A Not-so Brief History of Medically Everything

It's high time I spilled the beans on my medical history, to provide some relevant context and reinforce one of the important themes of this entire blog - take charge of your own destiny!

To begin more concretely, it all started when I was born. It was clear pretty quickly to my parents that I was not responding visually to their cues, and after a few weeks they took me to the doctor, who concluded I had congenital cataracts, a whiteness that covered the eyes and prevented me from seeing anything at all. I had a surgery when I was 8 weeks old to clear out the opacity by essentially poking holes in both eyes and trying to clearn it up. Nowadays they can peel the damn things off with a laser, but in 1971 their choices were very limited. The surgery was remarkably successful, though the cataract returned in the left eye. They had to do the same surgery again in that eye several weeks later.

This condition provided the obvious genesis for my visual challenges in two important ways. First, my eyes were completely covered during a time of critical neural development, providing NO visual information to the brain. It is believed that the visual area of the brain is likely undeveloped in comparison to a normal person. Second, the surgery itself caused damage to the eye, lowering my visual acuity and likely causing (or at least contributing to) the nystagmus I've had ever since. Since the surgery was done in the left eye twice, its visual acuity is even lower, rendering it far inferior to the right. My strabismus (lazy eye) was likely caused by the fact that the brain was trying to focus on the input of the good eye, and ignore the poorer signal of the other. The turning in of the eye is a means for the brain to try and ignore the bad eye's input.

Incidentally, for my whole life I did more or less try to pretend that my left eye didn't exist. It has always caused a distraction. I often close it out of habit. Interestingly, my impulse to do this has dropped to zero post surgery. For years I didn't wear a left contact lens, feeling like additional acuity in the eye caused exhaustion and terrible distraction.  I was even half-serious when mentioning to Eliza that if the only thing a surgeon could do for me is rip out my left eye and replace it with a glass one, I would do it. One thing I did know is that I was still seeing out of the left eye, and consistently so. This of course was endlessly frustrating to me before, but I believe it was a critical piece of what allowed me to be able to have the two eyes work together. Apparently other patients experience a total shut-down of the eye, or at least even more diminished than even mine, and that they can never get that eye to cooperate. Another way in which I was in the end insanely lucky. The eye was ready to do the right thing when it was pointed in the right direction. Miraculous.

Anyway, I was put on a solid treatment plan after the surgery. My mother was instructed to have me wear contact lenses as soon and as much as possible. Let that sink in. Contact lenses. On an INFANT. My mother tells stories of pinning me down and bracing my head to get the lens into my skull. I would start to cry and rub my eye and POP it would fall out, leaving my parents diving to the floor to find it. As a parent of a three year old I could not IMAGINE trying to get a pair of contact lenses into a kid that young. And I remember from starting lenses again in high school that it takes a bit to get used to them. And these were HARD lenses. Miniscule pieces of hard plastic take a bit to get used to.

Apart from frustrating bouts of contact lens wear, I just had a REALLY thick pair of glasses. My prescription is +13.50 right and +11.50 left. Strangely, my left eye is less blurry but worse in terms of overall vision (20/200 vs. my right eye's 20/80 optimally corrected). They've essentially been the same prescription my whole life, which is remarkable, from what I understand. I still have the same pair now that I've had for 20 years. I just keep going back in and having them adjusted. They  are uber coke bottle glasses, and always have been.

I recently got a snazzy new pair that has Carl Zeiss lenses. They are much lighter and a fraction of the weight. Interestingly, before surgery I really hated them. They are progressive lenses, and I struggled to adjust the slightly different way of focusing to read, and the image always seemed to have weird streakly Doppler effects and other blurriness that made it a struggle to use them. However, since surgery I swear by them. I switched to them immediately and was so thankful I had them. They distort the view much less than the ol' coke bottles, so that's certainly one reason. I think I can focus with them better now than I could before.

Anyway, I stuck mostly with the coke bottle glasses and occasionally an attempt at contact lenses. I remember having them when I was five and unable to adjust to the discomfort. I remember lying on the floor and my mother looming over me trying to get them in. Ugh. Sorry, mom and dad. I tried contacts again in junior high, and that didn't work, and then finally in high school, and took to them. Of course it was high school, so I was psyched too ditch the coke bottles, and I was older and a bit more mature so sucked it up and dealt with the discomfort. I've worn them ever since, though I always still used the coke bottles to read.

I couldn't live without my contact lenses now. I adore them. Especially the new pair I have - soft lenses, disposable after a month. Having previously used expensive hard plastic gas-permeable lenses that I kept a year or more, this is MIRACULOUS. Plus my vision is better, and the soft lenses irritate my nysatgmus much less. Thanks, Parelli Optical!

These lenses are good enough that I can use $25 readers from CVS to read, which is better than carrying the cokebottles around and popping out my lenses to read.

Frankly, I don't understand why ANYBODY would wear glasses when they could wear contact lenses. The experience with lenses is INFINITELY better than glasses, and seriously, the "sticking something in your eye" oogieness subsides within DAYS. And then you have super clear full-peripheral without a heavy plastic thing on your face. Do it if you can, you guys!

Anyway, as I grew up, doctors didn't push too hard to get contact lenses in, or to do much of any treatment really. Most every medical professional had pretty much the same attitude about me my whole life, up until my very recent change. I was apparently lucky to have the sight that I did have. The surgeon who did my original cataract surgery had done a beautiful job, but it was still a miracle that my vision is as stable as it is. As I got older and more interested in improving my sight, I always asked what new procedures were available, and doctors only said that there was nothing that could help me, most of the trouble was in my neural development, I was lucky to have any sight at all, and that it was questionable whether it would stay stable. I was told that I was susceptible to glaucoma.  The only treatment that was ever suggested was lens implants, which are essentially permanent contact lenses. My doctors always discouraged me from pursuing it, and admonished that the benefit was far outweighed by the risk. (I'm actually going to see a new specialist in this area next week.) I even went to Mass Eye & Ear in 1997 for a second opinion after years of getting annoyingly negative news from my regular doctor at Lexington Eye Associates. MEEI essentially told me the same thing, that I was fine at Lexington Eye, that there was nothing they could do for me. The next time I went to Lexington Eye my doctor got bent out of shape that I had been to MEEI. I got really discouraged at Lexington Eye a few years later when, in response to me complaining that using my left lens made seeing more distracting, they just said "yeah I can see how that would be". My doctor used to, when he passed a colleague in the hall with me,  say "hey, check this out!", wave us into an examining room, sit me on the chair and let the other doctor examine me. Not for an official task or a second opinion, but to check me out as an oddball case. I really didn't like their whole vibe - sour and pessimistic. But that's just me. Lots of other people go there and I'm sure are happy. They do give good treatment.

Note that nobody - not MEEI, and certainly not Lexington Eye - suggested strabismus surgery. I hadn't even heard of it until this past year, though they've been apparently doing them for 40 years. Either they hadn't heard of it, or they thought it was too risky for me somehow. I don't know, I can't imagine.

I don't hold any grudge for them not hipping me to this surgery sooner. I'd rather focus on the fact that I'm living the positive benefits now, and there's no point in looking back. Though I do mention it here to emphasize the main point of this long screed. BE YOUR OWN ADVOCATE. Do not rely solely on the opinions of experts to be informed. There is unprecedented access to good medical information on the far side of a Google search. Look stuff up. I sure wish I had.

Then it all changed in summer 2012 when, thanks to my wonderful employer, an author named Susan Barry came to talk about her book Fixing My Gaze. I didn't usually go to these authors talks, but the caption was captivating - the story of a woman who gained stereovision at age 50. I consumed her book, and immediately sought out a new eye doctor. Based on internal recommendations also at my employer, I went to the Massachusetts Eye Research and Surgery Institute. I found these folks to be endlessly optimistic, enthusiastic, and interested in my case. The intern assistant who did my initial exam there asked me more interesting questions and performed more interesting tests than I had had in the last 20 years of eye exams. They told me that strabismus surgery was a possibility for me, and there may even be other surgeries they could do to help.  I was immediately given a referral to Boston's Children's Hospital, and that brings us back to blog #1.

I grew up believing that I was lucky to see at all, and didn't question this overwhelming opinion for my whole life. I was so set in my belief that my eyesight would be the same for my entire life that frankly, I skipped a year or two of eye exams. Thanks in large part to where I work, whose stock in trade is connecting people with information, my eyes were literally opened to a completely different view. A circumstance that essentially came by accident, despite my efforts to understand how I could improve my sight. I will never be so casual about my medical care again, and I will be much more wary to rely exclusively on the voices of the expert in front of me, and check things out for myself. More information from more sources will always help in providing a full understanding of a situation. Take it from me. But not exclusively.

Days Since Last Accident

Back in college I used to do a gag where I'd walk with my head to the side talking to someone, then deliberately slam into a doorway. It apparently shocked a few of my friends and so eventually I stopped. I realize now how alarming that must have been, and see that gag as a way of acting out my frustration about something that regularly happened to me without my choice. I ran into doorways. I smashed against tables. I knocked over lamps. Things jumped out at me shockingly. I broke dishes. I was the embodiment of a bull in a china shop. I did feel like I was kind of battling against the world. Colliding and trying to gracefully recover, maintain my dignity, and move on.

After surgery, as I have reported here many times, my view of the world has changed. I feel now much more like I am in the middle of a big dome, with all my experience surrounding me. Doorways are no longer surprises, but in their position in the hallway, easily understood and navigated around.

But my "Days Since Last Accident" counter is regularly re-set to zero, even now. I still collide with things, but it is much better. Much much better. With more time and experience, I will be able to clock some days on that counter.

In recent years I had started dealing with my balance and coordination issues by going to yoga. I have attended classes at O2 Yoga  regularly for the past few years. I love the flexibility and core strength exercise, the full-body approach that leaves you feeling like you glow in the dark. I am getting pretty good at the flexibility poses, despite chronic tightness in the calves and hamstrings. I can do twists, and my body has elongated in a way where I've unlocked a lot more flexibility in my shoulders, back and core area.

One area of chronic weakness is leg balances. I cannot stand on one leg easily, and cannot sustain it. I am very wobbly and unsteady, and despite all the admonishments about stacking the bones and flexing the toes, I cannot sustain a good leg pose.

Some months before surgery, I complained about this to Mimi the owner of o2. She mentioned that my lazy eye could definitely contribute to balance issues, as the brain is getting conflicting information and the left and right sides are off-kilter. Additionally, it occurred to me that my nystagmus makes it very challenging for me to focus on one spot, an essential skill to gain the kind of gaze that supports balance poses. It's hard for me to feel still and grounded with my eyes jerking around. I was hoping surgery would help this, but thus far my nystagmus is not much better in either eye. I can maybe control it a bit more, but it's hard to fight off the eyes' impulse to move.

My goal with eye surgery was to remove the conflict between the two eyes, and give them the chance to work together. Removing the conflict and correcting the left-right alignment would improve my overall sense of balance. As of now, I would say that I can see where it's going but it's still a little early to tell. My brain is still adjusting, and I am very wobbly in some situations. Before surgery I could smoothly go from down dog to high lunge with confidence, but not so nowadays. Holding some poses just makes me stumble.

I do feel however that I have a stronger more stable base now. Someone shoved a folded paper under the table leg and now you can play Jenga on it.  And with that stability of vision I have a better fundamental awareness of the world now that I didn't before. This new awareness will help me get to a better sense of balance, I can see where it's going, but I have to walk the road to get there. Here's my answer to that -

Strap them boots on!

Depth Takes a Holiday

or "Straight Eye for the Pale Guy"

As previously hinted in this blog, I recently returned from a family trip to Mexico. Since we sipped internet through a straw for 10 days, this is my first chance to blog, and boy do I have a few things to lay on you today. The beaches of Tulum and Playa de Carmen are wonderful playgrounds for my new view of the world, and it has been a great time of experimentation for me in this area.

Here's one of the places we stayed. A friend of a friend who lives in Tulum says it this place is considered an insider place and the best on the beach strip. We tend to agree -

Rancho San Eric

We had direct access to an extremely private beach, on one of the world's great beachfronts, on the east side of the Yucatan Peninsula in Mexico, right across the Gulf from Florida. Dry, scrabbly country lay across the interior, while gorgeous palm-tree jungle-rimmed white beaches lined the shore. Turquoise water, sand like flour, a steady breeze and sunrises over the horizon in the east. A very mellow vibe, definitely off-season, very international crowd. I didn't get to a yoga class but I did run up and down the 3 mile stretch of beach a few times. We took daytrips to Chichen Ittza, Tulum Ruins and Punta Leguna Nature Reserve  We swam through a few different cenotes, and let me tell you those things are ASTOUNDING. Eliza promised some instant gratification batch of photos, so I will post them as soon as they're available.

So yes, there was an astounding array and quality of visual stimuli for me to play with. And play I did.

I previously described my depth perception like a magical bird that would grace me with an occasional visit then fly away, with no assurance of return. If my depth perception were still that rare magical bird from, then our relationship has changed reliably from a rare wondrous occurrence to a regular presence. This bird has become like my new cool laid-back roommate. He always knows what to watch on TV, he's usually pretty fun to hang out with, and occasionally lobs me a few curveballs to make life more interesting. I no longer question whether or not depth will return, but only how much and when. Depth doesn't jump out at me as much anymore, but has insiunated itself into my overall view. Especially around familiar places like the house and the car. My collected 3d map of these familiar spaces lends a great deal of sense of volume to these places. New places tend to be flatter. Only after accumulated experience in the space does a sense of its true depth emerge. My brain is still learning to work with this new influx of data, and appears to fudge some scenes. Not everything has a ton of depth individually, but objects are generally still positioned reliably in space. Busy scenes are flatter. Individual objects are more pronounced. Everything inside a car is well-defined, while the exterior can be very flat. This has improved since I got home, as I am now spending more time around cars. They individually are starting to have more of a boxy quality than before.

The interiors of airplanes are groovy. Curves bulged in on me like the ceiling of a Cheesecake Factory.  Dramatic lines and narrow fuselage wrapped itself around me. The repeated, boxy seats were always worth a visual chew.

The sight of moonlit palm trees bobbing and swaying in the night breeze is the planetarium laser show of my dreams. They are a repeated cadence of 4ths or 5ths, spiked by a chromatic woodwind run, then easing into a 5ths to 6ths pattern, always moving, never resolving, but always soothing, always swaying. Silver fingertips reaching for my cheek.

People continue to dazzle. Faces hold my stare, and hand gestures pop and catch the eye. People appear to reach toward me in an exaggerated manner.

As for curveballs, depth is still casting some spells on me. My interpretation of the world through this new lens is still flawed. Walking back from our car one night, I was lighting the way with my Android phone LED "laser". Lyra was in front of me, being line leader as she always wants to be. Her shadow took on the appearance of a separate being, standing direct walking in front of her. It really popped like an individual entity. I think my brain was trying to grok whether it should have depth.

The ocean looks higher than before, and like every next wave could wash over my head. Waves and foam are entrancing and dazzling. Being in the water, the waves in front of me draw much more focus with their hypnotizing undulations. I can perceive bubbles, volumes of roundness that swell out and then pop in the swelling and release of the sea.

Snorkeling was lovely. In the cenotes, there are spaces where the floor of the pool drops away, and it's another underwater cave deep below. Even underwater, I got a real deep sense of my relative smallness when compared to the space. The wake I made with my hands had a wonderful depth of space, like a 3d simulation of the Universe on your iPad. SolarWalk is my favorite.

Also in the cenotes, floating on my back and looking up at stalactites and little caves, with birds and bats flying from one hole in the rock to another. The awesome gravity of the rock pressed down on me from its bulging, imposing belly up above. But seriously, cenotes are the coolest things ever. Check them out.

There was one area that I really hoped would be helped by depth, that has instead proven to be more problematic than ever. Supermarkets. I live near the Porter Square Shaw's, and my preferred time to go there is 1am, as I have the place to myself. Busy supermarkets for me are kind of a sensory overload. The act of having to find a specific object in a strange supermarket is extremely stressful to me. The combination of navigating strange carts in strange aisles among strange people reading strange currency on shelves arrayed in strange ways melts my brain. The addition of depth has definitely provided more of a sense of arrangement of people and stuff in the store, but I struggle to wrap my head around the trajectories of people with their big carts in small busy aisles. Then having to look for what I wanted to buy? That was one too many things.


So depth is taking on much more of a supporting role, rather than being a front player. Defining spaces, informing me constantly of the relative position of my body to the environment. And it feels right, the way it should be. And I think it will get better. My brain will continue to accrue memories and experiences and have more information from which to build its internal referential models of the environment. I am better informed about what's around me, and am blessed with a truly awesome fresh source of beauty and wonder (and confusion) in my world.

After a week of a rustic paradise of mostly home-cooked meals and open windows, we spent a couple days in an all-inclusive place in Playa Del Carmen called Sandos Playacar.

I had never been to a place like this. Massive pool with peppy instructors giving pool-dancing lessons. Open bars and frozen blender drinks. Spa, gym, tennis courts, mini-golf, monkeys, not to mention a gorgeous beach. And not to forget all the beach vehicles and activities on offer. Eliza and I went para-sailing while Lyra was in the kid's club.

One of the indigenous species at an all-inclusive is the multi-station buffet. This place had several different buffets running at any one time, and one night they had a Mexican night with yet another ad-hoc buffet.

I have to be honest. I hate large buffets. The buffet we went to regularly was crazy loud, and set up in various different stations. There is so much visual and positional information going on at any one time in an environment like that for me that I feel paralyzed to both process and navigate that information. You might as well put me in for a fluff cycle in a clothes dryer.  A single-line buffet I can handle. I have a grounding element in the line of serving dishes, or tray rail.  Navigating a multi-station buffet for me is the very definition of stress. This has not improved with depth. In fact, people feel like they are jumping out more as they zoom back and forth. People do not move in predictable trajectories in multi-station buffets. They think they're going back to their table with their pile of fries, but notice the display of sweet and savory sushi. My strategy for dealing with this personal terror was to gravitate toward the hot cook stations. I ate crepes, steak bites, omelets and tacos. Also, if you go for the fresh-cooked stuff, you don't have to worry about how long it had been sitting around on a buffet line. I can hang out there waiting for my fresh-cooked thing and get the lay of the land for the rest of the buffet, and figure out specific points to which to gravitate. I really can't stand carrying plates of food through zig-zagging people and rows of tables. I like sitting at a table, having someone give me a menu, squint at it in the gleam of my Android phone's LED "flash", telling someone what it is I want and having them bring that thing to me. I also hate carrying a plate of food and trying to find someone in a cafeteria. It's brutal. Due to my vision I also loathe places where menus only exist above and behind someone's head on a high wall. And that is a LOT of places. So that's the view of one crappily-visioned person toward the food service industry.

Anyway, there were other great visual experiences at this place. They had a lovely Mexican party with lights and decorations dangling. Everything was bold, brightly-colored and open. Palapa roofs vaulted over my head. And oh so much people-watching.

I remain so in awe of the wonderful contribution of this new view to my quality of life. Even though my balance is still not back to where it was before surgery, I do have more confidence in my general navigation through the world. I feel somehow more a part of the world, less cut off from it. And I look people in the eye more, and strike up more conversations. I don't wonder if they're confused by my eye, or are judging me for being different, because I know I can lock in with them in confidence. It's an incredible feeling.

I'll be able to pop in my contact lenses in another few weeks or so. I'm going to wait to check in with my surgeon again in mid-May. The sutures and stitches are still dissolving, and there's still a bit of pink around the edges of my eyes. I don't want to push it, and I'm not feeling overly compelled to rush it. I am reliably living with depth now.

Before I close I want to honor something we were completely separated from this whole time away - the tragedy related to the Boston Marathon and the ensuing chain of reactions and events. My experience with this event was completely through facebook postings and what I could pull down via Google News. It felt terrible to be so far away from the pain at home. Both Eliza and I have crossed that finish line multiple times. While we are not directly related to the killed or injured, our deepest sympathies go to those families affected by the horrible event. I also give my greatest appreciation and gratitude to the law enforcement community, and to the community at large for coming together so spectacularly to bring the perpetrators to justice. I also give my respect and love for the spirit exhibited by the city of Boston, the city I call my home by choice, and one of the great cities of the world. A lot of people come and go through here, but I feel very much at home here.

And home we are, and coming down from a long journey home. We were definitely "that" family today on UA1047 EWR-BOS 24APR13, so our deepest apologies for the passengers from rows 24 to 28. I welcome any advice for dealing with an irate 3 year old during an extended landing sequence.

Back to life as normal ... though for a short time for me. I leave again next week for the New Orleans Jazz and Heritage Festival, where I expect many new sights to behold. And I already have a good base tan, for a pale guy.

Boston strong!

They should have sent a poet.

But they didn't, they sent me instead.

So in the full light of all the bad poetry I've used to describe the sensation of adding depth perception to your ocular arsenal, I will try once again to explain what exactly it IS as an experience. I will use all of the scientific acumen I have to provide a clinical, factual account of the experience of depth perception.

I can't. I have no science for this experience. All of my words to describe it revolve around the concept of "feelings", "gut instincts" or, "just KNOWING" something. Is there a Scoville scale for depth perception?

My experience of depth perception is not one of seeing something additional, but of having my brain impose additional information upon what I already saw. I can point at myself in the mirror, and know without additional information that the finger in the mirror was separated in three-dimensional space from the shoulder of the arm attached to that finger. Based on the combined information of the two eyes, the brain can - not always perfectly - replicate a 3-dimensional arrangement of the things in view.

The perception of three dimensional space is not consumed as additional visual information. It informs the visual information. It is inherent in the visual experience. The knowledge of depth is not represented with any additional content provided by the external world, but as interpreted by the brain. This knowledge is immediately implicit in every interaction with the world.

Prior to having depth perception, when I would point point at myself in the mirror, I knew my finger was in front of me because it was attached to me, and because I know what it looked like to have a finger pointed at me. To me this came with the knowledge that the finger was far in front of its possessor, since I knew from accumulated experience that the shortening of the arm meant it was pointed at me and not toward the side. The same way I knew that when I saw a similar pose in a photograph, or even comic book.

Now, with the awareness of 3-dimensional space, it is the same finger pointing at me in the mirror, and visually looks exactly the same as without depth perception, but my brain has deduced from the input of both eyes that the finger is ahead of the holder.

Alignment of the eyes is essential for depth. The two eyes need to work together to ignite the neurons responsible for processing that internal 3d map.

In other words, I got a performance upgrade, and can now use the 3d chip in my GPU.

As a quick personal update, depth has returned regularly, and has taken on a bit mellower a quality for me in many situations, which is a good thing actually. The world still feels newly arranged in 3-dminesional space, but in a mellower suggestion. The brain is still learning to process the various images of my surroundings to present an interpreted version of 3d reality. Or at least, that's how it seems. So I can vibe the volume of the room around me now, when before I was more focused on the lamp or overhead fan. It has more fully insinuated itself into my visual perception. It's more solid when it is on. I do get the sensation that I'm still generating the kind of information my brain needs to be able to replicate that mental 3d map of my surroundings.

I'll be off and on the next few weeks, but will try to have some good updates when I do post. More soon!

She said it would take a couple weeks, and she was right - TO THE DAY.

Before surgery, and even after, my surgeon said it would take "a couple weeks" for my brain to sort out the new input and start to regulate. I don't think she knew how accurate she was. But as of wednesday, exactly two weeks after surgery, depth has returned reliably every day. I would not say this new killer app has reached "always on" status, as it still goes away when I'm tired. But once I get my contact lens on in the morning, the world starts to go into beautiful relief. Of course we'll see what happens tomorrow, this is all still pretty miraculous and hard to believe.

In my maudlin moments last week, I had described my experience with depth similar to encountering a strange and wondrous wild bird that settles on your porch rail on morning. You put out some food for it, encourage it to stay, and bask in its presence, until it unexpectedly flits away into the horizon. You feel sad, your loneliness put into stark relief by the magical animal's absence, and can only hope that you'll be lucky enough to get a repeat visit. You think about that bird, it keeps you up at night as you relive the sight of its glimmering feathers, its otherworldly stateliness. The next day you fill up the bird feeder and wait ... and hope .... and wait ... and look! He comes back!!!

But of course, sometimes he doesn't, and that makes you wonder if he ever will again.

But since wednesday, that bird is rocking my porch rail. It's set up a nest, and gotten a little comfortable. He sits and reads the paper. We have breakfast together. He hangs out and snoozes in the sun. He still flies home at night, but he comes back the next day, and I'm like "oh hey what's up depth?"

So, yeah I'm starting to apply personality traits to a neurological sensation.  That's probably a sign of psychosis.

I've enjoyed a few runs with depth now, and it really really enhances the experience. As I've described before, I feel a lot more connected with my environment now, I feel more of a part of that whole, and with objects and people more clearly arranged in space, I feel so much more comfortable finding my place in that environment. The road or sidewalk seems to stretch out ahead much more invitingly, the flat surface of the road defining my path and drawing out my steps. Objects, cars and people pop with a dramatic clarity that makes them so much easier to take in quickly. I know I'll want an optometrist to validate this, but I really feel like my vision is more clear with depth. Edges are more well defined, everything has a hyper-real, hyper-focused quality.

I can tell with much greater detail the contours and inconsistencies in the road, which is a HUGE benefit, as it makes me much more sure-footed and aware of spots to avoid. I ran along Memorial Drive today, the Charles to my right, and really got a sense of the scale of the river stretching off to the distance. The buildings on the other side didn't take on any new quality, but they did seem more in focus than maybe they had before.

With trees and fences in such relief, it feels like I'm zooming down a trench. I thought of this more than once on my run today -

especially that classic shot right at 4:52.

As my friend Sully put it in his classic way, I was making a trench run on the Depth Star.

My favorite part of the run was when I turned left off Memorial at the Longfellow Bridge and cut into Kendall Square. The tall, dramatic buildings are at the perfect distance and scale to stimulate my depth perception in an awesome way. I felt like I could touch them.

Frankly, I want to touch everything. More than once my descriptions have sounded like the rantings of a drug-addled club kid but well, at times I do feel a bit stoned, and this new sensation invites all these goofy emotions and desires, like to put my arms around the big beautiful box truck that's careening around the corner. I won't really, but hopefully you see what I mean.

People, again, have such a great new visual excitement now. Their movements, hair, clothes, shapes, with their infinite variation. are all so interesting to look at. I feel like I'm wandering around with a super power, and think to myself "you have no idea how good you look to me".

Objects with depth seem to take on a whole new sense of scale. My previous experience with depth limited my reactions to items of very large scale. I could appreciate the awesome magnitude of the White Mountains, or St. Peter's Basilica, or a 747. Now that same sense of scale and magnitude is somehow applied to smaller objects. You've already read my description equating my bathrobe to a mountain range, and bread to the surface of the moon. The ham I referenced earlier had curves reminiscent of the Guggenheim museum. A bus going by in front of me feels like that opening scene in Star Wars (yes, going full nerd now) where the Star Destroyer slooooowly comes into frame overhead. Trees feel like cathedral columns. That sort of thing.

Navigating people while running used to fill me with dread. I'd enter Harvard or Kendall Squares and be like "oh boy, here we go", and just do my best to muddle through and not bang in to anyone. Now I feel like I've gotten an amazing power-up, I'm at level 100 of the real-life Frogger game and have the skills to go with the flow in such an easier way. I'm a water sign anyway, and feel like that affects my attitude on the world. It's now so much easier to snake among people. It's fun. It feels like a challenge, a dance routine. And my confidence is just so much higher.

So, I really do feel my brain has turned a corner and depth is much more reliable now. It doesn't introduce itself into every situation - nor should it, or else the day would get very exhausting very quickly, but when it does, it is almost always a wonderfully clarifying and organizational contribution to my experience of the world. And a rampantly beautiful one. I continue to be in awe and feel so lucky, and a bit pissed off that you all have been hoarding this beautiful depth from me for so long! :) It was probably better not to know until I was ready.

Posts are going to be a bit more sporadic over the next few weeks as I do some traveling. I'm sure that's a relief. :) That should hopefully give me lots to discuss when I do get a chance to post an update.

I'll leave you with the soundtrack to my run, a great energy boost to get me through the windy morning...

Have a great weekend. Go deep!

P

I had beautiful, glorious depth today. Probably the best yet.

I think it helped that I now have a contact lens in. Everything is gorgeously clear. Things feel even MORE clear with depth, somehow.

It started when I was talking to a workmate who had a cochlear implant installed in 2002. In the middle of his explanation of his fascinating borg-like technological enhancement, his head started to become remarkably round and his hair resembled a tidal wave. It continued as I was talking to another co-worker about my recent visual transformation, then after that, it was ON.

Big as life, really as big as day 1.

Signs loomed near, trees towered far. Branches reached out toward me like beckoning fingers. Buildings seemed taller, exaggerated by their geometric lines. Cars were at a stark relief from the road, and their shapes were more defined, like eggs in a crate as opposed a row of indistinguishable blobby bars.

People seemed to exist in their trajectories, defined as much by the space between them than by their interesting and peculiar bodies. With roundness, bodies take on a quirky feeling, somehow even more human, more blobby. Hair is a mist, a fog of depth tricks. People stand out from the ground with the obviousness of pieces on a chessboard, each one in its place with its specific path. With them arranged in space, I could see my own trajectory among them. I didn't feel compelled to scrutinize each one individually like I used to need to do, I could take in all the pieces on the chessboard and see where each are going.  I can plot a course through the objects as I go.  This makes it IMMEASURABLY easier to navigate crowded spaces. I feel like part of an environment, as opposed to a driver forcing their car through a rainstorm. That metaphor is more about the effort and attention involved more than the clarity or acuity. Yes, I had the constant distraction of double vision before, but the widescreen life just gives you so much more data in a nicely arranged way. The world feels more organized. The stark relief of objects on the relatively flat surfaces accentuates this.

Based on previous anecdotes I was wondering how a stairwell would feel, and I thought about this as I was descending into the subway (I was going to meet some friends in Davis Square). I hopped down it as normal, and dashed to catch the train. With a moment to look around me, I observed the sensation of the handlebars looming downward, other passengers looming near or arranged far.  I could vibe the openings in the crowd and easily saunter among them, now knowing how close I was to colliding with someone. I used to just barrel through a gap with casual abandon, hoping for no collision. Now I really knew where people were standing in space, could be relatively sure of my own position, and felt like Fred Astaire navigating among them. I enjoyed looking down one long narrow side of the train than the other, really getting off on how damn long the subway train looked. I also enjoyed observing peoples' rocking back and forth, and how the arrangement of different sized people resembled an arrangement of flowers, each with their deliberate position and height and quirk. I don't know, more like a wad of Q-tips in someone's hand. They all seemed so individual, each a single cigarette in a partially shaken-out pack.

I'm sorry. I've been really struggling to find the language to describe this experience. People have been asking for more detail, and I want to be able to provide it. All too often I resort to technology metaphors, relating my new vision to IMAX or widescreen, or like a beautifully rendered simulation. Real life is the sweetest Pixar movie yet. I'm trying to change it up and find a different way to describe the sensation, get at that unique feeling of the difference in specific situations. Now that I have a bit more experience with it, I can hopefully describe how depth affects the way one interacts with the world. It really is a subtle but powerful change. I longed my whole life to describe to other people how my vision differed from theirs, but every time I tried, I always ended up saying something like "well, you know! You're the one who has it! Why can you catch a ball and I can't? What's different?" Now, I think I have SEEN and EXPERIENCED the difference, and am still at a loss to put words to the difference. But it's there and it's palpable. It's not really even in the eyes, the experience or sensation of depth. It's in the mind. It's in the gut. It's an abstraction, anyway, the way the brain takes the individual images in from your two eyes and makes some assumptions and provides this additional sensory input to your brain.  It feels sensory. The position of something or a person close to me is more something I feel in my gut than my eyes. Though objects up close do feel a little hyper-focused, somehow. It's an instinct more than a visual sensation. I couldn't draw the difference, but I can FEEL it. I had been asked a few times whether I hadn't been noticing the depth because I was just getting used to it. I have thought about this many times, but today I can tell you, I had that difference back and it was unmistakeable.

The contact lens really helped, I think. The brain's ability to build upon its input was helped tremendously by this, and I am really excited to see if it boosts again with the addition of the left lens in a few weeks. Who knows what tomorrow will bring, at this point?

I called Eliza the minute I got off the train. "IT'S BACK, BABY!"

And it still is. It was all night. I could find my way around in a dark place so much easier. Instead of a ruddy Rembrandt knockoff, a dark interior space was just a dimmer version of the spatially-arranged world, and I found I made no accidental contact with no chair or patron, and could comfortably navigate the room to get to and from my table. Gene Kelly, people.

So I spent some time being giddy, and just looking around, and marveling again at what a gift I get to enjoy to observe this drastic and lovely change, to see all the normal mundane things in life imbued with a sense of wonder after so many years. On the way home, I looked down side streets and they seemed to stretch on and on. I can see cars coming from a long way and really tell how far away from me they are.

I wanted to stay for karaoke tonight, but was feeling beat and knew I had to come home and finish taxes. But if I had, this is song I was thinking of doing...

So yeah, I will continue to struggle with the language to describe it, but if I can be a voyeur to a few surgeons interested to know what it's like to come out the other end of their work a changed person, then I'll keep trying.

Rock that z-axis, everybody.

P

As previously repeated ad nauseam, I had my two-week post-op checkup yesterday, so had a chance to gush to my surgeon and find out how things were going from her perspective. I ran from home over to Mass Eye and Ear, and checked in at the Boston Children's Hospital annex there, which is where my appointment was (again, my kind of surgery is mostly done on kids). So as usual there were kids running around, and cartoons on the TV. I like going there, seeing the parents with their kids. It makes me think of what my parents must have been feeling bringing me to a place like that. If it were me, I imagine I'd be a maelstrom of hope, fear and anxiety masked in a veil of calm. Just the thought of bringing my child to the hospital fills me with such an emotional cocktail.

Now, I have really tried not to engage in hyperbole when describing my experiences with my changed vision, but sometimes it's difficult. It really is a very dramatic change. Having a toddler in the house and being well-versed in the Disney canon, I have had occasion to blurt out a particular song in my moments of existential reverie over my improved vision. I do this sometimes. Be glad you are not my officemate. He's a saint.

So what could possibly be better to have come on the TV in the waiting room than that very blasted song...

Synchronicity? Coincidence? Strategic counter-programming to lift the moods of worried parents? Doesn't matter, nowadays in my better moments I am jumping right on that magic carpet and swooping through that endless diamond sky.

Anyway, back down to earth, when I met with my surgeon, she said I was "healing beautifully", and she and her assistant did a bunch of different tests to inspect her work. At one point she held out this object with lights inside that spun around when she pressed a switch, and had me track it with my eyes as she moved it around. I wondered to myself what kind of opthamalogical wizardry was this? And being obnoxiously curious I asked, and yes, it was just a toy. To test my visual acuity I had to look at not a drab letter E but an adorable teddy bear driving a car. Being a father, none of this seemed odd to me at all. :)

At one point they put on red-blue glasses, and I noted that I very clearly saw one blue image (left eye) and one red image (right eye). No fusion there yet. The surgeon's assistant held up a wand with lights on it and asked me how many there were, and what color.  This indicated, as expected, that my left eye was doing all the heavy lifting. No surprise there.

My surgeon noted that the muscles were such that I was still having some trouble being able to look hard to my right, due to the tightness of the muscles on the outside of my eye resulting from their new position.  She said that this might mean my eye could eventually drift outward. She also said it could drift back inward again... or that it could stay the same. This is something I will have to watch over time. I asked if the fact that my eyes seemed to be working so well together would motivate the brain to keep it in its center position, and she said maybe. There's just a lot that's uncertain, and every case is different.

But she did say there was nothing I needed to do to work on depth or the fusion of my eyes, that it would just happen or not. She encouraged me to start wearing my right contact lens again (which I was incredibly happy to hear), but that I had to wait on my left side as the stitches were still healing. Apparently I need to wait another month before trying, and even at that point the contact lens may still irritate the eye so I have to be very careful. She said there was no concern about mental confusion with a contact lens only in one eye, that the left eye would behave itself for now. Hopefully when I go to see a vision therapist they will support this decision. I also asked here if there were any concerns with the fact that I stare at screens all day for my job, and whether the fixed focal length was a problem. She didn't seem to think so. Regardless, I will continue to take frequent breaks to look out the window and give my eyes some different input.

My surgeon was very kind to say how descriptive and observant I am about my eyesight. She said that doctors like herself tend to be "voyeurs" as they cannot know what the experience of their patients are, and must rely on our testimony. Perfect time to pimp the blog. Hello, doctor, if you're reading. :)

But in general things were very positive, and there was nothing to be concerned about. I was a model case, the alignment was still great and that was basically that. I will see here again in mid-May.

In the hope I would be cleared to wear contacts I dashed right to the bathroom and slapped one into my right eye and sang a silent halleluja chorus to myself. Finally, my best possible optics! I went outside and observed that world seems very cluttered indeed! Back with flat vision, the world is an assault of visual information with no true priority imposed on them except which I can sort out from a lifetime of visual cues. However, due to my eyes working together it is much easier for my brain to process all this data, so it's still infinitely better than before. I enjoyed running over the Longfellow bridge, seeing the whole sweep of my favorite view of my town across my entire periphery. Running is SO MUCH MORE FUN. I also note that I can now do something else  that I could NEVER do before - look to the side while I run. From Sue Barry's book this is related to being able to have a wide field of view, and looking with only one eye makes it very difficult to do this. This will be good news to my wife Eliza who loves to sightsee when we run, and will often say "ooh look at that house!" or something, only to be answered by a muted "uh huh" from me as I focus everything on the few feet in front of me. This is a very nice change indeed.

So, fusion continues. My double vision is barely there at all anymore, and only appears as a very subtle anomaly. I am starting to have a hard time telling what eye I'm using for what, even though my left eye is blurrier than the right. It's so great to have the view move smoothly into my periphery, it makes me feel like so much more a part of the world, a part of our shared immersive experience.

Depth is suggesting itself again, thanks in part to my contact lenses being in. I know it will be there for me when I am ready to work on it. I picked up a couple books on meditation last night and will start trying to practice that. I will spend the next few weeks letting my brain adjust some more, do the exercises I know, and then when I am back from various trips in May I will pounce on vision therapy and kick this whole experience into a new level. Cannot. Wait.