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About this time last night, I was seriously considering whether this might in fact be the single most miserable medical experience I've had. It's not; there are at least three worse. But I certainly set myself up for a miserable time. I'm an engineer and a former sysadmin: Looking at things with an eye toward how they could go bad is a professional necessity, and something I'm generally inclined toward doing. But I totally failed to take that view with regard to this surgery. They told me it was day surgery, and that I'd be able to type by Monday, with some cautions and caveats. And I said to myself Oh, day surtery. Been there, done that, no problem. And, best I can tell, thereupon willfully ignored any warning signs.

At a friend's encouragement (thank you, V!), I spent Friday and Saturday nights at business-suites hotel. I arrived with groceries, And was thus able to spend two days not having to deal with clothing (try pulling your pants up with one arm in a sling), with a comfortable armchair to sleep in (laying down hurt), and a restroom that was both close at hand and unshared. Money I wish I hadn't had to spend, but c'est la vie.

<TMI>Within hours of leaving the hospital, I realized, as I should have done weeks earlier, that not having use of my right hand was going to make personal hygiene a challenge. I remembered the similar situation the first few days after my stroke, when I had little control over any of my limbs. And remembered with gratitude Sandy, the nursing assistant at Youville Hospital who took care of things I simply could not take care of myself with with a patience and gentle kindness that actually managed to put me at ease in the most embarassing imaginable circumstances. At which point I was like damn it, I should have insisted they admit me to the hospital. But then I remembered the other nursing assistant, who dealt with my 3 a.m. toilet troubles with such conspicuous disgust that it left me in tears. And decided I was probably better off having to care for myself. (It also served me well to have memory of that second nursing assistant close to the surface when I was starting to bask in self-pity last night.)</TMI>

I managed to spend last night at home, though laying down was still painful and sleep much interrupted. And managed a half-day's work today — not that they expected me, but I figured, I think correctly, that I would be happier here, with people, restrooms, kitchen, and comfortable chairs all on one floor, than home alone, with stairs to climb (with a bad knee and one arm in a sling) whenever I wanted to go from doing one thing to another.

I'm seriously considering looking for a hotel again tonight. Which I suppose I should do now, if I'm going to.

Let me end with something I sent on zephyr earlier, in case someone here has a useful suggestion:
I had rotator-cuff surgery on Friday.  I'm cleared for typing, but it's
painful and fatiguing.  Least pain / most productivity with Kinesis on
my lap.  Most pain when I then reach for my trackball.  Pain much 
reduced but frustration greatly increased by using a mouse left-handed.
(My trackball --- old school logitech trachman marble --- is essentially
unusable left-handed.)  I'm thinking a third-party trackpad I could 
somehow impermenantly fasten to my kinesis, under my thumb.  Suggestions?
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I took a rather stupid fall a couple weeks ago --- stepping off a curb I failed to notice & coming down hard on the heel of my L hand and knee. I decided after some debate not to go to the ER, but did go to the walk-in the next day to confirm nothing was broken. Two weeks later, my knee's more-or-less back to normal, but my wrist twinges like hell pretty much every time I do anything with it. So today it was off to the wrist specialist --- to learn that a severe-enough sprain requires as much immobilization as a fracture (sometimes even more).

So right this moment I'm learning to type in a cast. (Casting type? Cast-typing? ....) It's definitely slow --- OTOH, I'm more productive than I have been the past couple weeks, when I had to take a break after maybe 5 min of typing because it would set my wrist off. By contrast, the cast is annoying but painless.

So, the subject: I decided a while ago that I want to spend more time around SIPB: I've always found it a good environment for learning, and I'd like to get to know the current students. So after I left the hospital, I came to campus. I picked up lunch at Goosebeary's and as I was walking between the Med Center and Ames, noticed my shoe was coming untied. So I stopped at the bottom of the stairs next to the Media Lab, put my lunch down, turned around, put my foot up on a step, and bent over to tie my shoe.

Now, my left hand has not been an entirely reliable contributor in its role in tying my shoes since my stroke. But it turns out that the additional constraint of the cast seems to be too much for it. So a few minutes later, there I am, bent over my shoe, with one shoelace in each hand, staring at them and wondering where the hell I go from here.

Just then, a woman walks up the stairs past me, and turns as she reaches the top, and says "Are you alright?"

"I just got this cast. And I seem to be in the process of discovering that I can't tie my shoes in it."

She starts back down the stairs and before I can say anything, has knelt down and started tying my shoe.

"You're too kind."

I'm no good at ethnicities --- I suspect because it just doesn't seem that important to me* --- but I want to mention that this woman was brown of skin, dressed solidly middle-class, somewhere between 30 and 60. I want to mention that because, during the six months or so I was using a cane, I noticed that every single time someone offered me their seat on the T, it was a dark-skinned woman of indeterminate age and crisply middle-class dress.

* A fact i should probably have cottoned on to when I was 17, and my dad referred to my friend Leslie "that little Jewess." At the time, I was too busy being shocked for it to occur to me that my cluelessness might say something good about me. And then, once Leslie and I had had the "Is your family Jewish?" "What, is this a trick question?" conversation, wondering how he could tell. It was only a dozen years later, when what in retrospect I now know was my third Ashkenazi girlfriend explained that word to me, that it made any sense.
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I'm due at Mass Eye & Ear in 12 hours, and I'm starting to freak out just a little bit.

The thought just crossed my mind that (save a dozen I read slowly the other day in a terminal window that took up my entire 23-inch cinema display) every single word I have ever read in my entire life; every sight I've ever clearly seen — every rainbow, every falling star; every snowflake, every budding flower; every dragonfly and every interesting pebble and most of all every smile whose memory makes me smile — all of these entered my brain by way of this matrix of transparent cells. Which tomorrow someone I barely know will unceremoniously vibrate into jelly, vacuum out, and replace with a piece of plastic.
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I'm very much pleased that my surgeon so readily agreed with me that in my case, reducing the net number of unproductive days trumped other concerns. It's going to save me a net three weeks or more of serious visual impairment. But of course that means I now have 3 days to plan my end of the operation — when I'd expected to have a minimum of 3 weeks.

The first and biggest planning hurdle: They will not release me after the surgery unless there is someone there to drive me home. It turns out that Alyse has an inflexible work committment — so I'm turning to you.

I know it will be in the afternoon: I'm presently scheduled to arrive at MEEI at 11:00 a.m, but those instructions will be revised on Monday, almost certainly 1 to 3 hours later. Having been through the process once, I now know what will follow: They'll prep me, and I'll hang out on a gurney in surgery waiting for a while. A resident will give me five minutes notice when they're ready to roll me into the OR — at which point it will be just about exactly an hour until I'm released. So I can call you then, giving you an hour to get to Mass Eye & Ear, which should work from most anywhere in the Boston area.

Note: I am not sure it's strictly necessary to have someone drive me home; it's just the most obvious way to comply with a vaguely stated requirement. So if you don't drive, but could come to the hospital and go home with me in a cab (at my expense, of course), I believe that would do.

If anyone can help me out here, I'll be eternally in your debt.
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Had my first followup this morning. When the doctor (not my surgeon, but a senior resident who'd been tasked to come in on the Saturday of a holiday weekend to do the 1-day followup of Friday's patients) took the shield off, the first thing I said was Wow, I can see you.

She smiled Well that's good.

No - I've been farsighted all my life. I've never seen a person so close so clearly without correction.

She looked over my eye in detail; my incision (2.7 mm - I asked the surgeon while I was still on the table, but I don't think I remembered to mention it here yesterday) is healing by the book, with no leakage. She had me take a fairly cursory eye exam (the first of many, I'm sure); I believe I did slightly better than on recent tests of my former left eye. Unsurprisingly, a new lens did not magically cure my atrophied-since-toddlerhood neural interface to the eye, and I still had the phenomenon where for all but the lines of really big characters (the ones so big there are three or fewer characters per line), I can make out that there is an 'A' or a 'Q' or an '8' - and I can probably do that for most (sometimes all) of the characters on the line. But I cannot state with certainty what order they're in (though I can usually say which is at each end). So I walked from MEEI to the T wearing my (until yesterday) current glasses, mostly keeping my left eye closed rather than try to make the poor nearsighted newborn try to make sense of the world through the distortion of my old farsighted eye's progressive bifocal prescription.

I took the T to Porter, and walked (wearing my ~10-year-old single-vision prescription sunglasses, which gave both eyes a somewhat soft-focus but not mind-bendingly distorted view of the universe) to General Optical, where I'd left an old pair of glasses (with my roughly 2004 prescription) o Thursday, asking them to replace the left lens with a clear, no-correction lens. While I was there, I had them do the thing I thought of last night, to turn my (until yesterday) current glasss into a monocle-of-sorts for my right eye. Then I walked home wearing my new/old (2004-right-progressive + new uncorrected left) glasses. It didn't take much of that for me to realize that I should have done more with them before taking them to the optician than put them on, close my left eye, look at the neighbor's roof out my window, and say "yeah, I can get by on this right lens for a month." Turns out I can see things ~5 m or further away through them reasonably well - but for near vision they're useless: I couldn't even read my watch, let alone a book or computer screen. Oops.

So I've spent most of the day wearing my half-glasses monocle. Which is kind of unbalanced and doesn't sit right in front of my eye - so looking through it much gives me a headache, and text starts swimming after 20 min or so. (It's not as bad as it was sitting on the end of my nose, yesterday. But not a whole lot better, either.)

Of course, since I'm now only required to wear the shield in bed, I don't really need a way to have my right eye corrected while wearing the shield over my left. (Though, in perhaps an overabundance of caution, that's what I've been doing most of the day.) So come Tuesday I'll go back to General Optical and ask them to assemble my monocle, right temple, and a clear lens into a new pair of glasses.

Oh well. I'm not going to kick myself too hard for not figuring this all out a priori.

Right: back to walking home. Which I did by way of my pharmacy, to pick up the prescriptions the doctor I saw at MEEI this morning had sent them: THree eye-drops, each to be taken four times a day - and none to be taken within 15 min of any of the others.

I've decided for now (not least because too much small print to just follow orders without understanding, so I'm thinking of the eyedrops as beige cap, pink cap, and grey cap. I have four sets of 20-min-apart appointments in iCal, repeating for for the next 14 days, always in that order (being, pink, grey.... That should keep me on target.

And now, it's time for today's last grey, then to put the shield on and and hope for a good night's sleep.

I want to thank everyone who's been reading this. I can't imagine being all that interested in somebody else's minor medical saga, so I can only feel humble and, with a full heart, grateful to know so may kind and lovely people.
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So, I have a problem, and I think I have a solution (or at least a significant improvement).

This is, roughly, what I look like as I'm typing this:

Picture of me wearing my glasses over my large, hard-shell eyepatch

An astute observer (or even a fairly oblivious one) may note that the large plastic cup taped over my left eye is causing me to have to wear my glasses nearly on the end of my nose. Said observer may also notice the indentation between my eyebrow and the bridge of my nose where my glasses normally sit. These are two very different places — different enough that I can't spend much time reading. To say nothing of the fact that every time I glance downward, I'm at risk of my glasses falling off. Which, since I'm not supposed to bend over for the duration, would be especially poor.

You may also note that my left lens is useless. And will be, permanently, since the brand new lens in my eye is nearsighted, and the left lens of my glasses is intended for a farsighted eye.

These glasses consist of two temples and a bridge, held together by the lenses. I know from experience, by breaking a temple, that I can wear them somewhat functionally without one temple — and what made that hard was the weight of the lens that was only supported by the bridge.

I have never examined them closely (chicken and egg problem there), but I can only imagine the lenses are attached to the frames by screws, And that if I were to detach the left lens from the bridge, I would in effect have a monocle, supported by the bridge of my nose and one ear. Which I believe I would be able to wear in something far closer to my normal position.

So if someone with good eyes and small tools would be interested in coming over and trying to take my glasses apart, I would be most grateful.....
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Just back from Mass Eye & Ear. Nothing even remotely traumatic; the worst thing was waiting just under an hour in the pre-op area - they preped me, put novocaine under my eyelid, started my IV and started me on a sedative and left me with the impression I'd be going in in under 10 min - and then there was a hang-up.

The strangest thing was watching the surgery from the inside. This was mostly a matter of a strange light-and-shadow show - but right at the very end came one of the coolest things I've ever seen in my life: Suddenly the (admittedly constrained) world around me quite literally unfolded, and I caught what seemed like a remarkably clear glimpse of the machinery above me before the surgeon put the bandage over my eye. To be sure, I asked her if unfolding the lens had been the very last thing she did. She was very excited by the fact that I'd seen it happening - apparently that's quite rare.

And now, time for a very belated morning coffee --- and breakfast!
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Well, I'm off in a few minutes to my first cataract operation. On my left eye, the one that, however good the lens, I'm unlikely to ever see well enough out of to be able to read with it: I have amblyopia, which basically means that optic nerve never fully developed when I was little. I'm doing that eye first so as to go through the process once, learning all the little weirdnesses it entails, without having to also be functionally blind for ... a few days? weeks? ... as part of the bargain.

Jan wished me luck last night, and I babbled at him for a good five minutes in a manner that might also be described as perky. I am way more nervous about this than I want to let myself know.
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Eye-anatomy drawing from wikipediaSo yesterday I went in for a routine eye exam  — only to have my new Ophthalmologist, Dr. R, tell me I have cataracts.

In particular, Posterior Subcapsular Cataracts. This is not the usual sort of cataract anyone who lives to a ripe enough old age is likely to get; this is a cataract on the back of the lens, which tends to develop rather more rapidly than the usual sort and is commonly associated with steroid use, extreme farsightedness, chronic iritis and diabetes. (Of which the first three pertain to me. Though at this point I'm rather a lot more interested in what to do about it than in why it happened.)

(I should mention here that I have amblyopia. It was diagnosed when I was 8; they tried patching my good eye, but by then the window of opportunity for that neurological development was closed. I'm not clear on the physiological details of amblyopia (and indeed, I'm not sure ophthalmology as a profession is), but what I know of eye anatomy and what I see from that eye are consistent with the idea that the fovea in that eye never developed. At any rate, while I have normal peripheral vision in my bad eye, for all practical purposes — driving, bicycling, reading, watching TV or movies — I only have one eye. That weighs heavily on any decisions I make about eye care: It is, for instance, why I have never seriously considered laser vision correction: the risk of a bad outcome is less than 1/1000 — but for me, the benefit comes nowhere near outweighing the potential risk. It is also why well over half the Emergency Room visits I've made in my life have been for something wrong with my eye: If I fall and my leg hurts so much I can't put any weight on it, I may decide that will wait til my Doctor's office hours; if my good eye hurts or is secreting something or I got something in it that artificial tears won't wash out, it's off to the MEEI ER right now.

This is also why I likely to be speaking in the singular below: I'm not strictly certain that Dr. R even mentioned a cataract on my bad eye, and I really couldn't care less.)

One of the main symptoms Posterior Subcapsular Cataract is glare: the cataract essentially causes light to bounce around inside the lens of your eye. I've been increasingly annoyed by oncoming headlights in recent years, which I had mostly been attributing to the advent of projector beams and other types of headlights that are brighter than what I grew up with; there have been a couple of times recently when I was so blinded by oncoming headlights that the only thing I could think to do was pull to the curb and stop. In the conversation with Dr. R yesterday, it became clear that those externalities have a lot less to do with it than I thought. I've also been less tolerant of glare on computer screens lately.

Cataract surgery is the most commonly performed type of surgery in the US, with a very high success rate. Currently, my cataract is still small, and it does not yet get in the way of light passing through my lens to my fovea. That means I have time to do some research, but not necessarily much — because when it gets there, my ability to perform my normal day-to-day tasks will be impaired.

Googling around today, I've determined that there are a lot of options: The state of the art procedure, Phacoemulsification, involves making a small incision in the eye, using ultrasound to break up the cataract and lens, vacuuming them out, and inserting a plastic replacement lens. There is a variety of equipment for performing the procedure, and a variety of lenses available. This is the procedure Dr R performs, using some of the most recent equipment available. But he only operates one day a week, and I don't even need to do any research to know that this is one of those procedures where my best odds of a good outcome lie in finding a surgeon who does them all the time. But since I'm not in a hurry, I think my best strategy would to first consult with an expert (in a perfect world, I'm imagining the cataract version of Claes Dohlman, the world-class cornea expert who treated me at MEEI in 2003) who's vendor-neutral and has a good overview of the state of the art. In order to find that person, I'm hoping some of you know a good Ophthalmologist you'd recommend I talk to. (Yes, I do plan on asking the Dr. R — but he's new in town and didn't go to medical school here, so I'm not sure how plugged-in he is.)

[Edit, 2010-01-05 20:30: Perhaps I should make it clear that I am not especially worried about this. Yes, I want to research the problem, and yes I want to do everything I can to improve my odds. But as I explain in a reply to an early comment, if I did nothing further, took Dr. R's advice, and signed up to have him perform the surgury next week, my chances of a bad outcome would be the same order of magnitude as those of my dying in a car crash this year. I am merely intending to research the problem and to do the most productive of those nerdy things I can to improve those odds — just as I wear my seatbelt, drive with my lights on, back into and pull forward out of driveways, scan the road and my mirrors, stay off the roads around bar-cloisng time, and do dozens of other things to improve my odds behind the wheel.]


Sep. 15th, 2009 10:27 pm
xela: Photo of me (Default)

A couple hours ago I had the biggest adrenaline rush since I found myself on the floor unable to stand and crawled across the floor to call 911 four years ago.

Nowhere near that big an adrenaline rush. But still, the biggest since.

Maybe I need more fear in my life.

Or maybe not.

More.... )

xela: Photo of me (Default)
This post brought to you courtesy of my 7th grade typing teacher, who made me into an old-school touch typist.

Sometimes when I wake up in the morning, I can't focus. I blink and clean my glasses and rinse my eyes*, all to little or no avail: I just have to live with a fuzzy world for a few hours til eventually I can focus again. I'm pretty sure this is caused by sleeping wrong and deforming my eye in my sleep - I think I may have even gotten a medical opinion to that effect some years ago (though long enough ago that I can't remember whether it was from Mass Eye & Ear or from Dr. Zephyr - I should probably check in with an actual opthomologist on it. (Note: I can't actually read what I'm typing, but I can tell that opthomologist is underlined in red. I suspect it's a case of the spellchecker being stupid, but feel free to correct me.)

I've now been up for four hours, which is a long time for this to last, and it's starting to get kind of upsetting. On top of that, I just spent a half-hour trying to assemble a "shop light" fluorescent light from Home Depot, only to conclude the buttheads didn't bother testing whether it was in fact possible to assemble it before foisting it on their customers. (The ... bulb sockets, for lack of a better term, are L-shaped plastic widgets, (imagine an L about 2cm deep by 3 tall by 1 wide) Near the base of the L, on the front and back, are two plastic spring tabs. The stem of the L is supposed to be inserted into a rectangular hole in the reflector; the tabs are clearly meant to hold it in place. Either the widgets are too small for the hole, or the hole is too large for the widgets - at any rate, the widget slips into and out of the hole without the tabs even being pressed upon. There is no way the light can be assembled this way.)

Where was I? I might be able to read this if I knew how to change font size in xjournal. Um. Anyway, my eyes aren't working, I'm annoyed by cheap-ass hardware, I'm s little scared by this eye thing, and I can't even web browse to see if I can find pre-assembled shop lights somewhere.

Hope your day's off to a better start than mine.

* except I can't really rinse my eyes this morning, because I don't know where the hell anything is post-move.

Addendum: Found the eye rinse: doesn't seem to have helped but my eye sure feels clean.

I should probably have mentioned that I only have one eye I can focus with in the first place; the other one's only good for peripheral vision. Not having a back-up, I tend to get really nervous when something goes wrong with the good one.

Turns out in FireFox I do remember how to change font size. Which lets me read LJ at what I'm guessing is like 24 point type.
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Today is the third quadrennial anniversary of my quitting smoking. I almost said "quitting smoking for the last time" but I know it doesn't do to get complacent about this addiction. February 29, 1996, was at least the 20th time I'd quit smoking since I started at age 13, and the third time I've managed to stay off cigarettes for over a year. I am for the most part repelled by the smell of cigarette smoke and always was, yet still to this day, every once in a while when I walk past someone smoking, my nostrils will flare and I'll breathe in the smoke deeply before i even know what I'm doing.

It continues to astound me that this drug, which has no benefits and is a known killer of millions, is legal while something as innocuous and useful as marijuana can net someone growing it for his own use a 93-year prison sentence. Seems to me a sane society would be putting tobacco executives in jail.


Feb. 2nd, 2008 11:58 am
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I only weighed once while I was in the not-a-cast, three weeks ago: I'd put on 3 kg since 6 weeks earlier, before the injury. Hardly surprising, given the enforced inactivity and that I had fallen back into my old habit of eating out of stress and boredom. I slapped myself about some over that, and have made some effort over the past three weeks to not be actively stupid about eating --- but I've hardly been rigorously avoiding carbs.

But when I weighed this morning those 3 kg were gone: I weigh exactly the same now as before the injury. Far better than I could have hoped for. Though it does make for an unwanted bump in my weight plot:
Why yes, the absence of a y-axis is deliberate )
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I didn't do self-pity when I had cancer. I didn't do self-pity when I had a stroke. So I figure I'm entitled. And besides, this isn't life-threatening, just seriously fucking annoying. So I'm going to allow myself five minutes of pissing and moaning, then it'll be back to my usual Okay, I can deal with this attitude.

My new right boot: )
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Yesterday marked six months since I was able to start working out regularly. Since May 15th I've lost 51 lbs and gone from being worn out by ten minutes on the nordictrack or concept2 to being able to take a 40 minute bike ride, park the bike, do my grocery shopping, have lunch at the store, ride a half-hour back home via a slightly less indirect route, and still not feel tired. My typical resting pulse has gone from the low 90s to the high 70s.*

I've spent a total of 96 hours and 3 mins doing aerobic exercise of some sort or other over the past six months — probably more, since when I have to estimate, I try to lowball it. I've recorded 329 aerobic exercise sessions on 122 days over those six months. (Yes, 122/183 or exactly 2/3. No I didn't plan that.) My exercise sessions had a mean duration of 17 min 31 sec, the median session being 13 min.**

I would have given up in despair long since without the support of my friends. Sitting here looking back on six months of solid progress, it all looks fantastic. But at any given moment during that six months, or the next six months, or the year after that, it can be awfully hard to believe there's light at the end of the tunnel. Friends matter more than I can say at those times. Thank you.
My doctor says the thing I need to focus on now is endurance, and with my median session being 13 minutes, he certainly has a point. Aside from my target weight, I didn't have any goals more concrete than "get into better shape" when I started this. Now that I know what kind of progress I can make, I want to set some concrete goals for the next six months:
  • Every day that I exercise, I will have one session of at least twenty minutes duration
  • Once each week, I will have at least one 60-minute session
  • I will have at least four sessions of two hours or greater
Look for another retrospective in six months, telling you how it went with those goals.
* The downside, such as it is, to my progress is that I can no longer get aerobic exercise in anywhere nearly as readily as I could six months ago. The other day I spent two hours cleaning out the garage and raking (wet) leaves, which would have easily gotten me into my aerobic range six months ago. When I finished and checked my heart monitor, my average pulse was 109: not high enough to count as aerobic. Six months ago, I could go for a stroll and my pulse would average 120; now a ten minute walk won't get me into my aerobic range unless I'm paying attention to walking fast.

** If you're interested, you can see a large and detailed graph of my exercise activity over the last six months. Or, if you're really, really interested, you can see that same graph in context, with an html-ified version of my exercise log. (That page is mostly for my doctor, who's very enthusiastic about it.)
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I've said it before (when talking about being treated for cancer) and now I'll say it again: Boston sucks in many ways, but it's a great place to be sick.

On Weds. Sep, 3 I woke up with my eyes a little gunky and irritated. The next day it was worse and I went to my optometrist, who diagnosed me with conjunctivitis, and prescribed antibiotic eyedrops. By Sunday it was much worse, and I called in the artillery: I went to the ER at the Massachusetts Eye and Ear Infirmary.

MEEI is one of the world's leading centers of research in ophthalmology, and is a teaching hospital of the Harvard Medical School. I've been treated there before, and I've mentioned them here before, when I was diagnosed with a detaching vitreous a couple of weeks before this. (It never rains but it pours: The first time I was treated there (which, come to think of it, was also for something that had been misdiagnosed as bacterial conjunctivitis elsewhere), I was also being treated for cancer next door at Mass General. This time, I have two completely unrelated eye disorders.)

Anyway, Sunday morning comes and I can't focus well enough to read. At the best of times I can only see well enough to read with my right eye, and it's by far the worse: all swollen and red, almost looking like I had a black eye, and with a feeling of pressure behind it. Driving didn't seem like a good idea, so I asked [livejournal.com profile] alierak to drive me to MEEI.

Once there, I'm seen in the ER by a young resident. She and I exchange nerd tribal recognition signs, she stares deeply into my eyes in the most unromantic way imaginable, and she starts to get excited. She calls in another, more senior resident, who also gets excited. They call in the senior resident on duty, who also gets excited. They tell me I have severe viral conjunctivitis, and that they want me to be followed up by Dr. Dohlman. All three speak of Dr. Dohlman in tones I recognize: the tones you hear, though all too rarely, from grad students working under the tutelage of a renowned leader in their field who nonetheless treat them like human beings. "When you call to make the appointment, make sure they understand that the emergency room wanted him to see you. If there's any trouble, get in touch with us here. Dr. Dohlman will want to see you."

The next day I saw Dr. Dohlman. A charming white haired gentleman in his 60s (I thought) with a nordic accent and the best bedside manner of any doctor I've ever known, he was the first person there to offer me a handshake in two days. As he did so, I said "you may not want to do that" (viral conjunctivitis is highly contagious, which is why nobody else had shaken my hand). He said "I've been doing this for fifty years and haven't caught anything from a patient yet. But you're right." And washed his hands. He examined me, had the resident with him examine me too, and asked her what she saw, helping her recognize what she was seeing. The guy's a natural teacher, and in the half-dozen times I've seen him since, I've never seen him without a resident at his side. I'm a pretty interactive patient, and ask probing questions. And I felt every bit as much a warm glow whenever he said "That's a good point" as I ever did in college when one of my favorite teachers would say the same thing. One amusing thing: he'll listen to one of my questions, say "That's a good point", and then turn and answer the question to the resident. It's clearly not meant to be dismissive, it's just that the resident is his student and teaching matters to him.

After that initial appointment, I came home and googled Dr. Dohlman. I had taken his remark about "doing this for fifty years" as hyperbole, but I was wrong: Claes Dohlman received his MD in 1948 and later got a second doctorate in medical research. He founded the corneal care specialty at MEEI in 1959, and in 1989 retired as Chairman of the Department of Ophthalmology at the Harvard Medical School and Chief of Ophthalmology at MEEI in order to go back to teaching, research, and clinical work. He's 81, and living proof that staying intellectually active and engaged with young minds will keep a person young.

I'm better now, and I almost regret it. Dr. Dohlman has made being "the worst case of EKC I've seen in several years" a privilege.


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