As we sat down to interview Dr. Rod Nowakowski for his "Get to Know" piece, Dr. Paul Batson pointed out an interesting problem. He said, "The challenge with getting to know Dr. Nowakowski is that he has basically taught everyone in the state." Yes, it's true that "Dr. No" taught the majority of Alabama's ODs during his 30+ year career at the University of Alabama at Birmingham, but we are willing to bet that we uncovered a few things that few, if any, of you knew! Check it out below! Tell us a little bit about your background. I was actually born in Deming, New Mexico during World War II. My mother moved to Miami, Florida where my grandparents lived while my Dad served overseas. Since I moved there at age one, I sort of think of myself as a native of Miami. My parents had a dance school and when I was about 12, I started working nights there. They were called cotillion clubs and that's where mostly junior high school students came to learn the basics of ballroom dancing, etiquette, and courtesy. I helped my mother there because my dad didn't really have time to do it every night. I also gave private ballroom dance lessons and I did that through all of high school and some of college at Florida State before moving back home. That same year, when I was 12, my mother asked me what I wanted for Christmas and I had no idea why I said this, but I told her I wanted a guitar. So I got a guitar for Christmas from the Sears Roebuck catalog. It was $12 and the neck immediately started to warp from the tension of the strings. After I got the guitar, some friends of ours knew I was interested in learning and they invited us over for dinner to meet a friend of theirs who was a classical guitarist. I came over to hear him play and was mesmerized. I wanted to learn to play like that and I asked him if I came to Havana, Cuba would he teach me how to play. He said that was the last thing in the world that he would want to do and that he couldn't stand to listen to all of the mistakes students would make. Two years later, he had to immigrate to Miami and he came with something like $24, his wife and two kids, and his guitar, which was extremely valuable. It was made in 1946 and he had convinced the guards when he was leaving Cuba that it was worthless so they let him keep it. I became his first student of guitar in Miami and we helped him get a house, a car, and all of that stuff. Truth be known, I am not a very talented musician. He thought I would go on to study music in college, but you couldn't study guitar at that time. How many guitars do you have now? Maybe 15? I'm not really sure. You know, Glenn Hammock came as Chief of Staff to UAB's Optometry School and I found out he played guitar. We started talking about forming a band and we put a sign up in elevators telling anyone interested to contact us. Low and behold, these extraordinarily talented students contacted us and we had several individuals who had played in bands. I had literally never listened to rock and roll music and I had no idea how to play the blues. We ended up with an interesting mixture of songs and played the faculty Christmas party as our first gig. Eventually, we played three or four of the student fraternity parties. Before I knew it, we were a real band and needed a name. The usual names came up such as "Macular Degenerates" and stuff, but we ended up being called "Rod and the Cones". So, when did you learn to fly? A classmate of mine and my best friend in optometry school, Billy Spitz, had been in the Air Force and had learned how to fly in a flying club. He was always talking about it and I knew some folks who flew. So maybe 1976? A year after graduation or so? My brother-in-law told me he knew a guy who taught flying and he was another physicist, Ivan Brezovich, at UAB. So, I called him up. I had always been afraid to fly, and I still was at that time. My first lesson, we took off and we are about 300 or 400 feet in the air and his dashboard detaches and falls in our laps! I thought, I am dead. He picks this thing up and slams it back in place like it is part of flying and keeps going. But I survived and have been flying ever since. I am on my sixth airplane now. Flying is in my blood. My mother learned to fly in biplanes probably in the 1930's and my father was a bombardier in B-29's and my cousin was a fighter pilot killed in the Philippines. You have spent your fair share of time at institutes of higher learning. Tell us more about your path to where you are now. I went through a lot of school and didn't really have a focus on a career. I started at Florida State University before transferring back to the University of Miami and getting a Bachelor's in Mathematics. I actually taught high school for a year in downtown Miami after that. It was during the major exodus from Cuba, so the school was something like 97% Cuban. Anyway, I was teaching high school and a couple weeks after I started the entire teacher force in Dade County went out on strike. Well, I needed the job so I did not go out on strike and when they all crossed back over I was exiled to the gymnasium. I was in the weightlifting room with 120 students and a football coach teaching basic mathematics for slow students. This was like how to use a ruler and how to use a compass to draw a circle. Many of the students were there because they didn't speak English and I spoke Spanish so they put them in this basic math class regardless of their prior education. These kids were bored to death and there was no air conditioning in the room. The good news was that there was no loudspeaker so we didn't have to listen to the announcements or anything else. So you were exiled to the gym because you crossed the line? Yeah. I crossed the line every day to nasty comments and whatever, but I didn't care. What did you do after your year as a high school teacher? Well, I liked it so much that I joined the Army. I was in the reserves and was on active duty and had to do summer camps and drills for six years. I was trained as a combat medic and was sure I was going to get sent overseas. At the time, life expectancy was like three weeks, but I didn't have to go and I am eternally grateful for that. I went back and to school at the University of Miami to get my Masters in Mathematics with an emphasis in Bioengineering and was talking on the phone one day with my sister who lived here in Birmingham, Alabama, about what I was going to do. I told her that I didn't really see any future for me in mathematics. I was considering getting a PhD in Bioengineering, but there was only one guy there I could do it with. He was working on an artificial heart and, at the time, it was as big as a house so I figured there was no way that was going into a human being in my lifetime. I needed to find something else to do. My brother-in-law was a physicist and he was teaching optics at the UAB's School of Optometry. He and my sister asked if I had considered a career in optometry and the answer was no, not even remotely. But I came up and visited the school and had an interview with the Dean, Hank Peters. He was a real talker and the interview was like three hours long. After two hours, I said, "Dr. Peters, do you think there's any chance I can get in this program?" He was like, "Oh, yeah. Here's what the new building will look like..." So, I was accepted and entered the third class of the UAB Optometry School in 1971. After two years, we got a Bachelor's Degree in Physiological Optics and then in 1975 we got the OD and they had an opening on the faculty for someone to head up the low vision program. That was one of the few things I actually liked in optometry school and thought was a chance to really do something for people who would appreciate it. You know, you give most people glasses and there is an expectation that they will see 20/20, but if you help someone with low vision, that seemed to make a big difference. We were going to the Alabama Institute for the Deaf and Blind in Talladega and, initially, I had the low vision clinic every day of the week. We didn't do it like we do now. Back then you were in a specialty clinic and you did that all the time for one term. So, while I was there I saw a lot of students with hereditary eye disease and thought that I needed to know more about that. I started taking classes in the genetics program at UAB. After about a year of that, they said they were starting a PhD program in medical genetics and I asked if I could get in. They told me I could apply, which wasn't exactly encouraging, but I did apply and I got accepted. I had already spent some time going through those other classes so I knew who I wanted to work with. He was a big biochemical geneticist who was always writing these unbelievable formulas on the blackboard. I wasn't sure it was going to work, but when I was accepted he was the one who told me. I told him I had a full-time faculty job and he said, "Rod, what you do in your spare time is your own business." So, in his view, I was a full-time PhD student and in my spare time, I was a faculty member of the optometry school. When did you graduate with your PhD? I don't exactly remember the starting date, but I graduated in 1989. It was 24/7 for a number of years. So you have your Bachelor's of Science, Bachelor's of Physiological Optics, Master's in Mathematics, Doctor of Optometry, and PhD in Medical Genetics? Yeah. I have five degrees and wasn't the youngest graduate in any of those programs. How did your career in genetics develop? After my PhD, I was still in charge of the low vision program and I really couldn't do a postdoc. I probably would have had to go somewhere else and give up the job. I didn't really do a lot in genetics until one day in 2006 when I got a call from a lady at the National Eye Institute and she described this program called eyeGENE. She asked if I would be willing to serve on the steering committee. The goal was to create this big depository of DNA from people with hereditary eye disease. I told her I would think about it and she thanked me for agreeing to serve. Literally. (Laughs) So, I have been on that steering committee since the inception of the program and that really beefed up my genetics exposure because I not only served on the steering committee, but I also became a submitter of samples to the program. The program has been a huge success. You retired from UAB in 2014. How did you end up at VisionAmerica? When I retired from UAB I got to talking to Jim Marbourg and... you shouldn't put this in there but I'll tell you the truth. I wanted to keep my license and to do that, I have to have an office because when you turn in your data for licensure they ask you where you are practicing. I talked to him about having an office here; not literally, but on paper. I wanted a phone number and to have a place I could go if I was ever going to see a patient. As we talked more, I told him that one thing VisionAmerica doesn't have is a genetics program and hand-in-hand with that is electrophysiology, which they didn't have either. He asked what my title would be and I suggested a bunch of possibilities and he picked one so I joined VisionAmerica on a two day per week basis. So you basically created your own job, reserved your own office and phone number, and chose your own title? Not everyone gets to do that... (Laughs) Well, I'm pretty sure that part of that has to do with the fact that Jim and I have been friends for many years. By now, over 40. But he had future vision and saw where genetics would become part of medical care. I know Dr. Batson did too and he was the one who got stuck with me. It's worked out pretty well. How would you sum up the genetics program here at VisionAmerica? The basic goal is we want to define whatever eye condition they have at the molecular level. The example I use with patients is, for retinitis pigmentosa, there are over 3,000 mutations in about 80 genes. We would like to know which one of those you have because when we have gene therapy, it will almost always be dependent upon what your actual molecular diagnosis is. To explain it better I tell them, if you said to me I have a car, I would say really? Well, what kind of car do you have? If you told me you had retinitis pigmentosa, I would ask the same question. What kind of retinitis pigmentosa? And that is true of all hereditary eye diseases. Our mission is to get that diagnosis so the patient can finally have an exact diagnosis, but the holy grail is to get gene therapy that one day actually fixes the condition. Just this year we have had the first FDA-approved gene therapy for one type of retinitis pigmentosa and I'm sure we will have many more to come. When I was in graduate school in the PhD program, I never dreamed that I would see gene therapy. It was really far away. We were barely able to do genetic testing and we couldn't do much of that. It has been exciting to see that transition over more years than I care to admit. How do patients get on your radar here at VisionAmerica? Well, like all of our doctors, they get referred. No one walks in the door and says they want genetic testing. If they didn't get referred, they wouldn't even know it exists. To facilitate that, we've done a lot of newsletters and a bunch of CE programs to let the ODs know about the service. Now, not only am I seeing the patients that are referred, but I'm also seeing their family members to see if they are carriers. You have multiple degrees and taught for a long time, but you also mentioned that you never thought you would see some of the things you are seeing now in the field of genetics. Do you feel like personalized medicine has set up the next phase in your career? Yes. I had been at UAB for 39 years on the faculty and decided that it was a good time to retire after five years of being interim and regular dean. But I knew if I didn't do something, I would go nuts. I was just too involved with all of these things and genetics was really just coming around, too. It seemed like a match made in heaven. A couple of groups have talked to me about the low vision aspect of gene therapy and asked if I would be interested in maybe working with them on that. It is totally undefined and may not even happen, but, to me, that was special. The two things I have spent my whole career on, low vision rehab and genetics, could possibly come together and address the issues of what you do vision rehab-wise when somebody has had gene therapy and it hasn't restored their vision, which it won't, as it stands right now. Can you think of one particular genetics case that had the biggest impact on you? I get a lot of nice comments from people who have been batted around and say we finally got an answer. Barry McNamara referred a patient from Montgomery who had a confusing-looking retina. People would say it looks like Stargardt or it looks like RP, but we don't really know what it is for sure. So I did genetic testing and it was actually Stargardt's Disease. We were sitting in one of these exam rooms and she looked at me out of the corner of her eye, because she didn't see straight ahead, and she said, "I've waited 47 years and you finally got me an answer." But that was so important to her. She wasn't thinking of cures or treatments or gene therapy... she just wanted to know. That one was really unique. That's a wrap! We hope you enjoy this GTK with Dr. Nowakowski! We definitely learned a few things about him in the process! P.S. If you have any "Dr. No" stories, send them our way! We would love to hear them!
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