Surgeries, Pt. 1

My cat Frida likes to stare for hours out the pet door and I can’t fathom why. I don’t even know when that particular door was installed. The house itself is over a hundred years old, so we could be talking a half-century of doggy commutes here. It’s since yellowed with age and the flap is marked with a myriad of scratches. It certainly can’t afford much of a view. The door is tamped shut, too, and with good reason. Upon moving into the house, Frida—who had until then only known the comfortable interiors of apartment life—decided the outdoors was a temptation worth exploring. Or so she thought. Twice I rescued her from a tangle of vines along the side of the garage, pissing herself and yowling in absolute terror. I figured she’d just realized how big the world really is. Which would terrify anybody.

I imagine Frida’s world is now comfortably smaller from behind the nailed-shut pet door, albeit blurrier and more jaundiced. In which case, I understand Frida’s point of view. For a while my world was plunged into a yellowed soft-focus as cataracts ripened into something ochre, and although my eyes are fixed now, my days—like Frida’s—were similarly sepia-toned.

I was my ophthalmologist’s youngest cataracts patient at age thirty.

By ‘ripened’ I mean ‘proliferated.’ Cataracts are blemishes that affect the lenses: as they grow in multitude, the world slowly loses its sharpness. You don’t notice it at the time because it happens so gradually, but the world begins to lose color while you lose focus. Everything yellows slightly, takes on an unwelcome veneer. Like a plasticizing pet door, or your friend’s poorly chosen filter on Instagram.

Remember when television sets had knobs for adjusting sharpness and color? Imagine you’ve knobs connected to your optic nerve and a random toddler has given them a similarly random twiddle. It’s like that.

When cataracts decide to ripen, it’s a slow disorientation. I discovered I was having problems when I undertook a physical exam prior to a Jackson Hole research expedition.

Mind you, my right eye has always been worse than my left. I could show you grade-school pictures wherein my right eye has a characteristic squint. I said so to the nurse practitioner but—when in socks and a slit-robe—and standing in a doctor’s office hallway, I fairly read Greek when listing the letters I saw on an optometrist’s chart. I had just my left eye open, the right properly shielded with a black plastic paddle. My posterior had a breeze.

“F-Z-…_E?”

The practitioner was confused: “I thought you said your right eye was worse.” There was something judgmental in her tone.

“Maybe I need my eyes checked?” I offered.

Recently, the computer screen had been hovering pretty close to my face. The weekly readers, too. Not out of their particular insistence to be scrutinized. It was just that my eyes seemed simply southward-bound, and that my world was fast getting smaller, too close for comfort.

I left for Jackson Hole to do some bird research that necessarily involved binoculars. I had a referral to the ophthalmologist in my wallet and a particular penchant for rubbing my eyes ten times a minute.

Ironically, I was one of the best bird-spotters on the trip and despite the fact that I could never dial in proper focus on my set of binoculars. The body: it has ways of compensating and—quite frankly—I don’t remember any of my particular tricks. Sometimes you can see well without seeing well. I picked out the osprey on the tree 300 yards away, and that juvie hawk a half-mile out and lazily floating the zephyrs.

At the same time, and back in San Diego, I had to habitually count street signs when driving home. For lack of actually being able to read them.

Jackson Hole, mind you, was beautiful. I got to experience this only ex-post facto. Only when my doctor’s referral became a recommendation for surgery, and only post-expedition; when my eyeballs were sliced open and their lenses summarily removed; when I got pieces of plastic shoved into ocular space and I finally got to see my pictures of the Grand Tetons—literally ‘the Great Breasts’—in full photographic detail like some form of geographic pornography rising high and taut above the meadows of a milk-thistled Wyoming morning.

The photos were fantastic.

A picture of when you’re younger is, of course, always a picture of when you’re younger. That’s the way time works; you can’t say ‘here’s a photo of me five minutes hence’. Seeing pictures of the Tetons, though, was like seeing pictures of me when I was older, the way time’s not supposed to work. I took a few snapshots of these lavender moths in some rapine grass and I didn’t enjoy them until a doctor had done his work and, with eyes suddenly younger, I saw things in the past suddenly present. If you follow.

My eye doctor: he did not so much give a recommendation for surgery as he did surrender it. “I don’t think you have cataracts,” he would muse while gazing through his magnifying devices into the inner workings of my eyes. “I think you have…cholesterol spots marking your lenses. Something granular. Probably’ve had them since birth.” He was the first optometrist of mine to offer this opinion. Ever since childhood, my eye doctors diagnosed me with congenital cataracts. They saw the telltale flecks, seeds that would later proliferate into a gathering of motes scarring my lenses. They said surgery was inevitable. My current eye-doctor, however, refused the diagnosis for years. “They’re not cataracts,” he’d say, “They’re cholesterol spots.”

Once he showed me a model of an eye, carefully disassembling the orb into its component parts with steady, surgeon-like fingers. The lens came apart in numerous pieces. He explained: the lens is made of flexible fibers that interconnect in various concentricities. In effect, he went on, the lens is onion-like in its structure.

(My doctor was not convincing me with his choice of analogy—onions make the eyes water and blur. When I cut onions, I can’t see).

He continued: cataracts are malicious, they enter randomly into these allium-like cells and they form little pattern save for a final one in which light is completely denied access. You’ll wake up suddenly one day, and when cataracts have set, it’s like the ceiling lamp-switch hasn’t been turned on.

“What’s different about your eyes,” he countered, “Is that your blemishes are in perfect order. They’re rather beautiful, actually.”

Go figure. My disease is worthy of a headshot.

My doctor, two inches from my face and with a retinoscope in hand, peered deeper into my eyes than would have an attentive lover; he murmurs that my eyes look like constellations. If I were asked to have read a chart at that very moment, I may have spelled out: F-L-A-T-T-E-R-E-D-? I do like my doctor, after all.

Later I visit an ophthalmologist, post-Jackson Hole, with the goal of alleviating the question marks.

“Yes, you have cataracts. They don’t seem exactly terrible.” That was the surgeon’s summation. My friends’ faces, meanwhile, had been blurring at a rate of two-feet remove per second. That was my empirical summation, and I would have argued against the ‘not terrible’ verdict.

“If it affects your quality of life, then ok.” He’s a white-coated shrug.

Ok, then. I wonder, in this world of scopes and dials, and with eyebrows raised above glorified magnifying lenses, why is a diagnosis so hard to get? Somewhere there’s a mean balancing out subjectivity and objectivity and if I, as the subject and—with fogging eyes—declare genetic foul, doctors should be listening.

“I’m not stupid, actually. I’m just going blind.”

“I want you to cut my eyes open.”

“I can’t rightly see.”

“I get lost, a lot. I can’t read a sentence six inches away from my nose.”

Quality of life: if I need to hold newsprint this close to my face, if I can smell the fiber of the paper better than I can see it, I ask—please—for some help. If end all I can’t read, it’d be like surgically extracting part of my being; I would rather an ophthalmologist surgically extract the blur instead.

The blur, at this point, I envision as gauze soaked in milk; or an onionskin, soggy, and left unceremoniously in the sink. Seriously: I want this shit tweezed out of my eyes.

I’m at last granted surgery. I am assigned a date, an anesthesiologist, and a bed where I will lie—face-up—for open-eye surgery.

(Open-eye, open-heart. Finn is born two years later and he’ll lie, too, on a surgeon’s table, eyes closed but chest decidedly open, breastbone cracked and stretched by calipers, his heart stopped by machines and laid still and bare for surgeons’ fingers to reconstruct and make beat again; I simply go and get my eyes fixed. I want to see. Findlay—he needs to live).

Here’s a moment: the anesthesiologist has already dressed my veins in cold chemicals and the ophthalmologist has dilated my eyes with constancy: drop after drop after drop. My vision has since been reduced to fog. I see only the likeness of shapes, but decided color still—like the purple of the surgeon’s lamp and the blue of the surgeon’s gloves. I am forced to see a steady series of drops glaze my cornea because my eyes are pinned open like a scene from ‘Clockwork Orange’. Consider me Alex. I’m hostage to the operating table at this point, blankets wrapped thrice around my body. I can’t move.

The drops are so constant that all I see is purple. That and the drops themselves, which form in soft-focus, maturing as they do into resolute tear-shape before disappearing into my eye. I’m meanwhile bound to the table. Van Morrison is on the radio and a doctor is moving somewhere in my vicinity, exchanging remarks with the anesthesiologist. I know about isoflourane, and I know I should probably be asleep.

I really shouldn’t be hearing about ‘Gypsie Robin’ or ‘Emma Rose.’

The doctor begins cutting and I am wide-awake.

I have a strange association, and it’ll be hard to explain. This color purple I’m seeing, it has a particular depth to it. I know it’s just a reflection of a surgeon’s lamp relative to my dilated eyes but I’m reminded of when I was a young aviculturist and I opened a wrong egg by mistake.

To best and quickest explain: I’m a bird-keeper. That’s what I mean by ‘aviculturist’. And as a bird-keeper I habitually candle eggs with a bright light. The light illuminates the goings-on inside the egg—vessels, embryonic movement, etc. Sometimes the egg is dead and it’s summarily pulled from the incubator; the egg is generally opened afterwards to find out what or where went wrong.

So one day, I pulled an egg. It was supposed to be dead, but when I capped the shell with a pair of tweezers, I immediately saw purple beyond the cell membrane, a pulsing purple I can only describe as alive. It was a horrible mistake. Generally a dead egg is non-descript in color but there, floating in magenta, was an undeveloped bird embryo, breathing through vessels still, looking up at me in a suddenly mortal WTF. I’ll never forget that shade of violet, that abrupted vitality.

Why the surgeon’s lamp is the same purple, I don’t know, but from within a violet field there are issued continual eyedrops. I’m still puzzlingly unasleep.

Dear God, I’m actually now witnessing a needle being inserted into my eye. I don’t sense it, I observe it, and I’m not sure how I should be feeling. Turn off Van Morrison at least, please. Caravan is over. This becomes the strangest of phenomena. My eye’s supposed to be unseeing, but there it is, a silhouette of a needle exaggeratedly thick two nicks away from my expanding pupil. I’m not asleep and there’s a shadow against the purple. I’m seeing something inside my eye. I’m braced against the wraps, I feel the pressure, but all’s violet and there’s nothing I can do.

The surgeon actually says at one point: “This is not good.”

Really? I can’t speak. I actually watch as my new lens is shoved into place, roughly. The lens—a synthetic disc–unfolds and suddenly my world is in better focus. The drops still rain in continuous fashion, but the old lens has since been discarded and the new lens unfurls slowly, like a starfish arm curling curious, finding place within my eye. Everything is still purple. This, I guess is a color that incision suggests.

When I awake from anesthesia—and easily—never having been completely under, I’m fine. The nurses don’t have to steady me. I’m familiar with my ride home and I walk out the door just—well—fine.

I inform the surgeon that I’ve remembered every moment of the procedure. He says that he doesn’t believe that accurate, and he frowns. Doctors have a lot of ego, and I’ve grown to know this more of recent. I remind him that Van Morrison was playing on the radio and I say this while shrugging on my brown wool coat. Anesthesia makes you cold, not dumb. I list off the songs. I have an eye patch on, but I’m not blind. He frowns further.

I lift my eye-patch in, of all places, a Jack in the Box drive-thru. I never go to Jack in the Box, but I’m there and there are neon signs. The fact of neon is a complicated chemistry and what runs through tubes is something in a vacuum. I think there are noble gases involved; also cheeseburgers.

I see true purple for the first time in years, and oh my God: why does my cat stare out the backdoor? There is purple outlining the drive-thru window and there are tacos here. The windshield reflects the order-board in an amazing andluminescent yellow. I momentarily forget the stars.

The constellations were in my eyes; they were removed.

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