These Eyes

After a half and hour, I found the office. Before getting in the rickshaw I asked the driver if he knew where he was going and he didn’t answer, set his mirror to zero and motioned his head for me to get in. He didn’t know. This is common and sometimes so frustrating and sometimes really fun – you know a landmark, get there and ask around, get pointed in every direction and somehow end up right where you needed to be. Normal. Here we are.

Everything about this doctor’s visit was different, mostly in ways subtle, a touch unnerving but I am in India, not bad just unfamiliar. But, so too were there differences that stirred me deep in my stomach – not bad, just too adult for me to handle.

I walk up the stairs, take off my shoes, approach the counter, tell the secretary that I have an appointment with Dr. Dipan Desai for a Lasik surgery consultation. Hindi is her first language. Gujarati is her second language; English her third. I pay in cash, Rs. 200. I sit. I wait and look at the monkeys outside the window. Sunlight beams in. After 3 minutes my name is called.

The walls are not white. The floor is not tile. None of the staff are wearing scrubs, it doesn’t smell like bleach, the couches are not made of vomit resistant material. We walk past examination rooms and offices, staff hustle about, don’t knock, prepare for their afternoon patients, dropping something off, asking a question, not interrupting, just working. Normal. The cadence of office operations play on, a different rhythm in a different tone from what I know of eye examinations and doctor’s offices, but this is the best eye clinic in the state, treating people how they do, in a way that is new to me. My feet are clammy. I am adjusting.

There are no other patients in the office. I am alone. As I walk down the hall behind a woman wearing a salwar kamiz and bindi, I am alone. I am 22 and my mother is not with me. With my head high trying to fool people, I hold the strap of my bag a little tighter. People make fun of me because I went to my pediatrician until I was 21. Familiar, I liked his bow tie and he was the doctor who knew my body best. When I had surgery during my freshman year in college, I had it in the Children’s Hospital. Since I was three I’ve been seeing the same two doctors for my eyes.

With my teeth clattering in the waiting room of a clnic in Kibera, I was not this nervous. You have malaria, take these tablets and if you are not better in three days, come back. Done and done. Back to work in 2 days, no big deal. Something about having my eyes worked on by a new doctor is hard to face on my own.

It’s been a long journey. Since birth this has been an issue for me, a constant, nothing too traumatic but a something to deal with. Not seeing the corn on my plate, my lazy eye, wearing a patch, the chiropractor, more broken frames than stars in the sky, bifocals, surgery in 8th grade, contacts, really thick lenses, that stupid fly, slow improvement, astigmatism, strabismus, the flirtatious introduction of the idea of Lasik, more contacts, poor binocularity, shitty depth perception, more glasses, getting my eyes dialated, and the beat goes on. Standing in the smalls pools of my sweat from my feet, I am getting ready to talk to a doctor about ending this, a surgery that will fix my eyes. Just like that. 22 years later. Out patient, some drops, 3 days later back at ‘em 20/20. My parents aren’t with me, here I am as an adult facing decisions that feel really important, all on my own. The color of the walls don’t matter – it is this that is unsettling.

Arrogant, this doctor is a surgeon. Daily he plays god, knows it, and wears his hubris in his smile, posture. He calls me Boss. This is his normal sales pitch, a confidence that is meant to be overwhelming and irresistibly reassuring. He doesn’t get how long I’ve been waiting for this appointment, that it is important to me, but that I could just as well wait another 2 years. He has the best machine and is the best at doing what he does, and this makes it harder to dismiss him with my normal response to people who are this smug. He talks a lot, some of it bullshit, a lot of it not, his tone hasn’t changed – this is who he is, a surgeon who is proud of himself, broadcasting.

Today I will go back to his office, have my eye mapped, cornea analyzed, eyes dilated and examined, and he will study these results, after which he will tell me if he thinks he can perform this operation.

It is possible that my vision is still too bad, the technology, despite its advances in the past years, is not ready for my eyes. So too is it possible that I could be in a position to make a decision, here, on my own, alone, an important one, a touch overwhelmed. No support system here, no one to sit in the waiting room with. 22.

A painful irony bubbles up, his surgical hubris met by my American ego. Surely, without question, we in America have the best medical technology, the smartest doctors, latest techniques. Right? No. I know this. I know that technology in other parts of the world is way ahead of what we have in the U.S. We send our computers to be fixed in India. India produces some of the smartest scientists and engineers in the world. One third of practicing doctors in the U.S. are of Indian descent. I know this. And yet, I am a little uneasy. There is no good reason to support this. This man is trained in Germany, indeed has the best machine in the world right now for this procedure – the same machine that FDA bureaucracy and medical supply company infighting prevents from reaching American markets – a machine developed in Germany, tested in Sweden and Japan. Tested. Proven. Accurate. Succesful. Still uneasy.

I spent last summer combing the slums of Kenya looking for brilliant and innovative new designs among the ‘base of the pyramid’ – the poorest of the poor. I read development literature praising the resourcefulness of non traditional ways of thinking, alternative knowledge bases. Oral traditions. Collective memories. Homemade solar panels. Self constructed prosthetic limbs and wheelchairs. All sorts of inventions and ways of capturing knowledge that are non-Western. Call them what you will – they are not practiced by surgeons. Parts of me admire this thought processes, innovation. But, there is a stark contradiction in my appreciation and acceptance of lessons from non traditional places and my refusal or discomfort with lessons, advancement, medical treatment in traditional places that I trust with other ways of healing me. Maybe I do some yoga, drink certain types of cleansing teas, pour water through my nose, consider my energy and that of other people. But, if I get sick I am going to go to a doctor, not take ayurvedic treatment. If I have a headache, I take advil.

So why is this doctor any different from the advil I take. Why am I suspicious of his technicians? There are some really stupid technicians in the US, no? Are the patients that he has operated successfully on over here any different than Americans? How can I rationalize my discomfort when I will spew water through my nose or do yoga as a way to tend to my health for some things, but trust western medicine far more for sickness and disease? Here this man lies at the pinnacle of his profession within that tradition of medical treatment I trust most, the only difference is that he practices in India and not NYC.

It is stupid, but I am still uneasy.

Maybe it is because I am doing this on my own, maybe it is because I am being stupid, I don’t know. This afternoon will let me know if I really need to push this forward, or if it was just another exercising in exploring my independence.