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A Piece of My Mind
March 10, 2015

Insight on the Irrawaddy

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, Yale University School of Medicine, New Haven, Connecticut
JAMA. 2015;313(10):1015. doi:10.1001/jama.2014.13839

I stifle a gasp as the young woman lifts her blouse. There, her baby son struggles to suckle, his access to the breast nearly obstructed by a hideously engorged, phallus-like tumor that grows out of his eye socket. She looks at me, her only hope, with unbearable shame.

Treating patients at this Buddhist monastery–run hospital in central Myanmar is my annual immersion in the acid bath of human vulnerability, hope, and loss. There’s more blindness here than almost any place else on earth, an unending barrage of desperate cases unrelated to my ophthalmology practice in Connecticut. A cheroot-smoking woman with trachoma-scarred eyelids the consistency of cardboard requires an operation to sever and redirect her abrading lashes away from her corneas, now covered in blood vessels. A farmer with red-and-black betel-stained teeth holds a blood-soaked rag over his face, fresh from a scythe injury. A gnarled, toothless fisherman carries his aged mother on his back. Nearly blind from cataracts (cloudy lenses), she is all gristle, and grips his waist with her bony ankles, grinning from ear to ear. Suddenly the crowd of patients murmurs and parts for a child with a lacerated eye. His tears have traced designs on his cheeks, traditionally powdered with the pounded bark of the thanaka tree. I’ll operate on each of them today.