Sometime after we first met, my husband – a journalist,
historian and insatiable reader -- confided that one of his worst fears was to
lose the ability to see – or more specifically, to read. He frequently
recounted the haunting resonance of a particular Twilight Zone episode in which a bespectacled curmudgeon is
thrilled to find himself in a world absent of the pestering human race – a
population that only served to constantly interrupt his beloved reading. The
misanthrope is cursed with classic Serlingian irony. When poised to enjoy his
newfound peace he discovers his glasses are crushed, rendering him unable to
read – and no one available to rectify his doom.
When I arrive home one evening to Chris describing a black
curtain closing down the vision in his right eye, I realize he is experiencing
his worst nightmare. Cut to a happy ending: Within 18 hours Chris had emergency
surgery to reattach a retina that spontaneously decided to take a holiday from
its cornea. Overwhelming odds predict a full recovery. The path to this amazing
result was not without its moments of frustration, terror, relief and, yes,
even humor.
We leave our fifteen year old son home to clean up from
basketball practice and get some rest while Chris and I take off for the
Emergency Room. Friends and family who know Chris, who is by no means a
curmudgeon but can be very stubborn, will not be surprised that he spent most
of the 10 minutes before we got back in the car trying to convince me not to
get back in the car. He could drive himself. Driving with one eye is not so big
a feat. His left eye is working just fine. Proudly, I can report that I matched
his pigheadedness oink for oink.
For those who expect a saga of achingly slow health care
service and bizarre ER waiting room tales, read no further. It is not. In fact,
ours is a story of exceptional, prompt and thorough care. I drop Chris at the
ER. By the time I park the car no more than 50 yards away and come inside, he is
already undergoing a preliminary interview with a nurse – even though the
waiting room is crowded with weary, unwell folks.
After about 10 minutes the nurse got on a phone and made a
case with someone – presumably a doctor -- for Chris to be seen immediately. He
is. We are assigned our very own, not very private curtained examination space
and Chris dons one of those three-sided lean-tos of the wardrobe world dotted
with tiny flowers. What is with the flowers? Surely they are the brainchild of
some hospital supply designer who thinks creating outfits sans buttons or zippers
is not quite humiliating enough. Chris, who’s spent more than a little time in
hospitals over the years, anticipated this slight and flings a long-sleeve, plaid
flannel over the cotton garden. Ha! Take that!
Dr. Lagos joins us and Chris tells him what he’d already
described on the phone and to the nurse about the blackness rising from the
bottom and now covering 75% of his field of vision. He includes an explanation
of a head injury suffered two weeks previous in a street basketball game than
ran closer to street than it did basketball. Chris thought it might be related.
Or maybe he just likes telling the story of getting taken down by a thug,
briefly losing consciousness and getting back up to finish the game – a little
metaphorical chest pounding.
Chris also explains that the darkness, while it quite
dramatically and frighteningly worsened in the last several hours, presented
itself as a blurry edge a week previous. A few years before, Chris smacked his
head hard in a pool roughhousing with his nephews. In addition to a nice lump,
Chris enjoyed a week or two of eye floaters. A bit of Internet research assured
him they were related to the cranial bonk and would eventually go away. They
did. Consequently, he imagined the blurry edge of his vision to be a similarly
unfortunate but temporary circumstance and waited for it to resolve itself.
This time, his patience nearly became his undoing. Dr. Lagos
examines Chris and orders blood work and, although he thinks it unlikely, a
CAT scan to rule out brain injury from the b-ball smack down. “I’m pretty sure
it’s retinal,” says Lagos. When I ask what that means, he offers clarification.
“It’s his retina.” (Short pause in which should I catch on but don’t.) “It’s
not his brain.” Oh. Is that good or bad? Let’s go with good since surely brains
are harder to fix than retinas.
Lagos also arranges for Chris to see an on-call
ophthalmologist. The ophthalmologist wants us to meet him at his office,
however, where essential equipment will allow him to examine Chris more thoroughly
than the emergency room. Chris
relinquishes the lean-to and we drive a short distance to a dark a nearly
deserted parking lot where discharge papers instruct us to “keep your
headlights on.” How weird is this? A clandestine meeting in a deserted and dark
lot at 11 pm to meet (wait for it) an ophthalmologist.
A crisply pressed young man hops out of his hybrid, greets
us warmly and herds us past a small band of contractors working on some late-night
office remodeling and into his examination room. Dr. Hou could not be more
sweet or deferential or kind or remarkably neat. Who looks this together in the
middle of the night?
Chris recounts the story that he told on the phone, and to
the nurse, and to Lagos, to Hou. He includes the assault and recovery on the
basketball court. If Hou is impressed, he doesn’t look it. Chris is in a chair
that will support his head, back, butt and but only some of his long legs in a
prone position. The furniture seems to be saying, get comfortable, but not too
comfortable. With the mildly obscene banter of young laborers working in the background,
Hou begins his examination.
By now Chris’s vision is nearly gone in his right eye. Even
the foot-tall E projected on the wall in a darkened room is not apparent to him.
He gets his first of many doses of eye drops to dilate his pupils. Donning head
gear that looks like something Christopher Lloyd would wear in Back to the Future, Hou shines lights
into Chris’s eyes and prompts him to move his eyes “to the right. Excellent.
The left. Excellent. Above. Perfect. Now down to your feet. Excellent.” Wisely,
Hou repeats the process in both of Chris’s eyes, even though as far as Chris
knows, his left is cooperating just fine.
Hou takes his time, too. Lagos, the ER doctor, has already
told us Chris needs to come back for the CAT scan after the visit with Hou
“which couldn’t possibly take all that long, unless… well, surely you’ll be
back here before I leave at 12:30 am,” says Lagos. As the clock spins past
midnight we’re already wondering if Chris is in “unless” territory. The dark
room and Chris’s dilated pupils play a mean trick on him, and for a second
after Hou removes his bright examination light from Chris’s left eye, he is
rendered completely blind. He panics, but only briefly, while Hou explains that
in another moment or two, his left eye will readjust and start working again.
But the event has already taken its toll in frazzled nerves.
Indeed the news is bad. The retina in Chris’s right eye
seems to be completely detached. Because it’s folded over on itself, however,
Hou cannot see the crucial center point, which if it were still attached would
be much better – could be fixed immediately and restore his vision. Because Hou
thinks there’s a chance that it might be, although it really doesn’t look like
it, he’s writing a referral for Chris to be seen by a retinal specialist first
thing the next morning – just in case it’s not a lost cause. Hou is too kind to
use these words, but we get the gist.
He goes on to explain that he could
request an emergency specialist, but this would likely require we drive an hour
or more and since it’s already late, we might as well wait to take the next
step locally in the morning. “If you were my dad,” says Hou, “that’s what I’d
suggest.”
Whoa! If who were your dad? Okay, so maybe we are old enough
to be parents of a young man just out of medical school landing the low-man,
on-call ophthalmologist position in a large metropolitan area. Did you have to
say it like that? Might this have been paired, at the very least, with an ape-ish
and approving grunt for the basketball story? The frazzled nerves are at
upright attention unknowingly poised for the heaviest blows.
Hou reports that there is also a retinal tear in Chris’s
left eye. Good news comes in the form of a left-handed compliment: this can
definitely be fixed in the morning to save Chris from the threat of total
blindness. Oxygen leaves the room. Also it appears that the right-eye detachment
has only just happened. Had Chris acted sooner, it’s likely he might have reconciled
with the errant retina before its spontaneous divorce. To our questions of what
this means Hou offers very little. We must wait to speak to the specialist in
the morning. Hou apologizes that he can’t be more forthcoming; he can see Chris
is taking this badly. He encourages Chris to look toward the future. “You’re
here now and that’s positive. Move forward. Don’t look back.” The sounds of the
workers in the hallway suddenly seem very, very loud.
For a moment it looks like Chris will be okay. Then he begins
to lose consciousness. Because he’s already lying prone in a chair rather than
fainting, Chris feels his body go numb and shouts, “No! What’s happening?
What’s going on?!” Chris is pale. It’s clear his reduced vision is further
disorientating him. He tries to rise from the chair. Hou moves quickly and
stays calm. He puts his hand firmly and reassuringly on Chris’s chest to keep
him prone. He adjusts the chair so Chris’s head is lower than his torso and
explains what just happened. As blood flows back to his skull, the color
returns to his face and Chris starts to breathe normally again. He begins to
shudder but that passes quickly.
Hou stays with us until Chris is fully recovered, during
which time Hou apologizes again and again and again. His youthful but
well-intentioned inexperience is showing. Could this be the first time he’s had
to deal with the unfortunate circumstances that come with emergency work? Quite
probably. I feel nearly as bad for him as I do for Chris. If it weren’t for that if-you-were-my-dad slip he might get a hug.
Hou walks us the short distance to the exterior doorway to
confirm that Chris is steady, which he is. He apologizes again which we try to
drown in thanks. We head back to the hospital and Chris is re-admitted for the CAT scan.
This time we do a bit of the obligatory ER waiting room stall, but not for
long. Once the scan is done we have to wait around until a doctor can read the
results before sending Chris home. Eventually this happens, the scan looks
normal, and I have to be torn away from news of a Kardashian divorce and miss
the ninth replay of the doomed wedding kiss.
A few hours later, we drop our son at school and drive
directly to the specialist’s office. The first urgent appointment isn’t until
11 am. We prepare to settle in. The nurse looks at me, however, and says
quietly, “Don’t go anywhere.” She gets a thankful nod. After a short wait,
Chris is called in to Dr. Lewis’s office. Here we wait much longer, but at
least Chris is comfortable. He’s in one of those too-bad-you-have-shins-and-feet-below-your-knees
chairs. Watching Hou last night I’ve figured out how to adjust it so Chris can
stretch out. An office chair accommodates said shins and feet. I throw a fleece
N.Y. Jets blanket we keep in the car over Chris, hand him eye shades and turn
off the office lights. Soon he is snoring.
The set up gets a raised eyebrow when Lewis arrives. In
presentation, Lewis is just like Hou--neat and trim and polished. It must be an
ophthalmologist thing. He looks like the kind of guy who would have sat bolt
upright, legs uncrossed, hands folded neatly in his lap for the hour plus that
Chris napped in my improvised recliner. I give him a look that says, “Short
chairs aint nothing. Like to see what we can do with a cotton lean-to?”
Chris tells the story he told on the phone, to the first ER
nurse, Dr. Lagos, Dr. Hou, and the second ER nurse, to Lewis. Again he includes
the basketball story. It’s still not getting any traction. Chris gets more
eye-dilating drops and Lewis dons his own version of the Christopher Lloyd head
contraption and examines both of Chris’s eyes. Presumably based on the report
from Hou, he doesn’t bother with projected Es.
In short order, Lewis confirms Hou’s diagnosis, but offers a
much more encouraging prognosis. The tear in the left eye can be fixed with a
laser in about 15 minutes. For the right eye there are three choices: An office
procedure that has about a 60% success rate under normal circumstances. Since
Chris’s detachment is severe and includes at least five tears, Lewis does not
recommend this. The other two are surgeries. The first involves injecting a gas
bubble beneath Chris’s retina and sewing it back on the cornea. This has an 80%
success rate but will very likely cause a cataract to appear within three
years. That can be fixed in an in-office procedure when the time comes.
The second surgery uses a silicone implant to buckle the retina back to its
cornea. It has a lower success rate, but is still used if the bubble thing
doesn’t work.
The best news is that all of these procedures can be
employed sequentially if necessary. The overall success rate of restoring
vision for a detached retina – even if multiple surgeries are involved – is
about 96%. I let out a breath that feels like it’s been lodged in my chest
since the night before. Even before Chris asks Lewis his recommendation, I can
see that he’s leaning toward number two. Lewis echoes this preference. I remind
Chris that he could be passing up the opportunity to proclaim he has silicone
implants the rest of his life. This gets a smile from Chris and a stiff guffaw
from Lewis.
I pipe up that Chris, anticipating the chance of surgery,
has not eaten anything since 2 am the night before. Smart move. Lewis cancels
his afternoon appointments and schedules Chris’s eye surgery in two hours. In
the interim, Lewis fixes the left eye. Chris gets more drops, including some
that numb his eye. Lewis dons an even more impressive hat. This one secures a
laser beam to his forehead and has a thick wire trailing down Lewis’s back to a
small machine. Lewis holds a lens in his right hand and a metal probe on the
end of a finger of his left hand. He seems to be using the lens to focus the
beam streaming from his skull into Chris’s eye. Using the two in steady concert,
he’s tracing around the tear to prevent further damage to the retina.
All the elements of the scene before me coalesce into weird
science fiction. Lewis’s extreme tidiness – he even has the short, wiry hair
that looks perfect before and after all the head gear. I decide if OCD neatness
is ever a good thing, it would be in the guy poking probes and shooting lasers
into your eyes. Lewis uses a foot pedal to adjust something – the laser?
Chris’s position? I can’t tell. He’s not saying much but has the lip-tight
focus of a marksman. Twice I see Chris’s legs and feet stiffen. I don’t
interrupt.
Before I can pronounce ophthalmologist correctly, it’s done.
We are packed off to the eye surgery center – across the hall in this
brilliantly designed facility. Chris is no longer wearing his left contact and
because of the steady diet of dilating drops, he is both unable to see much and
especially sensitive to light. I move a pile of magazines off a Formica table
top which allows Chris to extend his legs over a waiting room bench. The
N.Y. Jets blanket makes for a pillow and I toss my hooded fleece over his torso
and head.
His position and muffled snores precipitate a few sniffs from others
in the waiting room – filled almost exclusively with folks who look like their
grandchildren could be young men just out of medical school landing the low-man,
on-call ophthalmologist position in a large metropolitan area. I ignore them.
Ours was not a predicted appointment made weeks ago. Besides a few moments of sleep
in Lewis’s office, Chris has been awake for the 30 stress ridden hours. Anyway,
there are lots of empty chairs.
An hour later, Chris is called in for pre-operative prep. By
now he’s given up completely on the basketball story but gets to regale the
surgical nurse with his near-death experience of multiple organ failure 13
years ago. Okay, I exaggerate. Chris is not the type to glorify a past hospital
experience. He nods at her examination of the blood work and confirmation of
his complete recovery.
Two hours later we leave the hospital after a very positive surgical
report from Dr. Lewis and an impressive eye patch. The ride home is a half
hour, so we run an errand or two before collecting our son from basketball
practice and heading home. Chris scores a last minute appointment with his
chiropractor who wisely doesn’t jostle Chris around much in light of very
recent procedures. But, hey, he thinks the basketball episode probably was
related, so it’s a worthwhile visit.
The next morning Chris is disappointed to not experience the
cinematic “I can see!” moment when the patch is removed. Lewis reminds him,
this is normal. Everything looks great and Chris’s vision should return gradually
over the next several days. We’ve already been handed our regimen of follow-up
appointments, eye drops and strict instructions to stay away the computer, out
of the car and off a plane.
On the way home, I think about hiding power cords and keys.
It’s not necessary. We reflect on the amazing care he’s received. In spite of
busy waiting rooms all around, Chris was moved to the front of every queue
where he found patient and kind professionals who performed excellent and
thorough jobs. Within a day, Chris’s vision was restored and proactively
protected in procedures not available in the recent past. Our grandparents, had
they suffered the same fate, would most likely lived in partial or total
blindness.
And the passed-up silicone implants? Chris grins, “I could still get those.”
The Round House by Louise Erdrich
