My Depressing Sight

My eyes still dilated after two hours of testing, I sat and watched the white-jacketed doctor pore over my chart. He intently flipped back and forth between 18 months’ worth of graphs and notations that tracked change in my vision. He peered down at photos of my optic nerve taken a year ago and compared them with those taken just 15 minutes earlier.

For 10 minutes, like a student cramming for an exam, he had his nose in my recent ocular past. At one point, without looking up, he said, “Sorry this is taking so long.”

All I could think to say was, “Uh huh.”

Finally he swung around in his chair and pronounced that he didn’t like the “trend” in my left eye. My field vision tests showed that my vision is still slowly deteriorating.

Let me be the first to say that I hadn’t noticed it. After all, I don’t go around one-eyed looking for little scattered lights blinking on the wall of a dimly lit dome in a doctor’s office.

I’m into sunsets at the beach, and evening of reading, a morning of writing and looking for signs of spring. My sight is still serving me quite well, thank you.

But the dome test showed I had this problem caused by early-stage glaucoma.

“I’d like to put you on beta blockers,” he said. “Do you have any problem with depression?” he asked, slowly introducing possible side effects from the medication.

“No” I said hesitatingly, feeling slightly depressed at the thought of drug-induced depression.

“How about heart problems. Palpitations, that sort of thing?”

“No problem,” I responded without skipping a beat.

“Occasionally, not often, but occasionally, patients experience these problems with the eye drops I’m recommending.”

For the past year I’d been using another type of drop to lower pressure in my eye. Less pressure could stop, or at least markedly slow, my loss of vision to glaucoma.

The right eye was fine, presumably thanks to the drops. But then the left….

The word “depression” hung in the air. I don’t think I’ve ever been depressed. Sure, some January mornings the warmth of bed has kept me from facing the day. The room beyond the covers has been depressingly cold.

No, when I come up short, my response is, sadly, anger at myself, but not depression.

Now the doctor was possibly, just possibly, presenting a Hobson’s choice. He never said it in so many words, but he was really probing whether I would prefer blindness to possible depression.

Does life at my stage come down to such choices?

As I say, the very thought of depression was depressing, and I hadn’t even started to squeeze the little bottle that would release a single drop of the drug into each eye once a day.

Is this the way it will be? You have a choice, “cancerous death or chemotherapy and radiation,” “deafness or hearing aids,” “blindness or depression.”

In each case, the choice is clear even though the obvious alternative is diminishes life.

Not quite take-it-or-leave-it Hobson's choices. Call them half Hobson’s. You accept them because, like full Hobson’s, you have no choice, not really.

• • • •

After reading this over, I should note that many people have no choice at all. There is no bad and less bad. It’s just plain bad.

I also know that some who read this will suggest that I have other choices besides the ones posed by the doctor. Indeed, the doctor may decide there is a better course if the new drug too doesn’t work or if the side effects, including depression, appear.

What I do find strange is the paradox that warnings of possible depression are themselves depressing. It's a bit like being intolerant of intolerance. Those are snares to avoid.

MRI results deem Red Electric blogger "normal"

The hammering, rattling, humming, grinding MRI scan that I had last Wednesday (and wrote about here) has produced images of my brain that show it (and me) to be "normal."

Oh.

I'm not sure how to take this, coming as it does with the authority of both science and technology.

I was hoping for a little better. Something along the lines of "truly exceptional!" or "fantastic!"

Nevertheless, given that the scan was looking for evidence of brain decay possibly leading to blindness, "normal" frankly sounds fantastic.

I'll take it.

Magnetic resonating with Willy and the Poor Boys

I won’t tell you how much this costs — yet.

I went in for an MRI the other day. Seems that I have telltale signs of impending glaucoma. Since the beginning of the year, I’ve been putting in eye drops to bring down my interior eye pressure, but the ophthalmologist has concluded that we may need to be “more aggressive." He’s seeing a “thinning” of my optic nerve just where it goes into the cup at the back of my eye.

I see perfectly well, but there is blindness on my mother’s side of the family. My mother’s cousin, Charles, went blind over the course of two or three months. Charles adjusted to living in a dim, murky world for another 20 years. When visitors came to his house, he instructed them not to move anything. He had everything's place memorized.

I suppose I could carry the blindness gene. They say if you detect glaucoma early enough, though, it is highly treatable.

My ophthalmologist tells me the next step is to prescribe beta blockers, which makes me think of some kind of football formation. “Beta blockers left on three! Hupp, hupp, HUPP!”

The list of “possible” side effects is long but does not include face masking, unnecessary roughness or excessive celebration.

Before bringing in the beta blockers from the bench, the ophthalmologist decided to check to see whether there might be, well, “something else going on.” Hence the MRI, magnetic resonance imaging.

I think he and the massive cylindrical MRI machine may be looking for a brain tumor.

If I have a brain tumor, I’d be surprised. Sure, I have my moments. I left the car keys in the rear door lock the other day and then went mildly ballistic because I couldn’t find them.

And I blank out on names from time to time, but that’s mostly a function of knowing more people than I can absorb — at least namewise. Apologies to all, by the way.

When I was a medical/health reporter in what now seems like another life, I remember the controversy surrounding CT scanners. The problem was that these hugely expensive contraptions got (and still get) an inordinate amount of use. So much so, that the government for a while regulated how many of them could be in a community.

The suspicion is that they are prescribed as diagnostic tools in order to pay them off, and, after that, to make a profit. They also drive up health care costs. The other suspicion is that because they are available and work, they are being used as a defense against medical malpractice suits.

Enter Perry Mason: “You mean, doctor, that you failed to prescribe a CAT scan, which clearly would have alerted you to this horrendous, agonizing disabling disease that will cause $100 million in pain and suffering to my client for the rest of her life?”

You get the picture.

Are MRIs and CAT scans cost-effective? Suffice to say … yes and … no. It depends. What's the value of life or health etc.?

So I show up for the MRI and the young guy in the green scrubs asks what kind of music I would like to listen to.

How’s that?

Seems that I will be slid into this confined tube with earphones on. To be precise, with ear protectors on, because MRI scanners magnetically resonate LOUDLY to produce their 3-D images.

MRI could just as easily stand for Mighty Ruckus Intensifier.

For three minutes you are bombarded with the cacophony of a humongous coffee grinder. Then for five minutes, it’s an industrial-grade vacuum cleaner in serious need of repair. Then for another three-minute session, it’s a jackhammer.

Then its all three at once. It goes on this way for 35 to 40 minutes.

So I’m given a menu of music selections heavily weighed to Rock. Columns of Rock. metal, grunge, soft, classic. “Jazz,” my choice offers on choice. It lists one musician, predictably Wynton Marsalis. Mind, I have nothing against Wynton but why does jazz rise and set on Marsalis for so many in the Post-Reagan generations?

I chose James DePriest and the Oregon Symphony, just to keep things familiar.

* * *

The resonating has begun. The aural assault spins round my head. The jackhammer, grinder, vacuum cleaner reduce the orchestra to a distant whimper. After three minutes, all goes silent.

The technician’s voice comes through the headset. Technician ex machina.

“How are you doing, William?” (He’s reading my name from a chart. “William Frederick Seifert.” I don’t tell him I go by “Rick” because I’m hoping the “William” reference is a one-off.

It isn’t.

“You’re doing great, William.”

Actually, I’m not doing anything but lying on my back with my eyes closed.

“One thing,” I say. “Let’s dump the Oregon Symphony for Credence Clearwater.”

“You got it,” he says as if taking an order for a hamburger and fries.

“Willy and the Poor Boys” ride to the rescue.

* * *

I haven’t received the scan results yet, but my guess is that the main thing the 35-minute clamor accomplished was another billing in the radiology department’s books.

“Could you tell me,” I inquired of the receptionist when I checked in, “what all this costs?”

I must have been the first to ask because she had to look it up in the computer.

“$2400 for your partial, head scan,” she said matter of factly.

I wonder whether Medicare pays Credence Clearwater Revival residuals.