Two funerals this weekend of old and dear friends, word yesterday of a college fraternity brother’s death, learning a few weeks ago about the tragic death of a good friend’s wife, the stunning, televised, funeral of John McCain, and several close friends with terminal illnesses. When you are in your mid 70s, it is hard to miss the writing on the wall: we aren’t going to live forever.

So what are we to make of this? Is death the moment of our passing into eternal life when we will be reunited with our loved ones who have died before and the moment we will be with God forever? Do you believe this? I don’t, and neither did the friend of mine whose funeral was this weekend. Yet that is what one of the eulogists said about him—that my friend knew that when he died my friend was certain he would go straight to heaven, be reunited with his loved ones, and sit next to Jesus.  Even though he was a loyal and regular churchgoer, I know he didn’t believe this because the two of us had a conversation about it the week before he died. He was in hospice, very weak, and knew the end was near.

“You know, Joe,” he said, “I am a deeply spiritual person and believe in God. I believe that there is a purpose to life and a purpose to the universe. I feel truly blessed and grateful for my life. But do I believe my cremated ashes will be magically reassembled and suddenly I will find myself at a banquet table seated next to Jesus Christ? Please! Death remains a mystery. And what happens next? Who knows? I know some Christians who say, probably nothing. When we die, it is over. And I say that is ok to believe that. What happens next is not what is really important. What is really important is how we live our life on Earth. That is what counts.”

The funeral service for him was  packed. By his standard he scored high.  He lived a rich and full life and was loved by many.

The other funeral Embry and I attended was also in an Episcopal Church. This friend was a former neighbor, a distinguished member of the  foreign service, a former ambassador, and a pillar of his church. His memorial service was also standing room only and recognition of a long and productive life, lived to the fullest. The liturgy was mostly from the Gospel of John with its assurance of  eternal life—but only for those who have committed themselves to Christ and are true believers. My neighbor lived and worked all over the world and knew people of many faiths. He was progressive politically and theologically. I could not help wondering what he would have thought of these passages.

As some of you may know, I studied to become an Episcopal priest and have a  Masters of Divinity degree. I was not ordained into the priesthood but have been an active churchman almost all of my adult life, serving in virtually every lay capacity that you can. Embry has done the same and currently sings in the choir and serves on the vestry at our neighborhood Episcopal Church. We have paid our dues. But does this mean that we have all the answers or that we have certainty that we are going to live in eternity after we die? And how important is having the assurance of eternal life in making sense out of our own, all-too-short, lives on this small, blue planet in a vast universe of billions and billions of galaxies, each with its billions and billions of stars, many with their own planets?

The short answer, in my view, is not very. My friend was right. While no one knows for certain what happens after we die, what we all know is that we do die and have a very short period of time to make the most out of the life we have been given.

I have struggled with the mystery of death and what happens next for a long time. During my years in seminary I spent one summer in Boston as a chaplain at Boston City Hospital where I also participated in a program called “clinical training.” Part  of this involved daily, group therapy sessions led by a trained counselor designed to help seminarians better understand themselves and do better relating to and providing pastoral care to their flock. Toward the end of the program we all had to write an essay about death. I struggled with this and then poured out my heart on paper, trying to make some sense of what death means. When I got the paper back, I received a D with the inscription by one of the program leaders that I would have gotten an F but for the fact that it would have meant that I would have failed the entire clinical training program and also that my essay was well written and thoughtful. My mistake: no mention of the guarantee of an eternal afterlife for Christians and no mention of being united with Jesus Christ forever.

When I asked him about it later, he replied earnestly, “Joe, this is the most fundamental part of the Christian faith. If you are not a believer in going to heaven where you will be with God and Jesus, many in the church believe you are going to hell. How could you leave something like this out?”

Short answer: because I do not believe it. I did not believe it then, and I do not believe it now. So after all some 55 years have passed, I am no closer today than I was then to “knowing the truth.”

 The main role of religion in the human drama, I believe, is giving us some guideposts and affirming universal values, which are remarkably similar across most major religions: values like love, fairness, generosity, justice, honesty, kindness, integrity, selflessness, helping others, humility, and reverence for the Divine.

Now you know why I was deemed unfit for the Episcopal priesthood.

So in my mid 70s when this weekend I attended funerals of two good friends, one about five years younger and the other five years older, I couldn’t help acknowledging that the end of the road is getting closer for my generation and for me. That is just the way it is for us humans, in fact, for all living things. And the odd thing is that the idea of approaching the end of the road scared me a lot more as a young man than it does now. But I suppose this is natural. As a young person you have a whole life in front of you. The fear is that you will not get your chance. As an old man, you have had your chance. You have given life your best shot.

I was a runner for most of my adult life until my knees gave out, and think that running a marathon is a good metaphor for our journey through life. Running a marathon—or any long race—is really, really hard. You struggle to keep going and finally when you stumble across the finish line, you collapse in fatigue and joy. Hey, you did it! You finished the race! No, you didn’t win, but you were never supposed to. You ran at your own pace. And you finished.

And I think that is the way life is. And for that I thank God, who goes by different names in many languages and in many religions. I acknowledge the Divine mystery that we humans can’t explain but which gives meaning to the race we run and in the end, gives us reason to believe that on some deeper level, it all makes sense.

 

 

 

 

 

 

 

 

 

 

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Continue reading “In Search of a New Eye: Epilogue” →

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Sometimes a life means more in the context of history when it ends.  Need I mention one such example that occurred over 2,000 years ago? In no way do I mean to suggest that John McCain was  like Jesus of Nazareth, but there was something about that historic funeral yesterday that seemed to me something more than words can express and possibly a turning point in the nightmare we call Trump. The moment came during his daughter’s emotional speech when she talked about America  “always being great” and was interrupted by a thunderous applause that seemed to last for minutes.  This kind of response to a sermon or eulogy never happens in the Washington National Cathedral.

We were watching on national television a direct, though subtle, verbal assault on a sitting president in a packed cathedral of both Republican and Democrats, the leaders of our nation. What was this all about? What were these flawed leaders trying to tell us by applauding spontaneously—these people from both parties who have on the whole failed our country by not standing up to a wannabe tyrant and dictator and not addressing our nation’s fundamental problems, by pulling us apart rather than bringing us together? Were they trying to tell us that they get it?

Lieberman, George W. and Obama all came next and added their two cents worth reminding the mourners of the traditional American values that John McCain stood for—inclusiveness, country over party, equal opportunity, civil discourse, and fairness. All the speakers pointed out that in the past, most of the time, the big fights in Congress were not over basic American values but rather the best way to achieve them.  Sure, there were big exceptions like slavery and the Civil War, and  the civil rights movement, but still we Americans are for the most part grounded in universal values that most of us accept and aspire to. But certainly not all of us and seemingly  not today.

Trump was asked not to attend the  funeral. He used the free time to tweet nasty comments about Canada, Mueller, Hillary, and Sessions before heading out to his usual Saturday golf game. But Jared and Ivanka were there and so were a handful from his Cabinet. Will they get the message? Were they applauding? Will that moment in Meghan’s eulogy  last in the minds of leaders on both sides of the aisle? Will this mean  that they realize it is now time for things to change?  Did the message from a weeping, 33 year-old, bereaved daughter get through to them? Did they see this, as I did, as a watershed moment?

Shortly after the service when driving out to Mt. Rainier, Maryland, to out daughter’s house, a perfect rainbow  appeared in the distance right in front of our car. All the colors were there, and the arc seemed to reach from one side of the earth all the way to the other. The most amazing thing  about this rainbow was that that it suddenly  appeared with blue sky all around it. What was that all about?

Could this mark the beginning of the end, or perhaps better said, the beginning of a new beginning?

I know. Don’t hold my breath. I won’t, but I can still hope.

 

 

 

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I am not sure exactly what got to me this morning. I have heard Trump  talk about the fake press before and how reporters are “the enemy of the people.” I have heard him send up trial balloons about censoring  “fake news” and how only the word of the President can be trusted. He has talked before about violence from the Left and how the Democrats will try to destroy the Christian faith if they get control of the House, and about how if this happens, it will be the end of the Republic. He does  not miss an opportunity to denounce Mueller and Sessions or to deny any collusion with Russia even while denying that Russia had anything to do with our elections. He continues to blame immigrants and look for scapegoats. His supporters still scream at the top of their lungs, “Lock her up!” None of this is new.

I think what bothered me today was his anger, which has always been present but with his enthusiastic base at the Indiana rally last night seemed to go up  a decibel or two.  He seems to be bordering on panic. Something in the air makes it feel like the end of this chapter is nearing. The Mueller investigation is getting close to winding down. Trump’s cronies who have been convicted or copped pleas are now all talking. Something big seems to be just around the corner.

But what will that be? What will the next chapter in this sordid drama look like? The Trump presidency has captivated our nation like nothing I have seen before. I do not see how his behavior can continue for a whole lot longer without bringing down the country with him.

 Will we as a nation come through this, asserting our values of equal opportunity for all, fairness and justice, the rule of law, and a level playing field? Or will be go the way of many countries in the past that have retreated to authoritarianism? How strong is our democracy? Will new leaders who are more like John McCain than Trump emerge to stand up for country over party or we will descend to more tribal warfare and instability? These unanswered questions are chilling. This could be our moment of victory like when we as a nation confronted Joe McCarthy and Richard Nixon and stood firm that they had stepped over the line.  Like when we passed the civil rights bills, outlawed Jim Crow and legal segregation. Or this could be our moment of  doom and disgrace. It was never guaranteed that these decisive historical moments would be victories. They happened because brave leaders confronted difficult issues head on and stood up to power and fought for what was right.

That is where we are right now. Regardless how the Mueller investigation turns out, it is time for leaders in both parties to put our country first and their parties second. The values of freedom of the press, free speech, fairness, civil discourse, equal opportunity, equal protection. and the rule of law must overcome what I call the forces of darkness.

It is also time for each and everyone of us who believes in these fundamental American values to do our part—by voting, speaking out, organizing, and standing up to Trump and the horrific values he has brought with him into the White House.

 

 

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Here is Trump’s speech,  delivered, prime time, from the Oval Office on all television networks, at 9:00 PM EST  one day following the Supreme Court’s decision regarding indictments of presidents while in office and the granting of presidential pardons:

Good evening, my fellow Americans.

I am addressing the American people and the world this evening from the Oval Office about a new direction that the United States of America will be taking and about decisions that I have made that will affect the lives of each and every one of you watching.

First of all, I would l would like to thank Justice Kavanaugh for casting the deciding vote on two important Supreme Court cases. Now it has been decided once and for all that no president of the United States can be indicted for any crime while still in office. It has also been decided that I can pardon anyone I want to, any time I want to, and for any reason I want to, and I can pardon who I want in advance. Thank you, Justice Kavanaugh. I knew you were the right man for the job.

Now let’s get down to the basics. I am sick and tired of this Mueller investigation, which is a sham, witch hunt and based on fake news. The American people know that Russia was not meddling in our election; and if they were, there was no collusion.  So I have fired Mueller and his team, but I have done more than that. At exactly 2:00 PM today, I entered his office, armed with a gold-plated, AK 47 given to me as an appreciation gift by the NRA; and since I now am entitled to do this by law,  I blasted away. Unfortunately Mr. Mueller, the no good Democrat sympathizer and witch hunter, was out to lunch as was his entire staff. Some kind of retirement lunch or something. Lucky for him and those flunkies who work for the slimy, low life, scheming cheat and liar. His life was spared, but his office was not. I shot up everything I could and left a note telling him he and everyone else who worked for him  that they were now history and that all the evidence was now destroyed. This sordid chapter of American history is now behind us, and we can move on.

Accompanied by my worthy vice president, who carried a large ammunition case of silver bullets given to me by my good friend, Vladimir Putin, I immediately went over to the office of the no good Attorney General, Jeff Sessions, who I never should have appointed in the first place, the dumb, ignorant idiot, and fired away. He too was absent, and no one was there to take their medicine, but his office is now in shambles and decorated with bullet holes. I left a pink slip on his desk.  I have a long list of people I intend to visit in the days and weeks ahead.

Now some of you may think that this behavior is out of character for someone who is President of the United States. Well it used to be, but not anymore. The Supreme Court has made that crystal clear. We presidents can kill anyone we want, anytime we want, and there is not a thing anyone can do about it until we are no longer president–except you can impeach us, but that is not going to happen in my case. My base loves me more and more every day. There is not a single Republican left who does not worship me now that the low-lifes, Flake, Corker and McCain are out of the picture. The votes are not there and will not be there to kick me out. America loves a strong man. America has been longing for one for years. And America, now you have got one!

And there are many ways to drain the swamp. One of them is with bullets. This is the one that works best.

But there is only so much one person can do, even if that person has the Vice President of the United States by his side carrying ammo and cheering with every shot. That is why today I have authorized the creation of a special police force, which I am calling “The Swamp Drainers.”  Eventually they will replace the incompetent, biased, and irresponsible FBI. I am inviting all Americans to apply to be part of this new army, which I believe will change the course of American history. Actually, world history. If you get accepted, you will be issued your own AK 47 with my autograph on it, and you  will be given a Swamp Drainer uniform including a green or red beret and an arm band with the Swamp Drainer logo showing an alligator with a knife through his throat and a big letter “T.” I designed it myself.  There will be two classes of Swamp Drainers. One will be for full time professionals, who will earn good money, well above the minimum wage, though I do not think there should be any minimum wage, plus special health benefits, which are not Obamacare but something better. Obamacare is terrible and a disgrace, and if it weren’t for McCain, it would be dead. You people get the green berets. The second class will be for volunteers, but you get to keep the  autographed AK 47 and your uniforms for as long as you like. You will provide the backup for the professionals. You people get the red berets. I am not sure how many Swamp Drainers we will need, but there will be an incredible number. Unbelievable, really.

But here is the thing. You Swamp Drainers will report directly to me. I am your boss, and you will do what I say, and here is where the second Supreme Court decision comes in: once you are accepted and become a Swamp Drainer, I will grant you in advance, a pardon for any act you do which I direct you to do. So even if you commit what fake news organizations might call a crime, as long as you are doing it for me, no worries. Home free. That is what the Supreme Court just decided. I would like to thank Justice Kavanaugh for that.

Speaking of fake news organizations–like the Washington Post, New York Times, CNN and MSNBC– you will be taken care of by the Swamp Drainers. You should all close down and get out of town—get out of the country—now while you still have time.

Some people who are liberal, bleeding hearts, Hillary supporters and namby-pambys are going to start crying like Chicken Little, “The sky is falling.”  Others are going to try the impeachment route. Do not even  think about it. It will get you nowhere. Keep in mind the power of the president and now the pardons granted to the Swamp Drainers, who will be doing the heavy lifting to restore order and move along the Trump agenda. You do not stand a chance.  I am a fighter and I win. I win on my terms and I always will. Some like all the Evangelicals who love me and  think that I am the second coming of Jesus Christ will understand why I am taking these decisive actions and why I am the salvation for this country.. While I admit that I rarely attend church and have not read any of the bible, I trust my Evangelical supporters. They know. They know who I am and why I am doing this.

There are some who still believe that in six years I will be forced out because I can’t run again and then they can indict me. Think again. Do you believe that for one moment I would let something like that happen? Consider me president for life. No jail time for me or any of the Swamp Drainers. Congress will have no choice but to go along even if that means throwing out the Constitution. I have made America great again! I will go down in history as the greatest man to ever live.

Which brings me to my final point. America has changed. I have changed America. This is no longer the tired, worn out country it used to be like when Obama was president–and he was not even legal since he was not born in the U.S. It is time for a fresh, new look and a fresh, new name. I have asked our marketing department to come up with a catchy new name that really captures who we are now and they have come up with “TrumpNation.” I like it. I am submitting legislation this week to make the name change a reality; and if the Congress balks, they will have the Swamp Drainers to deal with.

So this is where we are headed. A new time and a new era and a change in world history.

You  people who are watching on TV or listening on the radio are lucky to be Americans—no, make that TrumpNationals.

Good night, and may God bless TrumpNation!

 

Does the editor of Faux News really think that something like this could ever happen in the U.S.? Not a chance. But then again that is what the intellectuals and progressives were saying in Germany in the 1920s when a guy named Adolph Hitler was beginning to flex his muscles.

 

 

 

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So while one could wonder why in our health care system today a treatment, device or procedure would be withheld because of lack of or insufficient insurance, that did not stop Akhtar and me from moving forward to the next step: getting an optometrist to place an order for a prescription written by a doctor from the world’s greatest eye clinic. How hard could that be?

Turns out the answer is, very.

I started with my own neighborhood optometrist.  He is friendly, engaged with his patients, and I knew that he would be helpful. After studying the prescription and making a couple of calls, he scratched his head and suggested that it would really be easier to get the lens from Wilmer. He doubted it was commercially available anywhere else.  Or I could also search the internet, though he did not know exactly how I might do that.

On to the next optometrist, then the next, then another. I admit I did not do this scientifically since I was randomly dropping by various stores that I happened across. The same result happened each time. Initially they were cordial and volunteered to help me out; but after trying to figure out the exact prescription, concluded that I really needed to see an eye expert. Two suggested the Wilmer Eye Clinic. After a couple of weeks of this, I was about to give up.

Then  Embry observed that I really was not going to the right places. I was haphazardly visiting optometrists who probably were small, mom and pop outfits. What I needed to do was visit one of the big boys, who were really tied into the health care system and had their own experts. She suggested a company called Voorthuis, which had numerous locations around Washington, and which she had heard good things about. If they could not get the lens, she admitted we were probably doomed, but it was surely worth a try. I immediately looked up the closest  Voorthuis location and headed out the next morning on the Metro to arrive at the opening time of ten o’clock.

The store was located in one of Washington’s fanciest retail malls and surely looked impressive. A middle age man with a kind expression had just opened the doors and I burst in, threw myself at his feet and begged for mercy, weeping as I told my sad story. Okay, this is a bit of an exaggeration, but I did go into some detail and concluded my remarks with something like, you are my last hope.

He gave me the once over with a slightly amused look on his face and said three things:

“Look, you can relax. There is no prescription that we can’t fill. We will get you the lens that your refugee from Afghanistan needs.”

When he said this, my jaw dropped in disbelief, and it was all I could do to keep from hugging him.

“Second. My former associate happens to be from Afghanistan. We help refugees and immigrants all the time. And third, these specialty lenses can be pretty pricy. For your refugee we will sell it to you at factory cost with no markup.”

I stood there for a brief moment, muttering under my breath, “Thank you, Jesus!”

Gaining my composure, I smiled and replied, “Well, it looks like I am in the right place.”

The rest was easy and routine. The lens arrived in two weeks. The price to me  was $70, a substantial discount from what it normally would have been. The kind manager grumbled that the actual cost of producing one contact lens was something like $1.60. I thanked him profusely and once back on the sidewalk outside the mall raised my arms the way a referee does when a touchdown is scored.  Today Embry is hand delivering the lens to the Akhtar family on her routine visit to take the kids to the library and the local pool.

Happy ending.

But the refugee saga will continue. As a matter of default, we and our daughter’s family are really the only support system they have, and life is hard and full of daily surprises. It has now been just over a year, and hardly a week goes by without some kind of crisis, most but not all, minor. To say that the Akhtar family is grateful for our role in their lives is an understatement. After every doctor’s visit, Akhtar would repeat over and over, “Thank you, Baba Joe. Thank you, Baba Joe.” We rarely escape from his wife feeding us a delicious mid day feast when we visit. Life goes on. But, as our granddaughter pointed out when we first met them, “they are a handful!” More refugee stories will probably follow….

 

 

 

 

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Note to readers: This is installment three. You should start with the first if you have not already read it.

So the question of day was, is it actually possible for a special contact lens to restore eye sight. We would soon find out as Akhtar and I made our way to one of the satellite offices of Johns Hopkins  Medical System, located in the Washington suburbs.  I was surprised at how big the Wilmer Eye Clinic was there, not as big as the one in the huge Baltimore Johns Hopkins Hospital, but still very impressive. There were several receptionists, a large waiting area buzzing with activity, 25 or 30 people patiently waiting, and a wide screen TV showing something about buying fine homes at low prices.

After checking in and waiting for about 20 minutes, we were escorted to another waiting room, jammed with about 20 people. After only a few minutes Akhtar’s name was called out, and we were met by a somewhat frazzled lady wearing a long white coat, and  who appeared to me to be approaching sixty, maybe older. The exam room looked about the same as the  one in Baltimore, and the testing got underway as soon as the Farsi translator got on the line.

It did not get off to a good start.

Akhtar waived his arms in his typical fashion and spoke with intensity, which was translated by the Farsi-speaker on the phone as, “He says he is not interested in a contact lens and wants a new eye.”

I had to give the guy credit. He simply would not, as they say, take no for an answer.  But isn’t this the kind of attitude that so many immigrants have had as they faced overwhelming odds against them? If they had given up, they never would have made it.

The doctor was not pleased. She abruptly stopped, stared for at moment at Akhtar, then at me, and exploded, speaking directly to the translator on the phone, “Does he know who I am? I am a contact lens specialist. This is the Wilmer Eye Clinic of Johns Hopkins Hospital. If he does not want  a contact lens, tell him to get out of my exam room and get out now. We can’t help him at Hopkins. He needs to find someone else, just tell him to get out. I am very busy. I am an expert in this field, some say the best, and I do not have time for people like him.”

The translator translated to Akhtar, who frowned and remained silent.

 It occurred to me that the doctor must not be having a good day.

As she started to leave the room, I blurted out, “No, please. Do not leave. We have a referral from the Hopkins eye doctors in Baltimore. He needs a contact lens. He is desperate.”

“And who are you?” she snarled.

I paused, then stuttered, “Uh, I am his sponsor. He is a refugee from Afghanistan. He does not understand the U.S. medical system. He was told that he could get a new eye in the U.S. but now we know that is not possible. He really did not mean he didn’t want a contact lens. He did not want to insult anyone.”

She was not impressed, muttering something about how she had heard with her own ears what the translator had said and never had heard of “sponsors.” I clarified that actually my church sponsored refugee families, and I was representing my church. This, of course, was not true. My church was sponsoring a refugee family, but not this one, and I had no formal role other than being a friend. For some reason the refugee agency that assigns sponsors to people like Akhtar never assigned one to him and his family. Fortunately, however, my feeble explanation seemed to calm her. She pulled herself together, sighed and continued the testing.

The procedures lasted about 30 minutes. After the initial encounter with the contact lens doctor, Akhtar seemed to finally realize that he was on thin ice and kept quiet for the rest of the  time except to answer which number he saw on the screen. I think it was finally getting through to him that a new eye was not in the cards.

The doctor spoke again to the Farsi-translator on the phone, “Tell him that I will give him a prescription for a contact lens. It may or may not work, but he should try it and come back and we will test him.”

The translator then replied that Mr. Akhtar said that he would like to thank the doctor.

We made two more visits to the eye clinic. The second visit was more catastrophic than the first. When asked how the contact lens was doing,  Akhtar complained that for a long time he was seeing double and he was not happy. I knew that myself, but I also knew that he was slowly getting adjusted and that he could actually see something in that eye. The doctor did not wait for him to finish and practically shouted at him, “Well, if you don’t like the lens I prescribed, then I want it back. You are on your own. If you think you can do better somewhere else, then go, and good luck!” She slammed the door behind her, storming out of the room, leaving Akhtar and me alone with our Farsi-speaking translator, a middle-aged woman wearing Muslim clothes. The translator turned to me and replied that in 20 years of translating in doctor’s offices she had never seen anything like this.

We three sat there for about ten minutes, not knowing what to do when the door suddenly opened, and the doctor reappeared having regained her composure.  She then started the testing, and concluded that the lens was actually doing what it was supposed to do. She went on to explain that he would need a new, more advanced lens once he got accustomed fully to the first lens.  We returned home uplifted and hopeful. Bravo, I thought. A true miracle.

The third visit went more smoothly. The doctor was in better spirits and concluded not only that the contact lens was working but that with the next prescription he could achieve a vision of 20-40, but this would be the best that could be achieved.

But there was a catch. The catch was that Akhtar’s insurance would not cover the next lens. No insurance, no lens. Not to be intimidated after having had a similar  experience at Meddstar, I cheerfully replied as I had done at the Medstar eye doctor’s office, “No problem. I will pay out of pocket.”

“Not possible. If he has insurance, we can’t accept cash.”

“It is not his cash. It is my cash.”

“Makes no difference. No exceptions.”

I asked her if she could provide a list of manufacturers or suppliers who could provide the  lens. She replied that the Wilmer Eye Clinic was way ahead of the rest of the health care providers and that there were probably no other providers that could provide the lens. She suggested I could try by calling around to optometrists but not to expect much.

 “If you  are able to find the lens, be sure to make an appointment so I can test Mr. Akhtar’s eyes,” she said.

“Does this mean he is doomed? That you can fix his eye, but won’t  and probably no one else can?”

She turned her back without answering and walked away. I did not even have time to give her my outrage speech. I saved that for the finance people when we checked out.

“Yes,” the patient person behind the counter replied after I finished ranting and raving. “We are sorry but that is just the way it is. Maybe you will get lucky and find someone who can fill the prescription.’’

Akhtar was following all this with a quizzical look on his face. I was not sure how much he understood. What was pretty clear, however, was that he was not going to get from the Wilmer Eye Clinic the lens that would restore his vision to 20-40.

Reset and start over: At least I had in hand a prescription for a lens that would do the trick. But how to get it? Was such a lens even available outside the Hopkins system? Find out in the last and final installment.

 

 

 

 

 

 

 

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Note to readers: this is the second post in a  series.

My initial experience in trying to get Akhtar, the blind-in-one-eye refugee from Afghanistan, an appointment with someone at the Wilmer Eye Clinic was not encouraging. I assumed that I needed a referral from an eye doctor in the health system where he was enrolled.  I struck out with the ophthalmologist he was referred to in that system because she would not accept Medicaid. I was not hopeful that any other eye doctor there would accept a Medicaid patient. I could try to find a list of eye doctors and start calling, but instead I decided I would give it a try and call the Wilmer Eye Clinic myself.

Brilliant idea. Much to my astonishment, after getting all the information about Akhtar’s condition and Medicaid insurance, the kind person on the line at the Wilmer Eye Clinic said that Akhtar could in fact see one of the Wilmer eye doctors.

 “But there is one thing you must know,” she said. “As you know, the Wilmer Eye Clinic has to be selective regarding the patients we see. We will see Mr. Akhtar and will diagnose his problem. But given his insurance, we will not be able to actually do any procedures or operations to fix it.”

I replied, “Well, that is terrific news that you will see Mr. Akhtar, and for this I am very grateful. But just to be clear, Wilmer will tell him what is wrong but won’t actually fix it, is that right?”

“That is correct.”

“So to take this a step further, you guys are the best in the world when it comes to eyes, right.”

“That is our reputation. Our doctors are very good.”

“So it is possible that you could identify a problem which you could fix but few if any other eye clinics could fix?”

“That is possible.”

“But you won’t fix it?”

“We can provide a referral.”

“But, say, there is no one else who can fix it.”

“All we can do is provide a referral. It has to do with Maryland Medicaid. We only accept it for the diagnosis procedures.”

Okay, I thought, let’s take what we can get. You have got to start somewhere, and just getting an appointment with one of the best eye doctors in the world was a lucky break.

 Six weeks later when the date of Akhtar’s appointment arrived, I drove him to Johns Hopkins Hospital in Baltimore with both excitement and apprehension.

There are several things you need to know about Akhtar. I have already mentioned that he is totally blind in one eye and a welder. He is also illiterate, not only in English but in any language. When he was growing up, the Taliban was in charge, and all schools were closed. Also while Akhtar is fluent in Dari, Farsi and Turkish, his English skills are very poor. It is almost impossible for me to understand a word he says. For this reason I was a bit nervous as to how things would go at the Wilmer Eye Clinic.

I had been to the Wilmer Eye Clinic about ten years before with Embry, who had an eye operation there. The John Hopkins Hospital was located in a  tough area of Baltimore, and the clinic was in a pretty rundown condition. They may have had the best doctors, but the surroundings felt like a third world country. This is not the case any more. The new hospital is more like a massive palace with sparkling, wide hallways, original art on the walls, lots of glass, healthy plants everywhere, and a main interior “highway” system that connects all the departments, all of which are named after people who I presume gave them lots of money.

After walking what seemed like at least half a mile, we came to the Wilmer Eye Clinic, which it turns out consists of several clinics and individual waiting rooms. We were directed by one of six or seven receptionists to what was called something like the “general clinic.” There were ten or twelve people seated in an attractive waiting room area, and after a  wait of only about fifteen minutes we were whisked away into a small exam room with all sorts of eye testing machinery. Professionals in white coats of varying sizes were running about in the hallways, focused and engaged, just what you would expect in the world’s greatest eye hospital.

What kind of doctor would we get?  Would he or she really be the best in the world? Could the Wilmer doctor give us any hope of restoring sight to someone who had no vision in one eye?

Well, we actually got two doctors, one in his forties, slim and athletic looking, the other man, white haired, and close to retirement age. The younger one called in the older one about 20 minutes into the testing, I presume for a second opinion. These two doctors ended up spending over one and a half hours with Akhtar, assisted by several technicians wearing red, Wilmer Eye Clinic golf shirts. I could not determine if having two doctors was standard protocol or because restoring sight from a blind eye was such a formidable task. Whatever the reason, I was impressed. They were polite, engaged and obviously skilled. We had come to the right place.

What made the examination particularly interesting was the communication challenge. I had alerted the person whom I had talked to on the phone that Mr. Akhtar did not speak much English; and when we checked in, I made the same comment to the receptionist, who assured me that this was no problem and that they routinely used translators. The challenge was addressed by dialing up a Farsi-speaking translator on the phone. Akhtar would make a comment or respond to a question, and the translator would repeat what he said in English using the same tone and emphasis. When speaking in Farsi, Akhtar was quite animated,  waving his arms and speaking loudly. Just after the second doctor entered the room, as the doctors were asking him to tell them what letters and numbers he could see on the screen while looking through one of the devices, Akhtar suddenly appeared  annoyed and seemed to make a definitive statement. Over the phone from the translator came this in a very loud voice suggesting exasperation: ”Look, I came to the U.S. to get a new eye. They told me in Afghanistan and in Turkey that when I got here, I could get a new eye. I want a new eye!”

The exam room suddenly became quiet as both doctors abruptly paused what they were doing and looked at each other in disbelief. The younger one answered calmly, “You are not going to get a new eye. Not here or anywhere else. There is no such thing as an eye transplant. Maybe in 10 or 15 years, but not now.”

Akhtar immediately waived his arms and said something in  loud voice, which was repeated by the translator, “But they told me I could get one in America.”

The doctors ignored the comment and plunged back into testing his eyesight with the various machines and devices.

There was also a peculiar situation where Akhtar was able to read the numbers on the screen but not the letters. When I pointed out that he could not read English, they switched entirely to numbers, which solved the problem. The good news was that as the exercises continued, it became apparent to me that Akhtar could actually begin see some things in his blind eye.

Toward the end of the examination, Akhtar made one more plea about the new eye and questioned whether the doctors really knew what they were doing. The two doctors paused again and looked at each other, frowning. The older of the two replied harshly to the translator, “Tell this guy again that there is no such thing as an eye transplant and if he brings this up again, we are not able to help him.” That was the end of that.

The two doctors conferred briefly and then left the room. In about fifteen minutes the younger one returned and presented the findings:

“Look, Mr. Akhtar, we can’t give you a new eye, but we believe your eyesight can be mostly restored in your blind eye. You have a scratched cornea and you have no lens. We believe that this can be addressed by using a  special contact lens, but it is not guaranteed. It certainly is worth a try, however, and we will give you a referral to one of the Wilmer contact lens doctors.”

Akhtar  responded with what I feared was something like, “I still do not see why you guys can’t give me a new eye” but was gently translated by the Farsi translator on the phone as “thank you very much for your time and effort.”

Three cheers for the Wilmer Eye Clinic. Reputation well deserved.

So on to the next step: off to the contact lens specialist. It would be about two months before we could get an appointment. But would it work? Could a special contact lens correct blindness? Stay tuned for the next installment.

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The first time I met Mr. Akhtar he covered his left eye and muttered in Afghani an incomprehensible phrase which my daughter guessed at as, “He is saying he is blind in one eye and was told that in the U.S. he could  get his sight restored.  Actually ever since his family moved in about a week ago, he has been obsessed with this. He has told us that in Afghanistan he heard that in the U.S. you can get a new eye.”

Mr. Akhtar is a refugee from Afghanistan, who with his wife and two girls, age three and six, moved to the Washington area about a year ago after spending five years in internment camps in Turkey. They had just moved into the basement apartment in our daughter’s house. The story of our search to get his sight restored tells much about health care in the U.S. today.

Akhtar (not his real name) was injured when a friend accidentally pierced his eye with a sharp instrument when he was age 10, about 25 years ago. He is also a welder. A one-eyed welder is just a notch above a one-armed paperhanger. The man clearly needed a new eye. I volunteered to get him one.

“Well,” Embry said, “He has come to the right place. The Wilmer Eye Clinic  at Johns Hopkins is the best in the world. If they can’t fix it, nobody can. But I am sure you will need a referral to get to Wilmer.”

So the first stop would be his primary care physician. Akhtar had Medicaid, which was his ticket to getting essentially free health care, so score one for the U.S. –free health care for the poor. The doctor examined the eye and  cheerfully wrote out a referral to an eye doctor in the Medstar system, one of the major health care networks in Washington. I told him that we really wanted a referral to the Wilmer Eye Clinic at Johns Hopkins. As an employee of Medstar, he apologized that he could only refer to one of their eye doctors. Okay, I thought, we will start there and then get a referral to Hopkins. I knew that restoring eye sight from total blindness was going to be a real challenge and that eventually Hopkins is where we would probably end up anyway. But you had to start somewhere. So on to the next step.

A week later when we arrived at the Medstar ophthalmologist’s office and checked in, here is how the conversation went with the person at the front desk:

“I am sorry we can not help you. We do not take Medicaid.”

“But we just got a referral from one of your doctors, and he takes Medicaid.”

“That is his problem. Not ours.”

“Is there any ophthalmologist in the Medstar system who will take Medicaid?”

“Not to my knowledge, but you can try.”

“How do I get a list of Medstar ophthalmologists?”

“No idea.”

Okay, I thought. We will just go private pay. I told her I would pay cash for the visit out of my own pocket. Cash on the barrel head. How could she refuse? I figured it could not be too much, just to get a referral  from the Medstar eye doctor to the Wilmer Eye Clinic. She said that would not be possible.

“Wait a minute! You mean to tell me that the eye doctor won’t  see Mr. Akhtar even if I pay for the visit in advance with all cash or a credit card?”

“That is exactly what I am telling you. He has insurance. We are not allowed to take cash if a patient has insurance.”

“Yes. But you won’t take his insurance.”

“Correct. We don’t take Medicaid.”

The conversation continued along these lines for another few minutes at the end of which I admitted defeat. I complained that all we wanted anyway was a referral to Hopkins, which from the scowl on her face, I realized was not the way to win friends at Medstar.

“Well,” she said sarcastically, “Good luck on getting to the Wilmer Eye Clinic without a referral.”

Out of curiosity, I could not help asking how much the initial eye visit would have cost me if I were allowed to pay for it out-of-pocket. She replied that for someone with insurance it would be about $250. For someone with no insurance who was paying privately, it would be about $700.

“Oh.”

That disclosure eased the pain.

But what to do next? How to get to the Wilmer Eye Clinic? How to get this half-blind welder from Afghanistan a new eye? Follow the story on the next blog post.

 

 

 

 

 

 

 

 

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Note to readers: Here is a fictional takeaway from our week learning about “Russia and the West” at Chautauqua along with reflections from our travels there in 1993 and 2015.

My name is Boris Smirnov, and I love Vladimir Putin.

Contrary to what most of you in the West believe, we get plenty of news here in Russia about what is going on in the U.S. and we know what you think about us. You can’t understand why we overwhelmingly support our president and write us off as a bunch of stupid lemmings. There is a lot you do not understand.

The main thing you do not understand is what we have been through and why we are distrustful of the U.S. Our history is long and rich and proud. From the middle of the Sixteenth Century when Russia was first unified under Ivan IV, whom  the West calls the “Terrible,” we became a formidable power and culture. We became the largest country in the world and remain so.  It is true that the vast majority of the Russian people have suffered over the years as have, I might add, many in your country, especially slaves and people of color. But we also have produced the world’s greatest literature, its finest novels, short stories and poems, its most exceptional music and dance. There is no country that surpasses us with regard to the  intellectual and artistic legacy that we have given to the world.

We are also a people of extraordinary courage  and willpower. We are survivors. It is no coincidence that we were the country that stopped Napoleon and that stopped Hitler. Can you imagine any city in the U.S. that could hold out under siege, as did the people of Leningrad, for almost three years, with over 1.5 million people, half the population, dying from bombing, starvation or freezing to death? Can you imagine the U.S. tolerating losses of 40 million people in two world wars without surrendering? We as a nation do not give up. We are proud people. As a country we have never been conquered.

Now I and many other intellectuals like me acknowledge that the Communist Period was a mixed bag. To our credit we did away with the class system, practically eliminated illiteracy and created from whole cloth a first-rate, educational system, second to none in science and engineering. Our military might was close to being equal to that of the U.S. Communism eliminated serfdom and raised the standard of living for most Russians. But this came at a great cost. Perhaps as many as 20 million people—most of them innocent civilians—died from starvation caused by ill conceived five year plans or were murdered by the state or exiled to gulag work camps in Siberia.  Free speech did not exist. We are not proud of this part of our history, but it illustrates another important part of the Russian character: we know how to adapt. We know how to keep on going with our lives when you have a system that is hostile to its citizens or you have a ruthless dictator running the country. Perhaps you Americans could learn a thing or two from us as you try to adjust to life under your own president.

Now fast forward to the fall of the Soviet Union in 1991. Many in Russia welcomed a change from a failed system. Note that this may be the most significant “revolution” in all of human history where an old system fell apart with so little bloodshed. Many were hopeful that Russia could become a true democracy, but make no mistake: we never wanted to become a clone of your system. We wanted our own Russian democracy, which would take into account the uniqueness of the Russian experience and the Russian soul.

What did we get? What we got was chaos. What we got were Americans  coming into our country, thumbing their noses at us and telling us what we should do when most of these so called experts had never been to Russia and could not speak our language. Beginning in 1991 and lasting for almost a decade, the country teetered on the edge of catastrophe. Food disappeared from stores. Even worse, vodka was in short supply. No one was sure what was going to happen  next. There was no such thing as the rule of law. Gangs emerged, and the riches of the country were  pillaged by “free enterprizers” and a new class of bandits  called “oligarchs.” In 1994 there were more Mercedes Benz limos in Moscow than in the  rest of the world combined. But the life of the ordinary citizen was worse than it was before, and the period of chaos called into question the endless sacrifices made over the centuries by those at the bottom. Plus we witnessed the disintegration of the Soviet Empire as the Baltic states, Georgia, The Ukraine, and others suddenly gained their “independence.” Can you imagine what the reaction would have been in America  if your government had collapsed under its own weight, and a bunch of Russians arrived scolding you for your stupidity and failed economic system and telling you that Communism was the only answer?

Enter Vladimir Putin in the year 2000. Here is the bottom line: Putin has stabilized Russia. But Putin has done much more. He has revitalized the Russian Orthodox Church, restored our national pride and regained  our proper seat on the world stage. You could say he has “made Russia great again.”

Are there issues? Of course there are, and there is much about Putin that many, especially intellectuals like me, do not like, but you can’t help coming back to the threat of disorder and chaos that is still fresh in so many minds. What realistic alternatives do we have? Furthermore, to say that Putin is another Stalin is a total misunderstanding of the current situation in Russia. While more limited, there is still at lest some freedom of speech and the press. We are technically a democracy and have a constitution. And by the way, Russia has never functioned successfully  without some kind of strongman leader, be it a czar or a communist dictator. Maybe given our vast size, it is the only kind of system that can hold the country together. Perhaps it is the other side, the dark side, of the Russian soul.

So that is why I say I Iove Putin. Do I really love him? No, but given where we are now, he is the best we have. I can tell you right now that there was hardly a Russian who did not get some satisfaction from the now infamous press conference with your own version of a strongman leader. He rolled him. Long live President Putin!

And one last comment: I believe I forgot to say to you Americans with your President Trump—welcome to the club!

 

 

 

 

 

 

 

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