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This is part of the full text of the medical memoir "Cancer Patient" written by Hugh Cook. The full text has been published online on a free-to-read-online basis. This autobiographical non-fiction account deals with the author's initial health problems, diagnosis, and treatment with chemotherapy and radiation therapy.

The complete text of "Cancer Patient" is here on this web site but is also available for purchase from amazon.com as a proper printed paperback book. The full text may also be purchased as a download (a PDF file) from lulu.com for US $5. Go to lulu.com/hughcook

For a chapter-by-chapter breakdown of what's in the book (in its online version, in the PDF version and in the paperback version), see:-

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CANCER PATIENT is a medical memoir which deals with the author's autobiographical experiences which involve, amongst other things, chemotherapy, radiation therapy, a brain biopsy, a lumbar puncture (and then some more lumbar punctures), treatment with Ara-C, treatment with vincristine, treatment with methotrexate, treatment with radiation from a linear accelerator, and a vitrectomy (an operation to remove the jelly from an eye). This is a non-fiction account but it does contain a couple of fictional stories, clearly identified as such, and it also includes some poetry.

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Chapter Two

Summary

Initial tests fail to find a cause for my eyesight problem. An ophthalmologist tells me I do not in fact have a problem. The author gets progressive lenses and adjusts to them well, despite initial problems. The author's eyesight recovers.

        I now had a problem: What next? Dr. Quack's opinion, apparently wrong, was that I had cataracts. Mr. Goodman's opinion was that I had absolutely nothing wrong with me apart from "eye strain". However, it seemed entirely possible to me that I might be suffering from some kind of eye disease.
        I decided that I needed a third opinion, so I hunted around for a properly trained ophthalmologist, and eventually managed to line up an appointment with another Japanese ophthalmologist, a Dr. Slipstream. However, I had to wait a few weeks to see Dr. Slipstream, so I decided to go see an ordinary doctor right away and have my health checked.
        I ended up seeing Dr. Steadybrick, a Western doctor practicing medicine in Tokyo. He did the logical thing and checked my blood pressure. The list of things which can cause blurred vision is extremely long, but, statistically, one of the leading culprits is high blood pressure.
        Dr. Steadybrick also arranged for me to have a test for diabetes, since diabetes is a tolerably common disease which is notorious for damaging eyesight. Dr. Steadybrick said that given that I was in my forties, and had never had such a test, it was reasonable for me to have it in any case. The test involved skipping breakfast, showing up at a lab early in the morning, drinking a solution of glucose and water, and then having a blood test to see how my body handled the glucose.
        The results?
        My blood pressure was fine and I did not have diabetes.
        On top of the tests for high blood pressure and diabetes, we also did an occult blood test. This involved me delivering three separate stool samples to the lab so the samples could be analyzed for any traces of blood. This test aims to find any cancer that is causing blood to leak into the gastrointestinal tract. In my case, the occult blood test was negative.
        The reason for doing the occult blood test was that I was under the impression that I had lost some weight, and weight loss suggests the possibility of cancer. However, I did not at that stage have an accurate set of scales at home, so I was not sure how much weight I had lost. Additionally, I had modified my eating habits, cutting out junk food and chocolate snacks, and, as Dr. Steadybrick very reasonably said, eating fewer calories can result in weight loss.
        On top of that, because I was working with Westerners who were living in Japan, I was hearing a lot of stories about people whose weight was varying. Some foreigners lose weight when they first arrive in Japan because they can't handle the local food, and some gain weight because they run to the comfort of fast food joints and eat too many hamburgers. My own weight certainly varied after I arrived in Japan, initially going down because I was eating a healthier diet and then climbing because I developed a fast food habit.
        Anyway, the simple tests -- the blood pressure test, the diabetes test and the occult blood test -- found nothing wrong. And certainly I felt okay. The days went by, and, as they passed, my eyesight gradually improved.
        Good!
        My parents came to Japan in May of 2003 and we went to Kyoto, a busy modern Japanese city which still has a certain number of quaint old streets which the bulldozers have not yet got round to flattening. So my memories of the early stages of my eyesight problems (there was much more to come) include Kyoto. Zen rocks and a golden temple floating in the rain. Japan misperceived as a consequence of biological decay, pure and simple, my vision blurred and out of focus.
        But improving.
        By the time I finally got to see Dr. Slipstream, my eyesight was almost back to normal. But not quite. As far as I was concerned, there was still something wrong. But Dr. Slipstream disagreed. Dr. Slipstream examined me and told me exactly what Mr. Goodman had told me: there was nothing wrong with me. I could read the eye charts okay and my eyes, examined with a slit microscope, which allows shattering amounts of light to be poured into the hidden recesses of the eyes, checked out as flawless.
        No problems, then.
        I was unconvinced by this diagnosis. Obviously there was something wrong. Otherwise why was my eyesight, subjectively, still not one hundred percent okay? Furthermore, why had I earlier ended up with a really severe eyesight problem? For the benefit of Dr. Slipstream, I reprised my initial symptoms: the shimmering blurring that distorted my visual field.
        "Maybe you had migraine," said Dr. Slipstream.
        This comment struck me then, and, on mature reflection, strikes me now, as one of the silliest statements ever made in the history of medicine. How could I possibly have had an attack of migraine which went on for weeks and weeks and weeks, painlessly limiting its effects to my eyesight?
        Looking back on this incident in retrospect -- that is, looking back at the initial sudden onset of my eyesight problem -- I still don't have a mechanical explanation for exactly what happened to my eyes, and I guess I never will. The best I can say to account for what happened is to say that "Cancer messed up my eyesight, somehow," though I don't really know, even now, whether the initial problem that I suffered in 2003 involved something inside the eye (the blood supply to the retina, for example) or something inside the brain.
        Certainly Dr. Slipstream didn't enlighten me because Dr. Slipstream found nothing wrong.
        The bottom line is that medicine is still an incomplete science and that the machineries available for interrogating the human body are still pretty primitive. The slit microscope sees less than the eye of god.
        At the time I saw Dr. Slipstream, then, I was in the unfortunate position of having a problem which my eye doctor really could not pinpoint. In fact, as far as Dr. Slipstream was concerned, I didn't have a problem at all.
        By that time, I was on my third opinion, and I had no idea where to go next. Given that my eyesight was almost back to normal, getting a fourth opinion didn't seem all that important. Furthermore, my confidence in the validity of medical opinions was starting to ebb a little.
        Dr. Slipstream did tell me that, although there was nothing wrong with my eyes, my prescription was out of date. I needed a new pair of spectacles. In fact, two new pairs of spectacles. A pair of spectacles to wear when doing desk work. And, additionally, a bifocals. Or, alternatively, progressive lenses.
        "Progressive lenses?" I asked, never having heard of them before. "What are progressive lenses?"
        It turns out that progressive lenses are similar to bifocals. However, whereas bifocals offer the patient two fields of vision, progressive lenses offer three fields of vision, one for things near at hand, one for the far distance and the third for things in between. Additionally, unlike bifocals, progressive lenses do not have a telltale dividing line. They are seamless.
        Dr. Slipstream counseled me against getting progressive lenses because they are not recommended for people with a high degree of myopia. Why? Because things on the periphery of the visual field become extremely distorted. However, if I was ever going to try progressive lenses, then the time to do so would be now. If I first tried bifocals then it would be even harder to make the transition to progressive lenses.
        I decided to give progressive lenses a shot, and had a pair made for me. (I also had a pair of spectacles made for desk work, though I ended up making very little use of these.)
        When I got my progressive lenses, I found that Dr. Slipstream was right: there was extreme distortion at the edges of the visual field. Things on the periphery of my vision were grotesquely warped. Worse, I had real problems processing information if I was looking at a scene in which there were things moving up close, in the middle distance and in the far distance. A typical instance would be in a subway train, when I would be looking down the train and would see people moving (to get on or to get off) up close, a long way away and at various points in between.
        The optician who from whom I had bought the progressive lenses had warned me never to drive with them. But I didn't need this advice. I could have figured that much out for myself. When I was wearing my progressive lenses, I found that just crossing the road was a dangerous and frightening experience. I had trouble interpreting the size and distance of the grotesquely distorted missiles that were coming in my direction from the corners of my vision, and a couple of times I almost panicked and froze up in the middle of the road.
        I decided, however, to persist with the progressive lenses, believing that in time I would be able to adapt to them.
        I remembered reading about an experiment in which people wore spectacles which flipped their view of the world upside down. After a sufficient number of days had passed, they adjusted to their revised view of reality and accepted it as normal. The world no longer seemed to be upside down. I assumed that, given sufficient time, my brain would rewire itself and the world as seen through progressive lenses would seem entirely normal.
        And so it proved, although it took a couple of months to entirely complete this process.
        By that time my vision had entirely recovered, and I was seeing the world sharply and clearly. Obviously, I did not have cataracts. And, as far as I could tell, I did not have any other kind of eyesight problem, either.
        So my problems were over?
        No, my problems were just beginning.


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The text on this page is part of the cancer memoir "Cancer Patient" which has been posted online. All the chapters of this book are on this website and can be read for free online. However, the text is copyright - all rights reserved. For permission to use this text or any portion of it contact Hugh Cook.

Disclaimer

        This personal memoir of the writer's encounter with cancer (non-Hodgkin's lymphoma of the large B-cell type) attempts to cleave to the truth. However, the text may contain information that is wrong, outdated, incomplete or otherwise misleading.
        This memoir has been written in a time of illness by a cancer patient who, though he feels sharp enough, must admit to sometimes misinterpreting things, forgetting things, or, on occasion, quite simply not hearing things.
        This memoir is designed to communicate the writer's personal experience and is not intended as a source of medical information. Got a medical question? Ask your doctor.

Cancer Patient Copyright © 2005 Hugh Cook.

Hugh Cook

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