When the Curtains of Death Parted: By MARTIN C. SAMPSON, M.D.

Courtesy: Medical Miracles, from Readers Digest 1981. November.

From the frontiers of science and the far horizons of personal courage, these stories of medical triumphs and miracles will reaffirm your faith in the awesome powers of the human spirit. Dramatic victories and human triumphs.

Selected and edited by the editors of Readers Digest

It was a hot Philadelphia summer day, and the air in the old Pennsylvania Hospital hung heavy and still.  I had been up all night in a vain fight to save a little girl from meningitis.  In reaction of her death I was feeling completely disheartened.  As a young intern I had seen so much of dying in the past months that life seemed fragile and meaningless.  I was face to face with cynicism.  Faith seemed to exist only to be mocked by death.

The first patient I was to examine that morning was a man I shall call John Bradley.  He was in his late 40s, with deep-set brown eyes and a gentle face.  During the few weeks since his admission his condition had declined steadily.  As I looked through the window of his oxygen tent I saw that his lips were blue, his breath fast and strained.  I knew that his heart had been weakened by rheumatic fever in his youth, and that in recent years hardening of the arteries had taxed it even more.

I couldn’t help thinking of his wife, a small, white-haired woman with a face in which the shadows of work and sorrow mingled with faith and trust.  She and her husband had constantly looked to me for help.  Why, I thought bitterly, did they ask so much of me?

I went over Bradley’s medications again in my mind, hoping to think of something new to relieve his suffering.  He was getting digitalis to control his failing heart, an anti-coagulant to prevent the formation of clots in its damaged wall, and injections to help rid his body of excessive water.  The amount of oxygen being pumped into his tent had been increased.  This day, as on many previous days, I inserted a needle to draw off any fluid that had accumulated in his chest.  Still, when I left him I had the feeling that all my efforts were fruitless.

Shortly after six o’clock that evening the nurse in charge of Bradley’s ward called me to come at once.  I reached his bed within seconds, but already his skin was ashen, his lips purple and his eyes glazed.  The pounding of his heart could be seen through the chest wall, and the sound of his breath was like air bubbling through water.

“One ampoule of lanatoside C and start rotating tourniquets, quickly,” I said to the nurse.

Intravenous lanatoside C would give the rapid action of digitalis.  The tourniquets would keep the blood in his legs from circulating and temporarily relieve the failing heart—but only temporarily.

An hour later Bradley began to breathe more easily.  He seemed aware of his surroundings and whispered, “Please call my family.”

“I will,” I said.

He closed his eyes.  I was just leaving when I heard a deep gasp.  I wheeled and saw that he had stopped breathing.  I put my stethoscope to his chest.  The heart was beating, but faintly.  His eyes clouded over, and after a second or two his heart stopped.

For a moment I stood there, stunned.  Death had won again.  In that moment I remembered the little girl who had died the night before and a wave of fury came over me.  I would not let death win again, not now.

I pushed the oxygen tent out of the way and started artificial respiration, meanwhile asking the nurse for adrenalin.

When she returned, I plunged the syringe full of adrenalin into the heart.  Then I whipped the needle out and listened through my stethoscope again.  There was no sound.  Once more I started artificial respiration, frantically trying to time the rhythm of my arms to 20 strokes a minute.  My shoulders were aching and sweat was running down my face.

“It’s no use,” a flat voice said.  It was the medical resident, my senior. “When a heart as bad as this one stops, nothing will start it again.  I’ll notify the family.”

I knew he had the wisdom of experience, but I had the determination born of bitterness.  I was desperately resolved to pull Bradley back though the curtains of death.  I kept up the slow rhythmic compression of his chest until it seemed so automatic it was as if a force other than myself had taken over.

Suddenly there was a gasp, then another!  For a moment my own heart seemed to stop.  Then the gasps became more frequent.  “Put the stethoscope in my ears.” I said to the nurse, “and hold it to his chest.”  I kept pumping as I listened.  There was a faint heartbeat!

“Oxygen!”  I called triumphantly.

Gradually the gasps lengthened into shallow breaths.  In a few minutes Bradley’s breathing grew stronger and so did his heartbeat.

Just then the screen around the bed was moved slightly, and Mrs. Bradley stood beside me.  She was pale and frightened.  “They told me to come right away.”

Before I could answer, Bradley’s eyelids quivered.  “Helen,” he murmured.

She touched his forehead and whispered.  “Rest, John, dear—rest.”

But he struggled for speech.  “Helen, I told them to call you.  I knew I was going.  I wanted to say good-bye.”

His wife bit her lip, unable to speak.

“I wasn’t afraid,” he went on painfully. “I just wanted to tell you—“ he paused, his breathing heavier,”—to tell you that I have faith we’ll meet again—afterward.”

His wife held his hand to her lips, her tears falling on his fingers.  “I have faith, too.”  She whispered.

Bradley smiled faintly and closed his eyes, a look of peace on his face.

I stood there, filled with a mixture of exhaustion, wonder and excitement.  The mystery of death was right on this room.  Could I, in some way, begin to understand it?  I leaned forward and very softly asked, “John, do you remember how you felt?  Do you remember seeing or hearing anything just now, while you were—unconscious?

He looked at me for a long moment before he spoke.  “Yes, I remember,” he said.  “My pain was gone, and I couldn’t feel my body.  I heard the most peaceful music.”  He paused, coughed several times, and then went on: “The most peaceful music.  God was there, and I was floating away.  The music was all around me.  I knew I was dead, but I wasn’t afraid.  Then the music stopped, and you were leaning over me.”

“John, have you ever had a dream like that before?”

There was a long, unbearable moment; then he said, with chilling conviction, “it wasn’t a dream.”

His eyes closed, and his breathing grew heavier.

I asked the ward nurse to check his pulse and respiration every 15 minutes, and to notify me in case of any change.  Then I made my way to interns’ quarters, fell across my bed and was instantly asleep.  The next thing I heard was the ringing of the telephone beside my bed.

“Mr. Bradley has stopped breathing.  There is no pulse.”

One glimpse of his face told me that death had won this time.

Why, then, had the curtains of death parted briefly to give this patient another few minutes on earth?  Was that extra moment of life the result of chance chemical factors in his body?  Or did it have a deeper, spiritual meaning?  Had his spirit been strong enough to find its way back from death just long enough to give message of faith and farewell to his wife?  Could it also have been meant to give a small glimpse of eternity to a troubled and cynical young intern?

Whatever the meaning, and whether of not it had a purpose, the incident made a deep impression on me.  This was my first step toward acceptance of certain mysteries as an essential part of life.  This acceptance, the gift of a dying patient whom I could not save, put me on the road back to faith.

Can Science Produce Life?: By RUTHERFORD PLATT

Courtesy: Medical Miracles, from Readers Digest 1981. November.

From the frontiers of science and the far horizons of personal courage, these stories of medical triumphs and miracles will reaffirm your faith in the awesome powers of the human spirit. Dramatic victories and human triumphs.

Selected and edited by the editors of Readers Digest

For years scientists have carried on a wave of unprecedented laboratory experiences to test their theories of how life on Earth began.  The results have been amazing.  Retracing the probable steps by which the raw, lifeless elements of space became organic matter, they now have produced primitive cell-like structures that have many of the properties of living cells.  Here is the dramatic story:

When Planet Earth was born it slowly cooled to form a hardened crust of black volcanic rock.  In time, masses of silicon mixed with mineral elements were squeezed to the surface by the pressures of internal fires, and crystallized as big islands of granite, which formed the foundations of continents.  The whole crust heaved and bulked, cloudbursts drenched the rocks, and sterile water collected in wide depressions to form the earth’s first seas.  Countless volcanoes and fissures continuously gushed methane, steam, ammonia and perhaps carbon dioxide, to give the earth its first atmosphere.  That ‘air’ contained the four chief elements of life—carbon, oxygen, hydrogen and nitrogen.  But they were in the form of gases deadly to present-day life.  Moreover, the atmosphere was flooded with ultraviolet radiation and stabbed by incessant lightning.

How, in this elemental turmoil, did life on earth begin?  Many have tried to supply the answer.  Among the first was Anaxagoras of Greece, who in the fifth century B.C. declared that life comes down to earth in raindrops, in the form of spermata [little seeds].  Came the 20th century, and the origin of life was still a mystery.

Then in 1924 the Russian scientist A.I.Oparin stated that life might have arisen out of inanimate matter in a prolonged process of ‘preorganic evolution.’  He showed how, in theory, atoms of carbon, oxygen, hydrogen and nitrogen could have formed molecules basic to life, even under the raw, inhospitable conditions of the primordial earth—and how self-reproducing clusters of these molecules might have adhered together and then evolved toward more complex forms.

Three years later the English biochemist J.B.S.Haldane wrote that although such substances would be destroyed by microorganism, “before the origin of life they must have accumulated till the primitive oceans reached the consistency of hot, dilute soup.”  And when the ultraviolet light radiated the surface of this soup, inorganic compounds would have been converted into organic molecules—molecules containing carbon.  At once time scientists believed that only living things could produce such organic molecules.

By the 1050s the scene was shifting from the theorist’s armchair to the laboratory, where scientists were striving to demonstrate that the molecular constituents of life could have emerged under primordial condition.

Using the cyclotron at Berkeley to create high-energy particles to represent cosmic rays, Dr. Melvin Calvin of the University of California bombarded a mixture of carbon dioxide and water vapor; ingredients he thought likely to have been present in the earth’s ancient atmosphere.  Some organic compounds were formed.

Dr. Harold C. Urey, atomic scientist then at the University of Chicago, reasoned that methane, ammonia and hydrogen were probable constituents of the original atmosphere.  What would happen, he wondered, if these raw lifeless substances were placed in a flask and then stabbed repeatedly by electric flashes to represent lightning?  In 1953 his student Stanley L. Miller performed this now classic experiment.  To their delight, they found that amino acids had been formed.

Amino acids are the building blocks of protein and hence of all life.  They are also believed to have been involved in the first stage of the evolution toward life.  The theory is this:

The colossal retort of the primordial earth must have yielded myriads of molecules as ephemeral as bubbles.  But, because of their peculiar molecular structure, the molecules of amino acids are especially stable.  The four elements of life—carbon, oxygen, hydrogen and nitrogen—are assembled in every amino-acid molecule into two opposing groups so well-matched in their electrical charges that they are stabilized like wrestlers locked in equal combat.  Thus the tenacious amino acids could have survived in the chaos to become an early link between no-life and life.

In experiments that followed, a surprising fact turned up.  The basic molecules of life could also have been produced by many other forces in those fierce, elemental times, including X rays, cosmic rays, ultraviolet light and volcanic heat.

After the creation of amino acids, two even larger problems remained.  Giant protein molecules, discovered everywhere in living things, are made of long chains of amino acids.  How did the amino acids get hooked up into these long chains?  And then how did these twisted protein giants turn into living cell?

Giant proteins are fantastically elegant structures—“the noblest piece of architecture produced by nature” in the opinion of biologists.  One molecule of the vital protein of blood, hemoglobin, for example, has 8954 atoms fitted together in a dazzling pattern.  The problem is that all the complicated proteins in life around us—living cells create those, which make flesh, blood, bone, hair, eggs, milk, seeds, and feathers—.  Those living cells in turn are made of protein.  How could protein be created in the first place, when there were no living cells?

This question is puzzling many scientists around the world.  No one has yet developed a foolproof theory that explains which steps came first of what triggered them.  One line of reasoning, first put forward by Dr. George Wald of Harvard, is that there may be conditions occurring in nature in which amino acids might themselves furnish the answer.  And so they did—quickly and beautifully—when the stage was set for them by Dr.Sidney W. Fox, then of the Institute of Molecular Evolution in Miami, Florida.  The “miracle” occurred when amino acids were permitted to dry out.  The thinking was that solutions of amino acids, billions of years ago, had puddled in warm, dry spots.  What would happen to such solutions today if the water was allowed to evaporate?  The scientists who watched this experiment saw a marvelous event.

As the spot on the warm test tube dried, its amino acids formed long, submicroscopic thread-like structures.  These chains some with hundreds of little molecules jointed end to end, were named proteinoids.  The sum of their electric energies endowed them with power to bend and fold!

There are 20 kinds of amino acids common to the proteins of life, and the precise order in which these are lined up in the chains spells what their protein creates—flesh of bone, hair of feather.  The scientists have been able to manufacture all these amino acids under presumed primordial conditions.  Dr. Kaoru Harada was able to synthesize 14 in a single experiment.

So the answer to one question is found.  Amino acids by themselves can produce primitive protein-like material under certain conditions—no need for a cell to help them.

Still, the final question remains.  How could these proteins from a living cell, with its millions of atoms and molecules carefully arranged in a precise pattern?

The primitive proteins came long before living cells appeared.  The precisely ordered proteins of present-day plants and animals would have acquired their amino-acid arrangement in the course of many millions of years of evolution.  Dr. Calvin estimated that molecular life must have evolved for two billion years before the first living cells appeared.

Duplicating this great leap, making a whole living cell in the laboratory, may take a while.  But it now appears that we’ve begun.  The most striking experiment, which has produced crude cell-like spheres that maintain their identity and are capable of dividing themselves, is truly fantastic and has taken us a giant step along the pathway toward understanding the origin of life.

Again, Dr. Fox did the experiment.  To reconfirm his laboratory findings, he climbed up the broad slope of a cinder cone in Hawaii, looking for spots where conditions might have permitted primitive proteins to form in the pre-life world.  He was surprised to discover that large areas of the cone were oven-hot just beneath the surface.  Might not this warm primitive earth have been the womb of the molecules of life—where they could bake and boil, before being washed through the loose lava by a cloudburst and so into the sea?  What would this have done to the elemental amino acids?

Dr. Fox took hunks of lava back to the laboratory and placed on them amino acids coined from methane, ammonia and water.  With everything sterilized to avoid contamination, he baked this concoction for a few hours in a glass oven at 338-degree F., the temperature he found four inches under the surface of the cinder cone.  When the materials cooled, a brown, sticky residue was left clinging to the lava.  He then deluged the lava with sterile water, and a brown soupy liquid resulted.

This unpromising stuff turned out to be very exciting.  As seen through an ordinary optical microscope a wonderful galaxy of spheres swarmed across the field of vision.  The amino acids had first united to make proteinoids—and then these had combined to form little spheres!  Dr.Fox named these fascinating strangers ‘microspheres’.n  they looked like, in many ways behaved like, and were the same size as certain simple bacteria, and they clung together in chains as do the one-celled blue green algae.  Bacteria and blue-green algae are two of the most elementary forms of life that exist on earth.

Although these spheres are not true cells—they have no DNA genes and they are simpler than any contemporary life—they do possess many cellular properties.  They have stability: they keep their shapes indefinitely.  They stain in the same way as the present-day protein in cells, an important chemical test.  But the real significance of these micro spheres is that scientists did not synthesize them piece; they simply set up the right conditions—and micro spheres produced themselves.

In the meantime, scientists working independently in other laboratories are making DNA and other essential constituents of the living cell could have formed.  It becomes hard to avoid the premise that life is inherent in matter, and that life will exist on other planets whenever the conditions are right.

Wonder of the Firstborn: By LAURIE LEE

Courtesy: Medical Miracles, from Readers Digest 1981. November.

From the frontiers of science and the far horizons of personal courage, these stories of medical triumphs and miracles will reaffirm your faith in the awesome powers of the human spirit. Dramatic victories and human triumphs.

Selected and edited by the editors of Readers Digest

She is, of course, just an ordinary miracle, but she is also the particular late wonder of my life.  This girl, my child, this parcel of will and warmth, was born last autumn.  I saw her first lying next to her mother, purple and dented like a bruised plum.  Then the nurse lifted her up and she came suddenly alive, her bent legs kicking crabwise.  Her first living gesture was a thin wrangling of the hands accompanied by a far-out Herbridean lament.

This moment of meeting seemed to be a birth time for both of her first, my second life and us.  Nothing, I knew, would be the same again, and I think I was reasonably shaken.  Then they handed her to me, stiff and howling.  I kissed her, and she went still and quiet, and I was instantly enslaved by her flattery of my powers.

Only a few weeks have passed since that day, but already I’ve felt all the obvious astonishments.  Newborn, of course she looked already a centenarian, exhausted, shrunken, bald, tottering on the brink of an old crone’s grave.  But with each day of survival she has grown younger and fatter, her face filling, drawing on life, every breath of real air healing the birth-death stain she had worn so witheringly.

The rhythmic tides of her sleeping and feeding spaciously measure the days and nights.  Her frail self-absorption is a commanding presence, her helplessness is strong as a rock, so that I find myself event to her silences as though some great engine were purring upstairs.

When awake, and not feeding, she sports and gobbles dryly, like a ruminative jackdaw, or strains and groans and waves her hands about as though casting invisible nets.  I see her hauling in life, groping fiercely with every limb and muscle, working blind at a task no one can properly share, in darkness where she is still alone. Each night I take her to bed like a book and lie close and study her.  Her dark-blue eyes stare straight into mine, but off-center, not seeing me.  Already, I suppose, I should be afraid for her future, but I am more concerned with mine.  I fear perhaps her first acute recognition, her first questions, and the first man she makes of me.  But for the moment she stares idly through me, at the pillow, at the light on the wall.

Meanwhile, as I study her, I find her early strangeness insidiously claiming a family face.  Here she is, brand-new, my daughter whom I must guard.  A year ago this space was empty; not even a hope for her was in it.  Now she’s here with our name upon her, and no one will call in the night to reclaim her.  She will grow, learn to run in the garden, run back and call this home.  Or will she?

All those quick lively tendrils seem so vulnerable to their own recklessness—surely she’ll fall on the fire or roll down some crevice or kick herself out of the window?  I look at those weaving hands and complicated ears, the fit of the skin around that delicate body, and I realize I’m succumbing to the new-parenthood shakes.  My daughter is so new to me still that I can’t yet leave her alone; I have to keep digging her out of her sleep to make sure that she’s really alive.

Her face is a sheaf of masks, which she shuffles through aimlessly.  I watch eerie rehearsals of those emotions she will one day need, random, out-of-sequence, but already exact, automatic, yet strangely knowing: a quick pucker of fury, a puff of ho-hum boredom, a beaming after-dinner smile, perplexity, slyness, a sudden wrinkling of grief, popeyed interest, fat-lipped love.  Ever since I was handed this living heap of expectations, I can feel nothing but simple awe.

What have I got exactly?  And what am I going to do with her?  And what for that matter will she do with me?

I have got a daughter, whose life is already separate from mine, whose will already follows its own directions, and who has quickly corrected my wooly preconceptions of her by being herself.  I am merely the keeper of her temporary helplessness.  With luck, she can alter me; indeed, is doing so now.  She will give me more than she gets, and may even later become my keeper.

But if I could teach her anything at all, by unloading upon her some of the ill-tied parcels of my years, I’d like it to be acceptance and a holy relish for life.  To accept with gladness the fact of being a woman—when she’ll find all nature to be on her side.  If pretty, to thank God and enjoy her luck.  To be willing to give pleasure without feelings loss of face, to prefer charm to the vanity of aggression, and not to deliver her powers and mysteries into the opposite camp by whishing to compete with men.

In this way, I believe—though some of her sisters disapprove—she might know some happiness and also spread some around.

And, as a brief tenant of this precious and irreplaceable world I’d ask her to preserve life both in herself and others.  To prefer always Societies for the Propagation and Promotion of rather than those for the Abolition or Prevention of.

I’d ask her never to persecute others for the sins hidden in herself, nor to seek justice in terms of vengeance; to avoid like a plague all acts of mob righteousness and to accept her frustrations and faults as her own personal burden, and not to blame them too often, if she can possibly help it, or young or old, whites of blacks, East, West, Jews, Gentiles, television or bingo.

For the rest, may she be my own salvation, for any man’s child is his second chance.  In this role I see her leading me back to my beginnings, reopening rooms I’d locked and forgotten, and stirring the dust in my mind by re-asking the big questions—as any child can do.  With my tardy but bright-eyed pathfinder I shall return to that wood which long ago I fled from but which together we may now enter and know.

How I Beat the Tyranny of Cataracts: By EARL SELBY with MIRIAM SELBY

Courtesy: Medical Miracles, from Readers Digest 1981. November.

From the frontiers of science and the far horizons of personal courage, these stories of medical triumphs and miracles will reaffirm your faith in the awesome powers of the human spirit. Dramatic victories and human triumphs.

Selected and edited by the editors of Readers Digest

Two summers ago, I noticed deterioration in the vision of my right eye.  A tennis ball, when seen through this eye for backhand shots, was a blurry blob until it was almost on top of me.  At night, the lights of oncoming cars splattered into distracting shears of glitter.  I could read a newspaper only I held it close to my nose.

Although I felt no pain, I went to see an ophthalmologist.  Placing a corrective lens in front of my right eye, he asked me to read the wall chart.  What chart?  Not one letter was visible.  After a through examination, he said, “You have a cataract.”  I didn’t exactly know what a cataract was, but the diagnosis quickly sharpened my interest.

A cataract, I learned, is a cloudiness of the eye’s lens that occurs when the lens’s clear protein becomes opaque.  Normally, light rays pass through the cornea to lens, which focuses the rays on the retina, triggering the impulses we translate into sight.  A cataract impedes vision by preventing rays from reaching the retina.

Cataracts are among the worlds leading causes of blindness.  They can appear in one of both eyes, at any age and may be congenital, trauma0induced or, most commonly, associated with aging.  The National Society to Prevent Blindness estimates that 44 million Americans age 40 and over has cataracts.  Fortunately, only a small percentage has vision sufficiently impaired that they must have the lens surgically removed—the single cure.  In the United States, there are about 400,000 cataract operations a year.

Medical wisdom used to caution against surgery until cataracts were ‘ripe,’ or matured into grayish, hard kernels.  But this was not necessarily the best time for patients, struggling with failing sight for years while awaiting the operation.  Today, however, cataract victims almost always have the option of scheduling the operation at their convenience, when impaired vision forces significant changes in life-style.

I saw the shadow of my cataract everywhere—on my reading, driving, recreation and job.  Once the cataract was diagnosed, I had to stop flying an airplane, which is essential in my work; I could no longer pass the pilot’s medical examination.  I needed surgery; the only available treatment for cataracts.

Vaguely, I recalled horror stories of cataract operations in which patients were hospitalized for weeks, eyes bandaged, heads locked in sandbags.  A neighbor of mien who had twice undergone cataract surgery eased my fears.  He said modern techniques could reduce hospitalization to a day or two.

Somewhat relieved, I considered the options I’d have after surgery.  Once a clouded lens is removed, something must be substituted to focus light rays on the retina.  Cataract eyeglasses or contact lenses are the traditional alternatives.  But each has definite limitations for certain people.

On being introduced to thick cataract eyeglasses, most patients feel they have moved into the fun house’s crazy-mirror room.  Parallel lines bend.  Door frames bow inward.  Floors are wavy.  Peripheral vision is severely restricted.  The eyeglasses magnify about 30 percent, meaning they can’t be worn when one eye is normal.

Contact lenses, which cause a 6 to 10 percent enlargement, are compactable with a normal eye, but can be difficult to manage, especially for anyone with shaky hands, arthritis or poor coordination.  Patients with dry eyes or allergies also have difficulties with them.  Most contacts must be taken out daily for cleaning, and to rest the eye.

To escape either of these choices, a growing number of cataract victims—approximately 100,000 in the United States last year—are turning to intraocular lenses [IOLs].  Pioneered in Europe, IOLs duplicate nature’s way of creating sight: a plastic lens surgically implanted in the eye gives vision [essentially no magnification] 24 hours a day and never has to be touched, adjusted or cleaned by the patient.  Still, because implants require additional surgical steps, they do involve greater risk of complications than simple cataract extractions coupled with spectacles of contacts.

IOLs are not for every eye.  It takes a skilled ophthalmologist to ascertain when IOLs are advisable, and a well-trained surgeon to implant them.  In general, IOLs are not recommended for relatively young patients.

In September 1979 the National Eye Institute sponsored a Consensus Conference to determine guidelines for the use of the intraocular lens.  Participating ophthalmologists, research scientists, consumers and others recommended that, in general IOLs be used in elderly patients.  They also suggested that use be restricted to one eye unless special needs of the patient indicated otherwise.

Before deciding on an IOL implant, I sought information everywhere, especially since the ophthalmologist I consulted had shown no enthusiasm for the technique.  I again talked with my neighbor, who had implants in both eyes and could read without glasses.  He mentioned friends who also had good vision with IOLs.  I talked with his ophthalmologist, Dr. Steven G. Cooperman of Beverly Hills, California.

Also, I asked a neurosurgeon friend to refer me to other ophthalmologists.  One said that implant techniques were steadily being improved and lens designs refined; he considered implants safe.  Another said that he did not perform implants.  That was not surprising.  Until the 1970s, implants weren’t used much by U.S. doctors, and not all ophthalmologists are trained to do implants. [Others feel they cannot conscientiously recommend them because of the greater risks.]

I read everything I could from the Food and drug Administration, including what was to me a rather scary statement explaining why the agency is investigating the safety of IOLs.  May be implants are too dangerous, I thought, and began to waver.  Then I came across an article in the FDAs “Drug Bulletin.”  It said there was “widespread acceptance” of IOLs by doctors, adding that 3000 ophthalmologists in 2500 U.S. hospitals were doing implants.  That certainly did not indicate gloom and doom.  I could not believe that one in four ophthalmologists would be inserting IOLs if there were an intolerably high risk.

So, in august 1978, I elected to have an implant and went to Dr. Cooperman.  Within three weeks of my original cataract diagnosis, I was in a hospital, prepared for the operation.

There are several methods for removing cataracts; the surgeon chooses the procedure best suited to the patient.  In one method, the ‘intracapuslar” extraction, the entire lens and its surrounding capsule are taken out.  Although this means a relatively large incision [half an inch or so], the procedure is quick and is used by most ophthalmologists.

In my case, Dr. Cooperman went to and “extracapsular” extraction.  Looking through a microscope, he cut an eighth-of-an-inch incision at the outer edge of the cornea and lifted the corneal flap out of the way.  He then separated the lens nucleus from its capsule and cased the nucleus through the pupillary hole into the eye’s front chamber.  Then he inserted a hollow titanium needle, and with high-frequency sound vibrations softened and liquefied the cataract.  ] NewYork’s Dr. Charles Kelman developed this process, called phacoemulsification,] the fragments were removed by suction through the hollow needle, along whti the front portion of the lens capsule, leaving its back in place.

From among the many styles of implant lenses, my surgeon had selected a two-looped Binkhorst type [named after Cornelius Binkhorst, a Dutch doctor famous for his implant surgery.  To insert a quarter-inch plastic disc into my eye, Cooperman first widened the corneal incision to accommodate the lens.  Them be maneuvered it into place and anchored it by slipping under iris the two plastic loops extending from its sides.  The wound was stitched shut, the eye medicated and patched.  The surgery had taken 21 minutes.

The patch came off the next morning, and after 20 hours in the hospital I was discharged.  Three rules were lay down: prescribed drops three times a day for a month; don’t strain in heavy lifting; sleep for several nights with the eye covered by a protective shield.

How was my sight?  Blurry.  Although I could work and read with my good eye, I was worried.  I would stare at digital clock, wanting to strangle the numbers into recognizable shapes.  I tested the implanted eye continually.  One night a star I had not previously been able to make out suddenly popped into view.  It was my own personal miracle.

The blurriness gradually tapered off until the eye just had double vision.  Tennis court No. 2 was 22. On the second post-surgery visit to my doctor he found minuscule swelling around the sutures, which was pulling the cornea slightly out of shape and causing the dual images.  This is not unusual.  Once he had snipped three stitches to relieve the pressure, my vision cleared.  With a corrective lens, my eye tested 20/20.  Absolutely normal!

At the 1979 international symptom of the American Interlobular Implant Society, I heard Miami’s Dr. Norman S. Jaffe, a veteran of more than 4000 implants, report that 90 percent of his IOL patients got essentially normal vision, good enough at least for a driver’s license.  ‘Most of the remaining 10 percent had other conditions that prevented a similar degree of improvement].  He contended that good surgeons, using high-quality IOLs, have the same success rate.

The society’s president, Dr. Robert C. Drews of St. Louis, declared, “IOLs have come of age.”  Referring to the continuing FDA investigation, which after one year of monitoring all implants found no reason to suspend the procedure as unsafe, Drews called IOLs an “overwhelming success.”

Since I am in the FDA study, let me add some details.  One year after the surgery, my implanted eye tested 20/15 with ordinary glasses—better vision than I’d had in years.  For distance vision, I am 20/20 without glasses.  My new driver’s license says I do not need corrective lenses.  And the Federal Aviation Administration has approved me once again to be a plot.  One surgeon has an apt expression for all this.  He calls it IOL.  “Happiness factor.”