmology is not practiced to the same extent and quality at any other university hospital. When I joined the A1 pediatric ward as a junior doctor in the summer of 2006, the triad “children – eye – cancer” became the most motivating task for me in terms of content. My personal situation certainly played an important role, as I became a father for the first time in October 2006.

What is the particular challenge for a doctor – for you – with retinoblastoma?

Looking at retinoblastoma from a pediatric oncology perspective, it is a very treatable disease. The survival rate in Germany is over 97 %, in Africa only around 30 %. From an ophthalmologic point of view, the balance between oncologic consideration and the best ophthalmologic outcome is crucial. The first step for every newly diagnosed child is to reach an appropriate decision in the retinoblastoma conference in order to achieve the treatment goals. To this end, we network with pediatricians, radiotherapists, radiologists, geneticists and, if necessary, anesthesiologists, pathologists, neurosurgeons and oral and maxillofacial surgeons. The primary aim is to save the child’s life and keep the risk of secondary tumors as low as possible. The second priority is to preserve the eyes and the third is to achieve the best possible visual function. All of this presents a particular challenge, as decisions have to be made and weighed up on many different levels. In addition, early detection has not been promoted for far too long outside of everyday clinical practice. I was happy to get involved as a doctor and as a member of the KAKS Board of Trustees. The “See White” information campaign, the completed research work on initial detection and other KAKS projects are right on target. But more of these good measures are needed to hopefully catch the desired boomerang in everyday clinical practice at some point. The goal remains the same here: families with a suspected case must find their way to a specialized facility such as the University Hospital Essen much earlier. From my personal point of view, however, the most important task of the ophthalmologist is to be the appropriate point of contact for families in this exceptionally stressful situation. It also has a positive effect on the children affected if families overcome their disorientation in this unavoidable situation over time and find their way better into the unfamiliar, now everyday waters. Of course, an ophthalmologist can only provide support within the scope of his or her possibilities.

Do you remember your first little RB patient?

Even before my actual time as a ward doctor, I worked as a substitute on the A1 pediatric ward for a few weeks back in 2005.
At that time, a boy from a university town in northern Germany came to Essen for his first presentation.
During the first interview, I could hardly believe the father’s explanations.
The story sounded so absurd: an ophthalmologist’s practice had recommended a masking treatment for a small boy.
Only months later did it turn out that there was already an advanced retinoblastoma in both eyes.
Unfortunately, the first contact with this retinoblastoma child immediately revealed the ambivalence of this disease, which is difficult to comprehend, between the enormous consequences of cancer and the often inadequate initial medical measures.
To this day, the recurring examinations of this boy have had a special significance for me personally.

Has this work changed you, as a doctor, as a person?

This work has certainly changed me.
It is not easy for me to distinguish this from other factors.
Perhaps I can say that the work has allowed me to mature as a responsible doctor and as a person in that I have had to look beyond the scope of an ophthalmologist and always consider the overall health aspects first.
In my view, this applies more to retinoblastoma care than to any other clinical picture in ophthalmology.

Are there people you have met during this time who have particularly impressed you?

There have been so many impressive moments in recent years.
The most poignant are the families or even affected children who have been able to deal with their burden as if it were a worthwhile task and develop exemplary coping strategies.
Whether it was about blindness, eye removal, secondary tumors or simply the diagnosis of retinoblastoma – whether as a family or as a single adult – it is wonderful to observe how people grow and deal with their challenges.
I continue to be impressed by a family whose child sadly passed away and still sends mail to the A1 children’s ward on certain occasions such as Christmas.
As a father of two, these stories are extremely moving for me.

At the beginning of my work, it was absolutely incomprehensible to me how parents affected by retinoblastoma pursue the desire to have children and take on the responsibility of enduring the often arduous treatment period for offspring with a familial mutation, also with regard to the discussions that arise with puberty.
Here, too, I have been able to experience a learning process for myself that clearly shows me with these children: every moment in which the child feels happiness and love, even if unconsciously, makes any doubting thoughts about whether it was the right family decision absurd.

How did the families react to your departure?

Very different: some are dismayed, speechless, many have given me gifts, some have written me very touching letters. Many parents also respond with understanding and wish for a good work-life balance in Switzerland.

What do you say?

Above all, I hope that parents will transfer the trust they have placed in me personally to the University Hospital Essen. My highly esteemed colleagues such as Dr. Biewald, Dr. Metz, Dr. Deike and others will in future bear witness to the fact that retinoblastoma care at the Eye Clinic was not a “one-man show”, but that we complemented each other in a very collegial but also critical and constructive manner. Some parents may miss me, but the attention and good care will remain. The care team on Ward A1, with the nursery nurse Ms. Wibbe and the secretaries Ms. Augusto and Ms. Weiser, are already a guarantee of this. That’s what I want most for the families. The medical expertise in Prof. Bornfeld’s team stands for itself and is the best in the whole of Germany.

You are going to Switzerland.
Why?

I studied medicine in Fribourg and completed the practical year of my studies in Switzerland, among other places. Many friendships in German-speaking Switzerland have stayed with me from this time. One of my godchildren lives near Basel, my son’s godfather lives on the German side of Lake Constance in Wangen im Allgäu, as do my relatives in the canton of Bern and on Lake Constance. This region has always been like a second home to me, after my birthplace Düsseldorf and Essen as the home of my wife and our family. But the most decisive factor was the really fascinating conversations I had with my future employers. So much sympathy, agreement and mutual accommodation have their own special significance. I am curious to see how much of this will remain in everyday working life.

What will be the particular challenge now?

For me personally, this move means first of all presenting my role as a quality ophthalmologist in private practice.
In addition, I am a foreigner in a country that only recently showed with the referendum how critically foreigners, especially Germans, are viewed in Switzerland.
Over the next few months, I will have to find out whether this decision was the right one, especially when it comes to bringing my family here in the near future.
We feel very much at home in Essen and don’t need to move away.
Nevertheless, my wife and I are tempted by the challenge of redefining ourselves as a family, especially in a new place of residence.

Do you remain connected to the topic in any way?

In the last few weeks before I left, I told all the parents how happy I would be if we could meet again at the retinoblastoma meeting in my home town of Düsseldorf in June.
I would like to remain associated with the Children’s Eye Cancer Foundation as a member of the Board of Trustees and a kind of ‘KAKS ambassador’ in Switzerland.
This topic and the wonderful foundation with its many blossoming branches offer an increasingly vital field of activity.
I look forward to staying connected to the topic and the families in this way!

The interview was conducted by Monika König.

Dr. med. Markus Holdt

Back