Steampunk, the Industrial revolution and eye surgery

by liberal japonicus

This post starts with the juxtaposition of the Olympic Opening and my surgery for a detached retina, please skip it if you are squeamish about things going poke in your eye. However, no gross pictures below the fold.

A discussion of how the sequence was done is here. I still haven't been able to see it, which I will explain a bit later. This quote of Danny Boyle, related by one of the volunteer participants (though I have seen it in other places, so I'm not sure if this is the source, or if he's repeated this point), gets at the centrality of the Industrial Revolution for the opening

“You are creating hell. That is why we’re putting you through hell. The Industrial Revolution was the most important moment, not just in British history, but in human history. I’ll argue with anyone about that. It was monstrous, but it changed lives. People, including myself, can read and write thanks to it. The workers of the Industrial Revolution built the cities that are now the settings for every Games. Olympics don’t happen in the countryside.”

The reason I missed the opening was that the procedure I underwent, after taking a laser and repairing the tears in my retina, fills my eye with a gas bubble (Sulfur hexaflouride in case you were wondering) that then presses the said retina against the back of the eye. In the first operation, they just use air, ('just regular air?' I asked and they said 'yep'). Even though visions of the Three Stooges wallpapering were what was going on in my head, I followed (and am still following) the doctor's directions to always keep my head down and to sleep on my stomach, which keeps the bubble of gas in my eye, pushing the retina back, hence the inability to watch the TV. I guess the surgery is not super common cause they haven't put TVs in the floor here. My wife considered bringing me a mirror to watch, but since there is a huge problem here with perverts taking up the skirt photos, so folks might think, well, you get the picture.

Having my head down all the time along with a laptop and an internet connection has led to a lot of googling about eye surgery. While most eye surgery has actually been done for a very very long time (Two things from the cataract surgery wikipedia page (and here is where it gets a bit icky)

Cataract surgery was known in South Asia at a very early period, and was described by the Indian physician Sushruta (ca. 800 BCE), who described it in his work the Compendium of Sushruta or Sushruta Samhita. The Uttaratantra section of the Compendium, chapter 17, verses 55–69, describe an operation in which a curved needle was used to push the opaque phlegmatic matter (Skt. kapha) in the eye out of the way of vision. The phlegm was then blown out of the nose. The eye would later be soaked with warm clarified butter and then bandaged.

Or this:

The lens can also be removed by suction through a hollow instrument. Bronze oral suction instruments have been unearthed that seem to have been used for this method of cataract extraction during the 2nd century AD. Such a procedure was described by the 10th-century Persian physician Muhammad ibn Zakariya al-Razi, who attributed it to Antyllus, a 2nd-century Greek physician. The procedure "required a large incision in the eye, a hollow needle, and an assistant with an extraordinary lung capacity."

I shudder to think what Count-me-in's version of the job advert would be.

But surgery for a detached retina didn't really get going until the turn of the 20th century, with a doctor named Jules Gonin.

From 1902 to 1921 Jules Gonin almost single handedly changed the landscape of retinal detachment surgery forever. He recognised that the retinal break was the cause--and not the consequence as it was largely believed at the time--of the retinal detachment, and that the treatment had at all costs to comprise the closure of the break by cauterisation. He named the procedure ignipuncture, as he cauterised the retina through the sclera with a very hot pointed instrument. Despite rigorously detailed clinical observations and increasing success rates, his discovery was not readily accepted and sometimes openly opposed by a large part of the ophthalmic establishment. It was not until 1929 that he received worldwide acclaim at the International Ophthalmological Congress in Amsterdam for his surgical technique.

To tie these two thoughts into something barely resembling a post, with the Industrial Revolution and eye surgery, my thoughts turn to steampunk. Dr. Science is, I'm sure, much more in the know about this than I am, cause I'm not a steampunk fan, though I do like some stuff in that genre, primarily Alan Moore's graphic novels. However, and this is what I cannot figure out, is steampunk a homage to the Victorian Era or a tweak, suggesting that even though these ideas were within their reach, they didn't really grasp them? The inclusion of Kenneth Branaugh as Isambard Kingdom Brunel in the opening ceremony suggests if it is irony, we should be careful in dishing it out. F'rex, take his atmospheric railway. (Slight aside, on the Guardian live blog of the ceremony, they suggested that when Brunel came out, Americans were wondering why Abraham Lincoln was making an appearance at the opening ceremony. I hope I didn't startle my roommates with my laugh.) 

Anyway, I'm not sure how to take stemapunk, and I'm sure that some may question my relating a version of experimental surgery from 1902 to the Victorian era. But, as I often an wont to say, don't pick at the metaphor, you'll leave a scar. And even more so when it is a hot needle stuck into your eye as a cure. I've been trying to find some illustrations and explanations, but have only turned up this 1935 article about advances from ignipuncture. If anything, it explains that informed concept occurs historically later.

At any rate, things seem to be going well for me, the retina has adhered and the gas is slowly being replaced by fluid, though my reading suggests that the original fluid, called vitreous, is gone and the body replaces it with some off-brand knock-off found at the body's equivalent of Costco. The second operation necessitated them removing my old lens and inserting a replacement acrylic lens which is both thinner and actually provides some correction. I'm in the hospital for another 10 days, though in the US, efficiency is the key, and it's done on a overnight or an out patient basis. In order to cover that gap, Google ads helpfully pointed me to some vitrectomy support systems. The one linked to says that during the day, "the Face Support System becomes a temporary seating mechanism to help you relax while writing, reading, eating, socializing or watching TV while facing down from vitrectomy surgery." Looking at it, I'm going to get one through Amazon.com (if only to send a little love to Jeff Bezos) and see how using it goes over at my faculty meetings and I'm recommending y'all do as well.

Comments

[Doctor Science]

I was deeply disappointed that they had Brunel but not Steampunk Lovelace and Babbage -- they fight crime! (and hurdy-gurdy men.)

[CharlesWT]

"..., the retina has adhered and the gas is slowly being replaced by fluid, ..."

At some point, while looking straight down through the gas bubble, you should have a 2x - 3x magnifier that's great for reading tiny print.

[Brett Bellmore]

"though in the US, efficiency is the key, and it's done on a overnight or an out patient basis."

Not just efficiency: People who stay too long in American hospitals have a deplorable tendency to contract antibiotic resistant infections, and die of them. They're trying to get people back out before this happens.

[liberal japonicus]

I'm not sure who 'they' is, but your assertion is ahistorical, cf this

Since 1980 the U.S. policy focus has centered on keeping people out of the hospital and keeping hospital stays as short as possible. As a result, U.S. hospital use has declined more rapidly than the OECD median: Between 1980 and 1996 the number of inpatient acute days per capita per year declined by an average of 3.3 percent in the United States and 2.7 percent in the median OECD country.17 In 1998 the average length of a hospital stay in the United States was 6.1 days, compared with the OECD median of 7.3 days; the number of admissions per 100,000 U.S. population was 12,492, compared with the OECD median of 13,800.

If you have a cite that shows evidence that it was specifically because of antibiotic-resistant strains rather than overall policy of cost reduction, I would like to see it, however, even if that was the stated purpose, it merely helped give rise to community based rather than facility based strains.

[Brett Bellmore]

Admittedly, it's just anecdotal, a conversation with a doctor kicking mom out of the hospital amazingly early.

[Chris Johnson]

My colleagues in internal medicine tell me the pressure to discharge people early can be a problem, as Brett says. We haven't felt it so much in pediatrics, partly because we've always tried to get kids out as soon as possible. Of course children don't usually have the placement problems that elderly patients often have.

It is true hospitals can be dangerous places. Acquiring hospital-based infection is one of the dangers.

[Laura Koerbeer]

I wonder if the difference between your retinoplasty and mine is a matter of differences in training between the US and Japan, possibly related to different tollerances for lettig patients hanga round hosptials, or a difference in what went wrong with our retinas.

My eye doc told me my retina was rolling up like a window shade. They shot my eye full of gas but only after placing a plastic ring arounde my eye. (The ring is still there ).They would have sent me home the day of the surgery except I reacted badly to the anathesia.

So I did none of this layig around face down stuff I'd say your experience is worse than mine and you have all of my sympathy.

[Brett Bellmore]

Yes, mine, too. Cataract surgery was a walk in the park by comparison.

[CharlesWT]

On a Saturday about two years ago, I spotted a tear in the retina at the inside edge of vision in my left eye. Monday morning, I called a retina specialist clinic, told them what I though the problem was and made an appointment for that afternoon. The doctor took a look, agreed with my diagnosis and set up the operation for Friday morning. I was awake through the operation and walked out afterwards. At the post-op exam Saturday morning, the doctor said I should spend some time sleeping on my right side. From there, there was a number of follow-up exams and the two month wait—to the day—for the gas bubble to go away.

[liberal japonicus]

Charles, which eye was it?

Laura, that's a good point about the 'hopitalization cultures' and I'll probably post about it later. Would you mind if I lift up your comment as part of the post? thx

[liberal japonicus]

Sorry, Charles, just saw it was your left eye.

[Slartibartfast]

This all makes my panic over a few retinal tears about 8 months ago look rather trivial.

[Laura Koerbeer]

No I don't mind! Go ahead and use, it LJ.

I am stunned by Charles's comment that he ws awake during his operation.

There must be more than one way to repair a retina based on the nature of the problem. No way I was awak--they pulled my eyeball clear out of my head! They pulled it to the outside of my eyesocket in order to put the plastic ring around it. There isnn't a drug in the work that would have kept me calm thorugh that! They must have injected the gas inot Charles without pulling his eye out.

Panicking over retinal tears is not trivial. It is important to panic early and go straight to the doctor. I didn't go soon enough becaue I habitually talk myslef into thiking that thigs are o big deal. I didn't go until I saw blood drops the size of basketballs floating around in my vision.

[Countme-In]

Stop, for the love of God!

I'm waking up in the morning expecting Annie Sullivan to pull me out of bed and thrust my hand under the water flow from the pump.

Cripes!

I have a balky window shade in my place and every time I look at it now my eyes hurt and cloud over.

Last night I awakened screaming from a dream about Oedipus' mother chasing me up and down tilting hallways trying to poke my eyes out with her broach set.

The 450-lb chef in a bloody toque wielding poultry shears who was following her -- step-by-step-slowly-I-turned -- and screaming like Yoko doing the high-pitched stabbing sound effects from "Psycho" didn't appear to be on my side either, not that I stopped to ask.

Sometimes I dream that I've gone into the hospital to have both eyes operated on and I awake in the recovery room, look down (cause I can see ... "Eureka" .. that's the good news) and everything below the neck is missing.

The orderlies hustle to place my head on a gurney and drop kick me through the front door, while explaining that my procedure was of the out-patient variety to save Dick Armey (not a dick army, too!) money, and my poor head lands on a cobblestone street and I roll downhill, my screams dopplering through the city streets and I catch a glimpse of, what's that, San Francisco Bay, and I tell myself at least I can enjoy the view so the operation must have been successful, but shouldn't I be keeping very still, and just before I go plop and splash into the Bay, avedis steps out from the shrubbery and scoops my poor tumbling head up in a haberdashery box, puts it under his arm and sprints for the next cable-car alternately giggling manically like Peter Lorre and singing the Rice-A-Roni ditty over and over and over again .... and we end up in a gang shower full of really attractive lesbians on the USS Misogynist and they are soaping avedis' daughter's back with a gigantic Luffa, Loufa, whatever and she likes it, and well, a guy can be thankful for 20/20 vision, can't he?

So, lj, get well quickly for crying out loud and spare no expense.

The rest of you keep your heads very still and stop with the retinal tearing, please!

[CharlesWT]

The tear in my retina was small and I could only see it by covering my right eye and looking about as far to the left as I could. The operation seem to be by-the-numbers and the surgeon and assistants spent more time commenting on the content of the radio program playing in the background than they did on the operation itself. The surgeon may have done a number of similar operations the same day he did mine.

[Countme-In]

How the opening ceremonies could have announced by Bob and Ray, from Roger Ebert.

http://blogs.suntimes.com/ebert/2012/07/oh_how_i_wish_you_could_hear_t.html

The Industrial Revolution, the National Health Service, Shakespeare's The Tempest, and the Sex Pistols.

Don't skip the comments, leading off with some paranoid delusion from a so-called American steeped in the malign nonsensical dogsh*te the far Right in this country passes off as curriculum for the stupid on their way to batsh*t.

[Countme-In]

I didn't actually mean you had to stop talking about it.

I just needed to cringe.

Carry on.