Devices and Procedures


“Cataract surgery? Piece of cake. You’ll be better than ever afterwards.” I got that message in one form or another from several friends. They may be right in the end but right now, three days out, I’m typing with one eye closed and my view of the screen one step better than driving in a heavy fog. When I had my post-op visit the day after the “procedure,” I was shocked that all I could make out was an A as big as the side of a barn.

When I was bemoaning my situation in a conversation with a friend yesterday, we tried to imagine a world in which devices and those coldly named “procedures” did not exist. In fact, that was the world we humans inhabited not that many centuries ago, although my friend noted that there was evidence that doctors in the Arab world were performing cataract surgery in the 1500s. That’s remarkable, although I wondered how many of their patients died of infections in this time long before antibiotics were even a glint in the eye of scientists, but the miracle of medications for so much of what ails us is a subject for another conversation.

Let’s start with eyeglasses. How did nearsighted people manage in hunting societies when felling your prey was the difference between starvation and plenty? It seems to me that Darwinian laws of the survival of the fittest would have sharply reduced the ranks of the nearsighted, but that doesn’t seem to be the case. I welcome an explanation from readers more knowledgeable on the subject than I.

Of course, many of the needs and pleasures of modern life that required sharp eyesight, both near and far, didn’t exist yet – reading, watching TV and movies, driving, making sense of words on a computer screen, as I’m struggling to do right now. That list represents a sizeable portion of my waking hour activities. In the information session that preceded surgery, a resident raised the possibility that I might not need glasses anymore when the new lenses are inserted after the cataract is removed. I was horrified. My glasses are part of who I am and have been since I got my first pair in the seventh grade. I remember putting them on in the street outside the optician’s office and discovering a world of color that had gradually slipped away as all parts of my body, including my eyes, were growing. And what a miracle it was to be able to see the lettering on the movie marquee far down the block. Without the existence of eyeglasses, I would be wandering permanently in a world of shadows. And, as far as I know, I don’t even have the name of a scientist deserving of a Nobel Prize to thank.

I realized that I needed help with my hearing when the bewildered looks on my students’ faces led me to wonder whether the answer I had provided to a student actually matched the question she had asked. I had watched my father withdraw from conversations he could no longer hear clearly, and I was determined not to descend into that particular hell. He did acquire a pair of hearing aids which he rarely used because they buzzed and echoed, which made him prefer silence.

In my first fumbling effort, I acquired one – yes, one – hearing aid for the ear that showed up worse on the audiology test. Not surprisingly, that cost-cutting solution proved inadequate and I was soon back in a different clinic where the man in charge stared in disbelief at my one lonely hearing aid. “Would you go into a shoe store and ask to buy ONE shoe?” he exclaimed. So, I am now equipped with a modestly priced pair of hearing aids, thanks to Costco’s prodigious power to bargain with manufacturers, based on its mass purchasing capacity. I still miss a lot that others hear, including some birdsong, but I no longer annoy people quite as much with my incessant requests for them to repeat what they just said.

A very short digression into public policy. There is evidence that a fair number of people diagnosed with dementia are actually suffering from hearing loss which accounts for either their descent into silence or their sometimes-inappropriate exchanges. Yet, the government, in its infinite wisdom, didn’t include hearing aids as one of the reimbursable expenses under Medicare. My modest hearing aids still cost $1500 and that number can run as high as $8,000. Apparently, there is legislation in the works to rectify the situation, and there is word of a new over the counter, more affordable product that is soon coming on the market. That’s good news, but it doesn’t negate the fact that generations of the afflicted were left wandering in the desert in silence.

Circling back to the beginning, despite my current post-operative struggles, I hope to end up in the column of cataract success stories, which leads me to reflect on the centuries since those adventurous Arab doctors worked, when those fortunate to live long enough slowly descended into the fog as their cataracts grew and thickened. A procedure that had once been a big deal is now a fairly routine outpatient procedure, one that can dramatically improve the quality of life of people like me. I’m writing this on Thursday and I’m hoping I don’t have to be eating my words by the time you read this on Monday.

In the meantime, I will continue to follow my longstanding procedure of reaching for my glasses and inserting my hearing aids as soon as my feet hit the floor when I get out of bed. I’m ready to head downstairs for the newspaper and for whatever bad news my radio has waiting for me.

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Marv Hoffman
By Marv Hoffman

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