Do you have any regrets about leaving clinical medicine for administration? What are a few of your most and least satisfying memories of caring for patients with glaucoma?
When I was growing up, all I ever wanted to be was a doctor. I loved clinical medicine. Although I see patients rarely now, I still actively spend about 30% of my time on patient care and healthcare through projects such as building a hospital and overseeing a medical center and a medical school. What I miss is my personal connection with patients.

My favorite memories are of getting to know patients and working with them toward the common goal of preserving or restoring their vision. For example, I met a young woman who came to the clinic with vision loss from uveitis and associated retinal degeneration while I was a first-year resident. Because I stayed at the University of California, San Francisco, for my fellowship and faculty years as well, I saw her continuously for 26 years. Unfortunately, her disease ultimately blinded her. On my last day of active practice, she rode a bus 30 miles just to say goodbye. Relationships like that were a tremendous privilege. My least favorite memories are of cases in which a poor outcome was inevitable. If I could change anything, it would be to give everyone a perfect outcome.

What predictions would you make for the state of US healthcare in 10 years?
I think that the cost of US healthcare will continue to rise with modest gains in quality until there is a national epiphany that this is a ruinous course. Within the next decade, I believe that, as a country, we will realize that we need a real change in policy that improves the quality of healthcare and dramatically reduces the cost.

Chancellors are often blamed for actions taken at their universities. How do you cope with negative press?
It is essential to keep the long view. My goals are to help shape the future and to improve the quality of life of the individuals in my region as well as nationally. I focus on what is good for the University of California, Irvine, its students, and the individuals who will benefit from the information that this school develops.

An inevitable part of a position with a high profile is that you are a magnet for criticism and are largely shielded from credit! If you think that a job such as this one is about you, you have lost the game. It is really about what is good for the institution and its relationship with the community.

What would you like to see change in terms of higher education in the United States?
In general, higher education is one of the things that make this country great. To be robust, the system must engage the hearts and minds of young people. To the extent that entire segments of the population—for a variety of reasons—lack full access to higher education, the nation suffers, because it is not developing and drawing upon the best and brightest minds. We have to make sure that our policies and practices promote excellence and inclusion. This is a complicated area, but many people are committed to changing our inertia-bound system.

One way in which the University of California, Irvine, is working to improve education in the United States is by readying boys and girls for higher education—particularly those from communities that have traditionally lacked access to such institutions. The university has more than 100 programs in the local educational system, from preschool to 12th grade, that work with students, teachers, and parents as well as collaborate with industry to develop innovative teaching modules. I believe in developing the leaders of tomorrow by working with the children of today.

Word has it that you have not picked up a club since playing golf in Sacramento, California, 15 years ago. What do you do for fun?
Never believe rumors! I still play golf, poorly, about half a dozen times per year. I also have a bicycle that, when I am lucky, I ride fairly regularly. My job is extremely stimulating. It is great fun to work with people on programs as diverse as K-through-12 education, cancer research, and poetry. I can also enjoy the performing arts on campus. I am extraordinarily blessed to have these opportunities.