Seeing Is Believing

27 May 2014 Richard Parker

Seeing Is Believing

 

Richard Parker, Ed#458, April 2014

"Oh look, a kangaroo!" A story that puts affordable healthcare in focus.

I was on a road trip with my partner a few years ago, cracking along the highway at 110 (or thereabouts). It was the kind of summer afternoon some people like to write songs about. I can’t remember what was on the radio – Billy Joel or something like that. We were scoffing down boiled sweets and jelly snakes (as is the national custom) when we whizzed past an animal standing in the scrub.

“Oh look, a kangaroo!’ I said, in the manner of a person who only knows of the world through the pages of National Geographic. My partner gave me a strange look. One eyebrow raised, one lowered. Bemusement. “What?” she said. “That wasn’t a kangaroo – that was an emu.”

Er, no it wasn’t. Yes, it was. No – it wasn’t. Yes it was, yes it was! And so on, and so forth…for around three months, give or take a week. I thought I saw a kangaroo. My Immortal Beloved thought I needed a pair of glasses and a gentle pat on the head. And so, with the ‘encouragement’ of friends and family, I went in for an eye examination.

Did the reading-chart thing – not good. The optometrist whirled around, plucked a small bottle of amber liquid from the shelf and shook it up like a jar full of salad dressing. “This will cause your pupils to dilate so I can see what’s going on,” she said, squeezing a drop into each eye. After a few minutes staring at the ceiling, she asked me to lean forward. I nuzzled my face into a contraption that looked like a pair of binoculars bolted onto a food-processor. The machine buzzed and whirred. “Ah,” she said. “Cataracts. You have cataracts. Both eyes. Posterior, subcapsular. Your right is much worse than your left. You’ll be blind in a year without surgery.”

“Great,” I thought to myself. “Soon I won’t be able to get around the house without a walking-stick and a guide cat.”

Cataracts, in case you’ve never heard of them, are cloudy areas that develop across the lens of the eye. They are often associated with old age, but are also caused by a variety of genetic and environmental factors. Over time, the lens of the eye becomes more and more opaque. It’s like trying to look out of a fogged-up car window on a cold morning.

My dad, sister and brother have all had cataracts, so I suppose I should have ‘seen it coming. But no amount of knowing can ever prepare you for the ordeal of vision impairment. The pleasures of books, magazines and cheap prime-time television are no longer for you. The world you once knew starts to recede into the distance. You feel dependent on others and yet isolated from them at the same time.

That person sitting across the room could be your best friend – but you keep quiet just in case it’s not. Consider, too, the fact that more than 50% of communication is non-verbal. If you can’t read body language – the subtle blinks, winks and crinkled smiles – and the not-so-subtle illustrative and comedic gestures that punctuate any conversation worth having – you can miss the context and emphasis of a story.

One name synonymous with cataracts and vision impairment in this country is the late Dr Fred Hollows. Hollows was a kind, sometimes cantankerous ophthalmologist (eye surgeon), a man who saw things in a different way to most. He spent years working in remote Aboriginal communities treating an infectious eye disease called trachoma. He was also a pioneer in the provision of cataract surgery in developing countries. Hollows helped to establish intraocular (inside the eye) lens factories in Nepal and Eritrea, and also trained many other surgeons in restorative eye surgery. Hollows believed that everyone deserved equal access to health care, regardless of socioeconomic status. The foundation that carries his name maintains that half the cases of blindness around the world are caused by cataracts –a condition that can be treated using a simple surgical procedure that most still don’t have access to, 21 years after Hollows’ death. 

Living in Australia has countless advantages. Access to clean water is one. Education is another – our kids can go to school, no matter how poor we are. And let’s give a round of applause for a democratic framework that, despite its problems and the inequities it perpetrates, still promotes and delivers a higher standard of living and autonomy than most. Arguably the greatest product of that framework is our public health care system.

Whatever its faults, it is a system that can look after the most vulnerable members of our society – the sick and disabled – regardless of their ability to contribute to the cost of their own care. Despite being on a lower-than-average income, as an Australian citizen I am still entitled to benefit from the efforts and resources of the collective. And so, after waiting for several months, I found myself being wheeled into surgery for a procedure that would restore not only my sight but also my ability to contribute to society and help support the system that was now supporting me.

After half-an-hour in pre-op, which included two rounds of drops and some comforting words from my partner, the anaesthetist numbed my right eye with an injection and threw a green plastic sheet over my head. Although I had cataracts in both eyes, only one eye is operated on at a time – presumably to minimize the risk of complications. The surgeon was a thin, dignified man who looked like he had been to Hell a few times and enjoyed the experience. He took up a laser probe in his left hand and used it to break up and suck out my old lens. The machine sounded like R2D2 (from Star Wars) after one-too-many pints of Astro-Oil – burbling, bleeping and whining as my vision filled with swirling patterns of blue, dark green and red that one could only describe as psychedelic.

The surgeon then filled my eye with a saltwater solution and floated a new, artificial lens onto my eye. The operation was over in just 30 minutes. I don’t think I will ever forget the next day, when my partner helped me to take off my eye patch for the first time. The light flooded in like a wave crashing across a sandbank, carrying the gift of glorious, crisp, luminescent colour. The months of bumping into tables and being unable to work were now over. I could see once again. And it was glorious.

 

OUR eyes are beautiful, remarkable things. Some people think they are so miraculous and intricate that they must be proof of an intelligent designer. In other words, conclusive evidence that there is a god, and he or she is a mighty fine god at that.

But clearly the eye isn’t a perfect piece of engineering, as some would have you believe. It’s an imperfect product of evolution, random mutation and natural selection, and as such, has many quirks and flaws. The human eye is blind to most forms of light, for example. We can’t see ultraviolet and infrared. We can’t see very well in low light, like many other species. The eye has a blind spot, too, and is susceptible to many conditions and diseases, one of which is cataracts.

But our knowledge of these imperfections does not take away our appreciation of the eye, nor our gratitude for being able to see. It has led to a greater understanding about the eye and how to prevent and treat many of the diseases that affect it. That work has allowed people, like me, to lead fulfilling and productive lives.

The work goes on to cure global blindness. Some people, like me, are luckier than many others. But if there is one thing the world needs right now, it’s more people who can see, and more people who appreciate that simple fact.

 

» Richard Parker is an Adelaide-based writer.

This article first appeared in Ed#458 of The Big Issue magazine.

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