PXF, the power of the X-factor - Georgiana Dvorak-Theobald.

“Inch forward slowly

my footing uncertain

no conception

of what lies ahead

Could be a golden path

leading to glory

might be quicksand

lying in wait”

On December 28, 1884, a little girl was born to Mr. and Mrs Anthony Dvorak in the Czech section of Chicago. They belonged to a community known as Pilsen, named after the city of bottom-fermented beer, in the western Czech Republic. The Dvorak family owned a tailor shop that helped in providing for the education and well-being of Georgiana. After completing her schooling from the local schools, she graduated in 1906 from the College of Physicians and Surgeons, which later gave origin to the College of Medicine of the University of Illinois [Fig. 1]. As she suffered from pulmonary tuberculosis, her commencement of practice of medicine was impeded by 1 year.[1]

Figure 1

Georgiana Dvorak[7]

In 1910, Dr. Dvorak tied the knot with John J. Theobald, and therefore acquired the name Dr. Georgiana Dvorak-Theobald. Owing to her passion for medicine, she even succeeded in convincing her husband to switch his career from accounting to being a graduate from Rush Medical College in Chicago (1919) and turning into a successful otolaryngologist.[1] She was blessed with mentors like William E. Gamble, Ephraim Findlay, and Robert von der Heydt. The Austrian pathologist Hermann Richard Jaffe, later the chief pathologist at Cook County Hospital in Chicago, accepted Dr. Dvorak-Theobald as his protégé.[1] Dr. William Wilder and Dr. Francis Lane were the ones who introduced Dr. Dvorak-Theobald to ocular pathology. Later, Dr. Dvorak-Theobald replaced Dr. Lane as the ocular pathologist at the Illinois Eye and Ear Infirmary.

Dr. Dvorak-Theobald entered the world of ophthalmology in 1915 [Fig. 2] when she joined as an ophthalmic pathologist at the Illinois Eye and Ear Infirmary. She was also appointed as staff of the Hospital of St. Anthony de Padua. She also served the American Red Cross of the US Army from 1919 to 1920 and had the opportunity to travel to Siberia and Europe.[2]

Figure 2

Dr. Georgiana Dvorak-Theobald (1884–1971)[1]

In 1928, she became certified by the American Board of Ophthalmology and was elected to the American Ophthalmological Society in 1934. Her passion for teaching was well known by her residents, to whom she imparted the knowledge of ocular pathology along with treating them with home-cooked Bohemian desserts.[1] Her motherly instincts and warm nature were always appreciated by her peers and residents. Her ability to create a bridge between pathological observations and clinical applications made her stand out and gave her the power of shining bright as an ocular pathologist.

“But forward I venture

nothing to stop me

obscured by shadows

with fast beating heart

The past closed behind

no way to return

the future enshrouded

in mystery’s cloak”

Primarily, Dr. Dvorak-Theobald is strikingly known for establishing the important anatomic and clinical correlation of three areas:

Anatomy of the canal of Schlemm and its relations with the vascular system[34]

Pseudo-exfoliation of the lens capsule[5]

The location of abnormal resistance to aqueous outflow in the collector channels[6]

Even though Friedrich S. Schlemm discovered the “sinus venosus” (later termed as “Schlemm’s canal”) in 1830, Dr. Dvorak-Theobald was the one to comment on the anatomic significance and functional importance of this structure in 1934,[4] which she later elaborated as she presented her detailed microscopic analysis with ahead of time three-dimensional representations.[4]

Dr. Dvorak-Theobald coined the term “pseudo-exfoliation” of the lens capsule and was able to give food for thought to several researchers to be able to explore the etiology behind the deposition of granular substance on the lens capsule, ciliary body, and zonules. In 1954, she wrote a landmark study based on the histopathologic analysis of three enucleated eyes diagnosed with “wide-angle glaucoma with exfoliation of the lens capsule” along with a review of literature, thereby enlisting the alikeness and contrast between true and false exfoliation of the lens capsule and was able to differentiate pseudo-exfoliation from the true exfoliation seen in glassblower’s cataract.

The tireless work of Dr. Dvorak-Theobald along with her associate Harold Kirk on aqueous pathways and the location of abnormal resistance to aqueous flow in collector channels has today opened several gateways for probable clinical interventions.[6] Her passion and driven attitude toward her work made her an indefatigable researcher who explored several horizons of clinical aspects of histopathologic presentations.

“A step at a time

with careful concern’

I walk towards a vision

of light and still waters

Beyond lies the endgame

my final reckoning

between now and that day

I search for serenity”

-Socalalto (Treading an unknown path)

Her work inspired many to tread the path of the unknown, and several women took a step forward, like Dr. Leona Forden who was closely associated with Dr. Dvorak-Theobald and her arduous journey of traversing novel trajectories.[17]

Dr. Dvorak-Theobald was the charter member (one of the three women members) of the first national ophthalmic pathology club, started in 1947, later named as the Verhoeff–Zimmerman Society.[17] In 1957, to add to her numerous accolades, she was awarded the Howe medal, making her the first woman to have accomplished the same, and was also the first woman to join the American Board of Ophthalmology.[1]

The Mid-western Ophthalmic Pathology Society was later renamed after the legendary Dr. Dvorak-Theobald as the Theobald Society. In 1971, she departed for heavenly abode, leaving behind a legacy owing to her ability to discern the clinico-histo-pathological aspects and giving way to several women to ace and succeed with keen observations and a pragmatic approach in the world of ophthalmology.