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A Yankee Notebook

May 5, 2014


MONTPELIER – Do you remember all the advice about the care of our eyes that our parents and grandparents laid upon us when we were defenseless children? Never run with anything sharp, like a pencil, scissors, or a knife, and always keep the sharp ends pointed down. Never cross your eyes, because if somebody slaps you on the back while they’re crossed, they’ll stay that way. Never take the family flashlight to bed with you and read under the covers, or you’ll go blind. The Boy Scout manual featured illustrated directions for removing “foreign objects” from beneath our eyelids. Even the famous theologian and hymn-writer Isaac Watts got into the act with a well-known quatrain: But children, you should never let/ Your angry passions rise;/ Your little hands were never made/ To tear each other’s eyes. We didn’t want for advice; and some of us actually took it.

So why was I lying back in a reclining chair under a bright light this morning while a soft-spoken man in a white coat stabbed my eyelids with a hypodermic needle and then, with a sharp scalpel (“cold steel,” he called it when I asked) and a pair of tiny scissors went to work on me only about a sixteenth of an inch from my eyes?

I’d like to be able to say it was just another experience in my series of doing something new each week. But it wasn’t primarily that. It will, however, do just fine as a bead in that long chain.

We older folks can probably remember that Jacqueline Bouvier’s second husband, Aristotle Onassis, developed a case of myasthenia gravis not long after he and Jackie were wed. Poor guy! Richer than Croesus, owner of a yacht the size of a destroyer escort, but with a disease that’s almost impossible to do much about. In those days before the Internet, it was far more difficult for us to look up stuff like that, so pretty much all we were able to discern was that it caused droopy eyelids. As we’ve aged, many of us have kept alert for that symptom in ourselves. Sure enough, some of us aspiring fossils have it.

But we really don’t. What Ari Onassis had was far graver (hence its name) than just droopy eyelids. Myasthenia is an autoimmune disease that gradually weakens various muscles, and causes chronic fatigue. In its most virulent form, myasthenia crisis, the pulmonary muscles weaken to the point of paralysis, and only mechanical respiration can provide temporary survival. One of the most common early symptoms is weakness of the eye muscles; so the eager readers of the supermarket tabloids were treated to many photographs of Ari with drooping eyelids, until he started wearing sunglasses full-time and eventually was not photographed at all.

I spoke recently at the gym with a retired microbiologist who said he believed that, with the current swift advances in the various medical sciences, human beings in first-world nations will by the year 2050 be able to live as long as they want. Since I’ll be 115 years old by then and probably not in any condition to take advantage of that state of affairs, I’m able to view the prospect more or less dispassionately. Would we really want to do such a thing? Most old folks dismiss the notion quickly, almost scornfully. But the possibility hangs out there, like the Tree of Knowledge in the Garden of Eden, or conversely, like the room in Bluebeard’s castle that his new bride is forbidden to enter. Would we really want to have that many of our failing parts replaced or rejuvenated, as it’s rapidly becoming evident they might be?

The answer is that we already are. From the relatively simple orthopedic replacement of arthritic joints to the installation of stents in clogged blood vessels, from organ transplants to artificial organs, many of us are walking medical hardware stores who a few decades ago would have been immobile or already dead. Whether or not that’s an improvement is somebody else’s argument; I cherish my prosthetic walks in the park and hikes in the mountains.

A few months ago, facing increasing difficulty in driving at night, I was able to have a pair of ripe cataracts removed and the lenses that they’d clouded replaced. Tremendous difference. Then it became clear I needed to improve my peripheral vision, which had become blocked by the sagging of an excess of skin around my eyes. I didn’t mind it so much, although my wife said she missed seeing my eyes; and I’d been surprised a couple of times by cars coming from my right.

To qualify, I had to flunk a peripheral vision test. I guess I must have, because this morning Dr. Rosen of the Ophthalmology Department at the Hitchcock Clinic, ably assisted by Louisa and Christopher, worked his magic with his little tiny tools. It’s called blepharoplasty (Lawyers use obscure Latin and doctors obscure Greek), meaning to correct the eyelids.

He cut an ovoid opening about 15 millimeters wide at its widest point above each eye, right on the natural crease between the eyelid and the eye socket. That way, the stitches and scars are pretty much concealed when the eyes are open. Then he simply pulled the edges together and sewed them shut, while I tried hard not to jump when the needle pricks went beyond the limit of the local anesthetic. Louisa swabbed off the betadine, gave me a list of instructions and an ice pack, and turned me loose. I wasn’t timing it, but I doubt the procedure consumed more than ten minutes.

When I started typing these words, I was having trouble seeing the screen and the keyboard through a mist of ointment on my eyes. I’ve had to stop every so often to apply the ice pack per the doc’s instructions. I’ve taken a look in the mirror. Racky Raccoon. I think I’ll wear sunglasses like Ari and try to avoid the paparazzi for the next couple of days.

Photo by Willem lange