Stories From the Clinic
by Emily C. Lierman. Stories From the Clinic was first published in 1926.
He was only twelve years old, and blind. His name was Lewis and he was of Jewish birth. If Lewis had been born blind he would not have had so many plans about the future, nor would he have been so sad.
During the month of March, 1923, he was operated upon for mastoiditis. Dr. Bates found with the ophthalmoscope that the boy had atrophy of the optic nerve of both eyes. Prom the history of the case he believed that the cause of the trouble was probably associated with an abscess of the brain, from a disease of the left ear.
After an operation for the relief of the brain abscess, a cerebral hernia appeared above and behind the left auditory canal. The hernia was about two inches long by one inch wide, and projected outside the skull to a distance of one inch. The mother told us that for several months before the boy was seen by us the size of the cerebral hernia had not changed. Before the operation and the mastoid trouble, he was a perfectly normal, healthy boy, full of life and hope. I should not wonder if he were planning to be a bank president or a radio expert, from the discussion we had together, after we became acquainted.
The morning of the boy's first visit to us, a telephone message came from a teacher at the school for the blind, who wished Dr. Bates to see Lewis. The appointment was made and within an hour the boy arrived with his mother. Her eyes were staring at the doctor's face as he examined Lewis' eyes, straining every nerve of her body, fearing the verdict might be, "No more hope." After the examination, Dr. Bates came to my office and told me about the case and asked: "Wouldn't you like to see him? I think you could help him to see again!" It is the faith that Dr. Bates has in me that keeps me going. His encouragement has helped me to benefit cases that would otherwise have seemed hopeless to me.
When I entered the room where Lewis was, I saw a forlorn looking boy sitting all huddled up in his chair, staring out of his sightless eyes. His mother talked a blue streak to me.
"Oi, mine boy that he should be blind! Blees do you dink he can vunce more see? Vun year he vus blind, can see nuttink. Before dat he vus beeg and helty."
Of course the mother heart was crying out for help, and it was pitiable to hear her. I tried to explain that we would do everything possible for her boy, but I could not get a word in edgeways. I closed my eyes for a few moments and prayed for help.
I then spoke to Lewis as though he could see me and placed a test card in his hands, advising him to keep his eyes closed and relax in his chair as much as possible while he was doing this. I told him that it was necessary not to worry nor to think of his blindness. He could think of a sunset, he said, also a white cloud in a blue sky. With just a few minutes of this treatment, he opened his eyes and saw that the card was white.
I had him close his eyes again quickly and asked him to remember the whiteness of drifted snow. He said he could remember or imagine that he saw the snow, but he could imagine a white cloud much whiter. I said, all right, keep remembering the white cloud, but imagine it is moving. He said he could do that easily. After a half hour or more, Lewis opened his eyes and flashed a big black spot on the top of the card. I said: "If you will move a card slightly from side to side, you will be able to see what the black spot is on the top of the card." Another half hour passed by, both of us doing our best, when all of a sudden my patient said, "It is a letter C!"
Then the mother screamed: "Ach Gott, mine boy sees!" She threw her hands in the air, murmuring all the while that her poor boy could see. Then she became hysterical and disturbed all the patients in the treatment rooms. I placed my arm gently around her and led her into my office, and then we both cried. My heart was with this poor mother, but my thoughts were of the boy, too. We had left him all alone and I was worried. I told her to offer a little prayer of thanks to Him who had heard my plea. I said, "Your God is my God, too, so ask Him to help us." I left her to see what Lewis was doing and I found him faithfully palming his eyes.
Although weary and tired after I had worked with Lewis over two hours, I was repaid a thousandfold when he read every letter of the 70 line and SO line as he moved the test card slowly from side to side, close to his eyes, blinking all the time. He was instructed to stand and swing his body from side to side to lessen the tension of his body; also to blink his eyes all the time to stop staring; then to practice with the test card, many times a day, moving it slowly from side to side as he flashed the letters of each line on the card.
On his second visit he read the smallest letters on the card, the 10 line, but to do this he had to hold the card so close that it touched his nose. On his third visit he read the bottom line, holding the card an inch or more away from his nose. The sun treatment always helped him, and he was advised to stay in the sun as much as possible. The cerebral hernia, which on his first visit was very much inflamed or red in appearance, had lost most of its redness, and the size of the hernia was less.
On his last visit I placed him in front of a large mirror, and he saw it plainly. He could also see me standing behind him as he looked into the mirror. The sad look in his eyes was no longer there. Lewis informed me that a friend had given him a radio set, which he enjoyed when he was not practicing with the test card. His smile was a treat to see, and his mother was more than grateful because of the hope we had given her in restoring the sight of her boy.
During the hot summer days while we were still treating patients at the Harlem Hospital Clinic, a little girl named Estelle, about eight years of age, was brought in and placed in the children's ward. She had met with an accident which destroyed the sight of her left eye. Not being a clinic case, she was taken in charge by another doctor, who came to our room a few weeks later and asked Dr. Bates when he expected to take a vacation. Dr. Bates answered: "I take a vacation every day. Why do you ask?"
The other doctor answered: "But I am serious; when do you go away for a rest?"
Dr. Bates replied: "When I am treating my patients it rests me, so I don't have to go away. Is there anything I can do for you?"
"Yes," said he. "There is a little girl in the children's ward upstairs, and while I am away I should like to have you take care of her case. When I return I shall remove the injured eye, for it is in bad shape and the sight is completely destroyed."
Dr. Bates agreed to care for the little girl, and asked me to help him. We called on Estelle, and the nurse in charge of the ward led the way to the tiny cot in a far corner of the room. Rows upon rows of cots we passed and on each lay a young child. Some of them were the dearest little pickaninnies imaginable. A number were crying with pain, while others looked wistful.
My heart ached for them in their loneliness, away from their mothers, I glanced at the doctor's face and I could see that he, too, felt sorry for the little ones.
Finally the nurse stopped beside Estelle's cot, and the poor child looked very much frightened as the doctor and I came along. We could see only part of her face because the whole left side was covered with a bandage. Before Dr. Bates could say a word she began to cry and beg the new doctor please not to hurt her, as the other doctor did. The nurse began to remonstrate with her, but the doctor soon quieted her when he promised in his gentle way that he would not hurt her in any way. She stopped weeping instantly when the doctor asked her if she would like to see how really funny she looked in a mirror. Was there ever a girl or woman who did not want to see herself in a glass? Estelle answered: "But I haven't any mirror."
"Oh!" said the doctor, "Mrs. Lierman always carries one in her purse."
I produced it quickly, before the child lost interest. As she held the mirror and looked at her bandaged face, I noticed that the nurse was bored; doubtless regarding this as a waste of time. She had other duties, of course, but Dr. Bates believes in taking his time, and he surely did on this occasion. He directed the child to remove the adhesive plaster herself, and in this way the bandage was removed without discomfort or pain. After he had examined the eye, which was almost healed, he turned to the nurse and asked: "Why on earth is this child kept in bed?" The nurse answered: "Because of the injury to her eye."
"So I see," said the doctor, "but the rest of her body is not sick or injured. Why can't she get up and walk around here?"
The nurse replied: "But I am obeying the doctor's orders."
"All right," said Dr. Bates. "I have charge of her case now, and I think she ought to be out of bed."
Before the nurse could explain that the child would have to be dressed, he put out his arms toward Estelle and she reached toward him with a smile. He lifted her gently out of bed, and as she readily gave him her hand, both walked slowly down the length of the ward. But, coming back, she ran. Of course her steps were uncertain, for she had been in bed for two weeks, and was weak, but she had full confidence in the big doctor who held her hand so tightly. What a funny sight she was, in bare feet, a smile, and practically nothing else. The nurse looked on disdainfully, but I must confess that I giggled.
The other children in the ward became interested in the game of the doctor and Estelle. There was a grand exodus of most of the children from their beds, who were anxious to join in the fun. During this time Estelle was so happy that she screamed with delight, while the other children added their voices to the riot for fully ten minutes the nurses had a lively time getting their young patients settled again.
Back to the other end of the ward, ran poor little Estelle, with Dr. Bates trotting beside her. Returning, the doctor stopped by a cot where a baby lay swathed in bandages from head to foot. She had been horribly burned. Neither of her tiny hands was free to hold a doll or toy. Over in a corner of the room was a box containing all sorts of toys. At the doctor's suggestion Estelle produced a dolly from the box and held it up so that the poor baby could see it. Her moans changed to smiles and in an instant two little girls forgot their pain.
To go back to Estelle's trouble. She told us how she had been playing on the sidewalk near her home when she slipped and fell against the curbstone. A piece of broken glass lay in her path, and it penetrated through her upper closed eyelid and cut the eye so badly that the sight was destroyed completely. Dr. Bates treated the eye later so that it did not have to be removed. Even though she could see out of only one eye, no one observing her would have suspected that the sight was destroyed in the left eye. Both Estelle and her mother were very grateful to us, and at every visit Estelle would fill the doctor's pockets with fruit and candy, which she was eager to share with the big doctor who never hurt her.
On July 16, 1923, we treated a man whose blindness was caused by a sudden shock. As I stood before him and asked him what his trouble was, his eyes looked up toward the ceiling and immediately I knew that he could not see me. He had been sent to us in the hope that Dr. Bates would be able to restore his sight. Previous to his visit on that day, I had received a telephone message from a woman employed by the Compensation Bureau of the City of New York, telling me that he was blind and, in the opinion of eye specialists who had been consulted, incurable. Dr. Bates examined his eyes with the ophthalmoscope and found that he had atrophy of the optic nerve and that he was under a terrible tension.
With each eye separately he could see the 200 line letter of the test card at one foot temporarily. He could do this only in flashes, because he stared continuously, which blinded him. The variable swing improved his vision to 6/200 and his field as well. He came daily to the office for treatment, and on the 21st of July he read 9/20 after he had palmed his eyes for a long time. Sun gazing outdoors helped his vision also. His general depression became less and he informed me that he was feeling much better after each office visit. For a long time he did not have much to say, but after he had become better acquainted with us, he began to talk about his case. He had been working in the moving picture studios for some years, and apparently he had felt no discomfort in his eyes. In describing the accident, he said:
"I was standing on the top rung of a ladder readjusting electrical parts used in the studio for taking moving pictures. At the time there was just an ordinary light, such as is used in most offices. Without my knowing it, a strong Kleig light was suddenly turned on me and I received a sudden shock which caused blindness instantly. I was cared for, as are other employees in the studio, and then was taken home. Since then I have not been able to work. It seemed as though my troubles were multiplied when my little baby boy took sick and died. I had no money with which to bury him until my wife's parents came to our aid. Christmas came, with no hope of Christmas cheer for my other child, a little girl just three years old. We were in debt, but I had planned, when I was able to work again, to pay back the money which was used to bury my baby. My wife tried to console me and make me feel that things were not so bad, but I saw no hope ahead of me on account of my blindness."
We felt it the more imperative that our patient be given all the treatment possible in order to restore his sight, and we worked diligently all through the fall and winter, with good results.
During the month of May we had many rainy days with little sun. This patient demonstrated to us that the sun is necessary for the eyes, for during all the months of almost dally treatment he had not had such poor vision as he had while there was no sun. His vision was lowered to 10/50, and he became very much discouraged. After the sun had shone for a day, he came to the office feeling light-hearted and happy. He was given the sun treatment and immediately his vision improved to almost normal—he could read 10/10 at times. The doctor questioned his ability to dodge automobiles at the crossings. His answer was that he could get along very well on bright days when the sun was shining, but that he still feared the traffic on rainy days. While this conversation was going on, the patient was looking intently at the doctor's face as he stood about three feet away. He did not move an eyelash, but just stared all the while he talked; he had forgotten the very thing that helped him—blinking. AH of a sudden he exclaimed: "Doctor, now as I look at you, you haven't any head."
"No?" the doctor replied. "Seems to me, the other day somebody told me I did have a head. But you never can tell, some people don't always tell the truth."
Immediately the patient apologized and hastened to say: "Oh! but Doctor, when I come close enough to you, I can see that you have a head."
Dr. Bates has always advocated the movies. Whenever a patient stares, he advises him to go to the movies. We owe a great deal to the moving picture artists, for much of their work is done under unfavorable conditions. The Kleig light, while it is powerful, is not injurious to the eyes of the actors and actresses when their eyes are properly used. Most of them work under a terrible tension, with the feeling that their eyes will be injured by the strong glare. A great many eye specialists no doubt have treated injury to the eyes apparently caused by the Kleig light. The light would be harmless if those who work in the studios could keep their minds relaxed, and if they could also understand and use our method—resting the eyes all day long.
Dr. Bates discovered many years ago the benefit of strong light on the eyes, and I have seen many patients cured by the sun treatment alone. Some of these cases were seriously affected because of their inability to stand even the rays of the sun. It is curious but true, that this patient was benefited mostly by a magnifying glass which focused the light of the sun on the white part of each eye, as he looked down while the upper lid was raised. At the beginning of his treatment, the mere mention of light would cause him to frown and shrink with fear. Later he enjoyed sitting in the sun all day long. He was grateful for what had been done for his eyes, and insisted upon my writing to two of our most popular actresses of the screen, who were interested in his case.
In response to a doctor's request, I agreed to help two blind girls, Eleanor, aged sixteen, and Rosalie, seventeen. Dr. Bates examined their eyes with the ophthalmoscope and found that Eleanor had myopia in the right eye and atrophy of the optic nerve in the left eye, a condition which is seldom, if ever, cured. Both eyes were badly inflamed.
Rosalie had retinitis pigmentosa in both eyes, and could not count fingers in an ordinary light. In a strong light she could at times count fingers if held close to her eyes. Rosalie would cure anyone of the blues because she wore a constant smile. She had black curly hair and olive skin. I held a conversation with her for a few minutes in order to get acquainted, and also to watch her eyes. The first thing that I noticed was that she stared and kept both eyes open all the while. I did not see her blink once. She had a habit of talking rapidly, and I observed that she moved her eyes from side to side at about the same rate that she spoke. This is called nystagmus. I held the pot hooks card with the letter E of different sizes, pointing in various directions, close to her eyes, and she said I was holding something white before her.
I asked, "Do you see anything else on the card?"
"No," she answered.
Then I placed the palms of her hands over her closed eyelids and told her that this was palming and that it was necessary to remember agreeable things. She said that she could easily remember her music. I could well believe that, because she already had a good reputation as a pianist, having won' the district bronze medal, the highest reward she could obtain in her school. After she had palmed for ten minutes, I held the test card close to her eyes and asked her what she saw. She said that the white card was covered with black spots. Quickly I told her to palm again for a short time. After about five minutes she looked at the card again, and this time recognized the large E of the 200 line. We all rejoiced, because the rapid movement of her eyes from side to side had stopped temporarily.
Then I placed the card on my desk about a foot away from her, and had her palm again. When she opened her eyes later she saw the 100 line letters.
The next time she came I placed her two feet away from the card. After palming a short time she read the 70 line letters. She palmed again, and this time her vision improved to 2/50.
The chaperon for the two girls did not realize that it was possible for Rosalie to read the alphabet or to read figures, and, at my suggestion, she taught Rosalie. Her vision improved after six visits to 1/40 for the Pot Hooks, the letter, and figure cards. The nystagmus had disappeared permanently.
Eleanor's vision with each eye was 3/100. Her vision was improved by palming and the long swing. She could make out figures much easier than letters, so I placed the figure test card at five feet from her eyes. While she was moving her body from left to right, she was told to glance at the figure at which I was pointing. She was cautioned not to look at the figure longer than a second, otherwise she would be tempted to stare, and her vision would be lowered. She practiced this for a few minutes and her vision with both eyes improved to 5/50. Her left eye, which had atrophy, was greatly relieved by the sun treatment.
Every time she came for treatment, which was usually once a week, her vision improved for another line of the test card. Changing cards helped to improve her vision also. After the regular C card was used, we tried the pot hooks card. Eleanor never had anything to say, but did just as she was told. When her vision improved and she became able to read small letters and figures, she would smile and become very much excited. In one week's time her vision improved to 6/20 with both eyes. Then I gave her small type, called diamond type, and asked her to hold it six inches from her eyes. She could see black spots on the little card, but nothing more. I gave her the sun treatment for a few seconds, and she immediately read the fine print.
Later I placed a black card with white letters ten feet away and noticed that Eleanor turned her head over to one side in order to read the letters. The distance of only one foot further caused her to strain while trying to read the strange card. I directed her to swing and blink as she flashed the white letter. In less than a half hour, she read the letters one line after another with her head perfectly straight. She was given the sun treatment about six times in one hour, and was encouraged to read the card after each treatment, and before she left me her vision had improved to 6/15.
I did not see her again for a few weeks, and I feared that she would not get along so well by herself. At her next visit, however, she surprised me by reading all the different cards with which she had practiced, and she held her head perfectly straight. Her vision had improved to 6/10. Eleanor plays the violin and sings. When I guided her in reading the card with her head straight, I always reminded her of her violin and how well she played those selections which she knew. This never failed to improve her vision.
Eleanor and Rosalie left the city and I did not see them again.
I hope and trust that my friends will forgive me for not waiting until my patient could see better, or until I was able to accomplish more for him. In this particular case I feel very much like a child, eager to tell all about him even though he was not cured.
During the month of November, 1921, a dear old man came to our clinic, led by a younger man. They had been told by the clerk that the patient could not receive treatment there because he did not live in the district.
However, the nurse in charge did not send him away, but asked him to wait. After all our patients had been attended to, Dr. Bates had a talk with the old gentleman.
Upon examination it was found that he had all sorts of trouble with the nerves and muscles of his eyes. Dr. Bates asked me to examine him and suggest what we could do for him, where we could treat him. There he was, absolutely with no sight whatever, but with a smile that went straight to my heart. As the old man held his head up, waiting to hear what we had to say, I made up my mind to treat him at our office. Every moment of my time is taken up with the work, but there was my lunch hour before the clinic every Saturday that I could devote to his case.
I had not the slightest idea that we could give him even perception of light, for his eyes were in bad shape. No iris whatever nor pupil in either eye was visible. Instead, each eye had a thick, solid-looking white mass where the iris and pupil should be. That day we arranged that he should come to see me every Saturday, and I was to treat him for one hour. I made no promises, but said that I would do all I could for him, if he would do his part and carry out the treatment at home.
His age was seventy-four, and he lived in the Home for the Blind in Brooklyn. He was first stricken with blindness in the left eye in the year 1889, and the trouble was neuralgia. In 1898 he was stricken with blindness in the right eye after suffering with chills and fever. From 1898 he could see slightly with the left eye, until 1920, when his sight gave out completely. He had been treated by noted eye specialists without success.
The first week in December he came to our office and without thinking he said, "I am very happy to see you," and I answered promptly, "And I am happy to see you, also." I found that he was under a terrible tension. The muscles of his arms, especially at the elbows, were so tense that I made up my mind that he must go through some calisthenics with me before we started with the treatment.
I called him "Pop" from the start, and he seemed to like it. Well, you should have seen the poor old fellow throw his hands over his head and try to touch the floor without bending his knees. Of course he got only half way, as his hands just about reached to his knees. Nevertheless, it was a good start. We were very serious in our exercises, and to make it appear doubly so to him, I went through the 'exercises with him, guiding him as best I could. I taught him how to palm and to swing his body from side to side as I stood before him, explaining that the swing would help him to relax. While holding his hands I reminded him always to loosen up at the elbows. I told him that anyone could see that he was blind because he stared so much. He never seemed to close his eyes, which made his condition worse. So the next thing I taught him was to open and close his eyes often, which we call blinking.
The next time I saw him he was overjoyed. "I have so much to tell you. At times I can see just for a second," he said. "The other day, as I went to the washroom I did not feel for the wash basin, but I saw it and walked over to it. Then in my happiness and excitement my vision left me. Why was that, please?" I answered, "You began to strain and caused your blindness to return." I encouraged him by saying, "Don't worry, you will be able to see more next time when you are able to stop the strain."
Then, to my surprise, I learned that this dear old fellow had been shaving men's faces by the sense of touch. Before he became blind he was an expert barber. He repeats again and again how he shaved a Spanish prince by the name of Don Carlos and also his staff, as well as other notable men.
Next time he came he was even more interesting. He could not wait to tell me how young he felt and how he loved to exercise. He gave me a demonstration of how he could touch the floor with his fingertips without bending his knees. I was just in the act of praising him for his ability to do such a remarkable trick for a man of his age, when all of a sudden there was an accident, and a button went flying to the opposite side of the room. It burst from the back of his trousers as he touched the floor with his fingertips, and poor old "Pop" was more embarrassed than I was.
However, we soon remedied the trouble and started in with our treatment. As he had no perception of light in the beginning, I was quite thrilled when he pointed to both windows of our room and showed me just where the curtains were fastened. Placing him in another part of the room, I was delighted when he pointed with his fingers to a sunbeam shining on the rug. With this progress to encourage me, I worked earnestly to give him his greatest desire—his eyesight. I cannot understand as yet just how he did see, but I noticed that the white mass in front of the iris was not quite so thick as formerly. At another time he told me that while he was shaving a man, he suddenly saw the man's face and that he also saw walking past him, another man, who had entered the room quietly. He told me that at another time as the matron of the home passed out of his room, he asked, "Isn't your gown a blueish gray?" "Yes," she answered, "it is a blueish gray color. Your sight must be coming back."
What poor old "Pop" is most anxious about is that he may have the pleasure of seeing my face some day. But, of course, I merely tell him that he must not hope too seriously to see my face, for it might make him blind again.
There was an air of true refinement about him, and I was always anxious for the hour on Saturdays to be with him and help him.
As I became better acquainted with him, I encouraged him to talk. He was always cheerful when he came and tried to follow me in everything I directed him to do. As he told me a little of his personal affairs, he was very careful not to arouse pity. Even though he lived in the Home for the Blind he felt quite independent. He stated that the only sadness he has had in hit life was when his wife no longer wanted him. That was when he lost his eyesight and could not support her. Before she died, she lost all her earthly possessions. All he wished now was to have enough sight to enable him to work and realty see the faces of his many friends.
Pop enjoyed standing and swinging his body from side to side, and as his eyes moved with the body swing, he relaxed and got flashes of a black stone he had in his gold ring. He said that the stone became perfectly black to him and then he was able to flash the gold setting. One day he entered the smoking-room at the Home and for the first time since he became blind, he saw the outline of all the men in the room a few feet away from him. I was happy to hear this because heretofore a person had to be quite close before he could see his outline.
We worked together diligently month after month, hoping that he would surprise me some day and actually see. All things are possible and I have not lost hope. One day he said, "I know I am going to see again, for once in a while I see my whole hand, but it looks like a baby's hand. When I go out in the street, I can see the brass railing attached to our front steps. I can see a man's face now, when I am shaving him, but I see his face a gray color instead of pink or flesh color."
My chief concern was to keep up his interest and encourage him to practice faithfully. In order to earn a few pennies, he caned chairs in the work shop. While doing this work he stared, and that was a drawback, yet I had not the heart to stop him from earning his spending money. After a day of this kind of work he complained of seeing bright colors before his eyes, which indicated that he strained while caning his chairs. For quite a few weeks he was not employed in this way, so he practiced more faithfully than ever. I believe the sun treatment helped very much. This was given him, if it happened to be a sunny day, every time he came to the office. He was placed in the sun and while he was looking down, his upper lid was raised and the sun was focused on the sclera, or white part of the eye with the sun glass. At home, he would place himself in the sun and treat his eyes in the same way, only not with a sun glass. This treatment, in addition to palming and the body swing, helped a great deal.
Then came a wonderful change in his left eye, which in the beginning looked much worse than the right eye. The solid white mass which covered the pupil and iris gradually decreased. The upper part of the iris and pupil became visible in the left eye. The constant twitching of his eyes ceased. If I could have been with him more, and reminded him not to stare, I believe that the relaxation and rest would have restored his eyesight.
Week after week he kept coming, with always the same cheery greeting, "I am glad to see you, Ma'am." I became acquainted well enough with him to say, "Now, you big bluffer, you know right well you don't see me." This remark would always bring a hearty "Ha, ha" from him and then we would proceed earnestly with the treatment.
The last two months of the year 1924 I noticed that he was becoming more feeble, and that he was not so sure of his steps as he walked along with his guide, a boy of fourteen years. Recently he asked me a question which was indeed hard to answer. It was this: "When do you think I will see again? In six months or so?" Before I answered I watched him and thought perhaps that within six months he would be called to his Heavenly Home where there are no eye troubles, so I said, "Well, I don't know for sure, but wouldn't it be great if you would see again in six months?" It would be hard to tell of all the things he has promised me when that time comes. His favorite expression at the office, whenever he suddenly discovered a sunbeam on the carpet was, "Chee Rusalem, dat's great!" Then, in excitement, as his vision faded away the next moment, he asked, "Why don't I keep on seeing?" There was always the same answer, for there was only one reason, strain. When he held the test card five inches from his eyes after palming for a few minutes, he was able to see black spots on the card instead of letters. He showed me the outline of the large black letter C at the top of the card.
One day he exclaimed: "This week the Matron came into my room and while I palmed my eyes, she read something from a magazine to me. I laid down my pipe on a table before I palmed and after she left my room, I forgot all about my pipe. Later on, as I passed by the table, I saw the pipe plainly and picked it up. I called out to my friends in the next room and told them about this wonderful thing. When I shave a man now I can really see his face sometimes."
He called me his Shining Light, bless his heart. It thrills me to hear this and makes me want to do greater things.
During the month of August, 1922, Dr. Bates and I were extremely busy and had to turn away many patients. A blind girl, aged 25, was waiting with her sister for attention. When I asked what I could do for her, she mentioned the name of a doctor's wife who had been treated successfully for cataract by Dr. Bates. A dozen or more patients who were in the waiting room at the time listened, for she talked loud enough to be heard. She said: "I came with great hope that you might help me to see." She then handed me a note written by the doctor's wife, which read something like this:
"You have benefited so many patients in your clinic, won't you please help this girl if you can? I met her in Prospect Park, Brooklyn, as she sat beside me on a bench, resting."
I am sorry to say that I frowned as I finished reading that note, for I did not see how I could possibly take another case, when I already had more than I could handle. The girl was not eligible for treatment at the clinic because the authorities there would not allow us to take cases out of the hospital district. I was about to tell her that she would have to come some other time when I was not so busy, but I caught the anxious look in her face,—a look of hope, of faith. I solved the problem quickly and said, "I will take you this minute to our other office and see what I can do for you." At that moment, a gentleman sitting in the room sighed with relief, smiled, and said, "That was fine of you, knowing how rushed you are at present."
I disturbed Dr. Bates long enough to have him examine her eyes and to tell me whether there was any hope of her seeing at all. Dr. Bates said she had microphthalmos in both eyes. She had no red reflex from the pupils. A white membrane was visible in both pupils and the pupils were very small. She could distinguish light from darkness, but that was all. I asked her to tell me when her sight began to fail, or how long she had been blind. What a shock it was to me to hear her say, "I was born blind, so was my mother." What chance had I, if any, to ever help that poor girl to see even just a little of this, God's beautiful world? However, I started right in with the treatment, just as though she had sight. She had so much trouble with her poor eyes that I did not know where to begin. Her eyes moved rapidly from side to side, a condition called nystagmus. She also had a contraction of the throat muscles which caused a great deal of fatigue generally. Here was a big job ahead of me. I told her that I would do my best to help her if she would follow my directions.
Her sister, aged twelve, had normal vision and was called upon to help in the treatment. She proved later on to be a very good assistant. I asked the patient if her sense of touch was all right and she answered yes. Then I gave her an ordinary pin and told her to feel the size of it, then to feel the point and the head. She was told to palm and remember the touch of the pin.
She could remember the touch of the pin very well, she said, even though it was no longer in her hand. I was very much encouraged when, after a few minutes of palming, she removed her hands from her eyes and I noticed that the rapid movement of her eyes had stopped.
But when I asked her a personal question, the movement or nystagmus returned. I then told her to forget the question I had asked, and to cover her eyes again with her hands to rest them. While she was doing this I related what had been accomplished for an old blind man, who was at the present time under treatment. I explained how he once had good sight and now after several years of blindness and great suffering from eye operations, he was beginning to see. I watched my patient closely, and saw that she was interested in what I was saying. Again I told her to remove her hands from her eyes and I noticed the second time that her eyes were perfectly still. Her sister sat close by holding her breath in amazement and in an excited voice said to me: "This is wonderful. Anna has not been able to control that terrible movement of her eyes for years. I feel sure she is going to receive benefit from your treatment and care. I want very much to help you if you will tell me how."
It has always been my greatest desire to carry on Dr. Bates' ideas and methods and to follow faithfully his directions in all cases. I remembered something he said to me at one time. "If you have a pain, find out what causes it and cure the cause." So I felt in this case that perhaps if I could cure the nystagmus and the nervous contraction of her throat, I might be able to do more for her vision. Her sense of touch was good and her memory of the prick of the pin had helped while she rested her eyes. Now I decided to try the swing and see if that would help her throat. I told her to put tip her forefinger and to hold it about six inches from her eyes, then to turn her head slowly from side to side toward the right shoulder and then toward the left. I explained to her that even though she could not see the finger, "she could imagine she saw it. She answered me just as I wanted her to, saying, "Oh, I can imagine the size of my finger, and when I turn my head to the right my finger seems to move to the left and vice versa."
I encouraged her to keep on moving her head from side to side and to blink her eyes to prevent staring, which had been a habit since birth. I noticed that after a few minutes or so she settled herself in a more relaxed position as she sat in her chair. Then I called her sister's attention to the fact that the contraction of her throat muscles quieted down until they stopped.
When I handed her a test card and asked her if she could see a letter on the card, she answered: "I cannot read letters, I do not know the alphabet. I can only read and write by the sense of touch with the Brail System." Here was another problem. Of course, there was the test card with large and small E's pointing in different directions, which could be used to test the sight, but I had other plans. I wanted Anna to learn to read and write and give up the Brail System entirely. Her sister was called upon to help. She was directed to cut out of cardboard, letters about the size and thickness of the big C on the teat card. Then she was to paint them black and bring them with her the next time she came.
Her sister had good news for me when I saw them again. She had taught Anna some of the letters by the sense of touch. For instance, a letter T had a straight piece of cardboard at the top and another straight piece through the center. A letter C was round with an opening to the right.
We had made a good start, I thought, on this, her fourth visit. I handed her a test card, blank side up. At first, she could not tell whether there was print on the card or not, because she was very much excited in describing how quickly she was learning the alphabet. This made her nervous and she strained. I got her busy with palming, and while she was doing this I told her a story. I find that all patients enjoy this, especially when they visualize or follow me closely in what I am saying. If I remember a good short story from a magazine, I tell that, or I might cite the case of a patient treated by me who obtained good results.
After Anna had rested and relaxed for ten minutes, I asked her to remove her hands from her eyes and look at the card. She remarked: "It appears all white to me. There seems to be no print on the card at all." I told her she was right. I then turned the card right side out, and as she did the long swing of her body, moving her head with her shoulders from side to side and blinking her eyes with the movement of her body, she pointed to the 200 line letter on the card in her hand and said, "That's a letter C."
Can any one imagine the extent of my happiness? For twenty-five years she had been blind, born so, and never had had more than a slight perception of light. Her sister forgot where she was and screamed, "My sister can see!" Anna and I cried with joy. We did not talk, just held each other's hands, I whispered to her ear, "Anna, thank God with me, will you?"
"Yes, you bet," says she, "I'm doing that now."
We got busy again, and this time I told her to move the card from side to side, and imagine her body swinging opposite. She kept this up for several minutes and then she saw the R and B of the 100 line of letters.
On September 9, 1922, after one month's treatment, her vision had improved considerably for the test card. She had to hold the card about an inch from her eyes in order to see the letters. She was directed to place her finger under the letter which she tried to see, then to move her head slowly from left to right and in this way she saw the letters of the 70 line, one at a time. Before Anna left the office that day she said she had wonderful news for me. While walking in the street with her sister she saw moving objects for the first time in her life. In Brooklyn the trolley cars have an entrance in the center of the car. Anna was able to see this from the sidewalk and when a car passed by told her sister just what kind it was. She actually saw a letter-box fastened to a lamp post, and walked towards it without assistance to place a letter in the box. Later, Anna's sister cut out figures from one to ten, of cardboard, and she learned to distinguish them by the sense of touch.
On September 16, 1922, she began to read the 50 line letters of the test card at one inch from her eyes. The first on that line is a figure five. Anna puzzled over that for awhile and then she said, "The first one does not look like a letter at all; it looks very much like a figure five, sister has made cardboard for me."
I cannot express in writing how happy she felt when she realized that she had seen the figure five correctly. I placed myself in the sun and immediately she saw a beaded medallion on my gown and also remarked how my necklace sparkled in the sun.
The next thing was to teach her colors. As she never had more than a slight perception of light, the difference between bright red and bright green meant nothing to her. One day while walking with her sister, Anna stopped in front of a store where electrical supplies were displayed. In one section of this shop window was an electric heater and in the center of it was a red light. Anna drew her sister's attention to this and remarked, "Isn't that an angry looking thing?" When she related this to me she said, "I can get a pretty good mental picture of Satan now, since I saw that angry light."
By September 30th, she had learned all the letters of the alphabet and all the figures. Her sister patiently taught her various colors, so we had many things to work with in helping Anna to restore her sight. Much of our success in her treatment I owe to her sister Ella.
I had been in the habit of calling Anna my blind girl, or my blind patient, but I had to cure myself of the habit because Anna can now see. Her vision is not normal by any means. No one could expect that, not if one had seen Anna at the beginning of her treatment. People who have had fairly good sight and then acquired cataract and other diseases of their eyes have a fair chance or a better chance to regain normal vision than those who are born blind. I have seen many such cases entirely cured after they had intelligently carried out our treatment. But Anna, who was not only born blind, with cataract, but had also acquired other diseases, was the greatest problem I ever had. I want to say this for her. If she had not had the faith in me or in my ability to benefit her, I could not have helped her. She always did as she was told. For instance, Anna was caning chairs for a living, a trade at which she could earn at least six dollars a week. But when I told her that she stared and strained her eyes while caning chairs, and that I feared she would be wasting her time and mine if she continued to do this work while under treatment, she gave it up. It was not easy for her to make this sacrifice, because she was renouncing her independence. Her great desire was not to be a burden on her family.
During the months of October and November, 1922, Anna made steady progress. She could read the teat card up to the forty line at a foot or so from her eyes, but the smaller letters she read holding the card quite close to her face. She came every Saturday morning, accompanied by her sister Ella as usual. She was then going to the movies, and sitting about fifteen or twenty feet away. She could at times see the heads and faces of people on the screen. She had to keep up the body swing and also to blink constantly, otherwise everything before her became a blank. If she did not keep up the practice all the time, the staring and straining to see always lowered her vision.
During one of her treatments I had three visitors in our office whom I had invited especially to see the progress Anna was making. One of my visitors was a lady who happened to be in our waiting room the day Anna first appealed to me for help. This lady was a school teacher, a delightful person with a great deal of love for others. I placed her at a desk in one corner of the office, the desk separating her from the patient. To her left I placed a young man, a relative of hers who was also troubled with imperfect sight. To her right sat another young man who was at the time under treatment by Dr. Bates.
All objects seen by Anna on the street and elsewhere were viewed under favorable conditions, either in the bright sunlight or under strong electric light. While at the movie theatre, all lights being out, she was able to relax enough to see the objects thrown on the screen. Now, I was anxious to find out how much she could see as she entered the office, where I had purposely lessened the amount of light. As she stood in the doorway, I asked her if the saw anything unfamiliar in the room. Our visitors were perfectly still and intensely interested. Anna began to blink and swing her body from side to side, which was always a benefit to her. She looked about the room and then back again to the right where the visitors were sitting. She smiled and immediately walked unassisted to the desk, and as she kept up the blinking, she leaned over the desk and announced that the center figure was a lady with a light colored waist on,—there were two gentlemen also; one on either side of her. After praising her, I placed her in a chair to palm and rest her eyes for a little while. This was always necessary because in her eagerness to read or tell what she saw, she strained unconsciously and her vision blurred.
Ten minutes later I asked her to follow me about the room and describe what she saw. A Brazilian butterfly, in an oval frame hanging on the wall attracted her and at three feet she was able to see the color of it. As she had never seen a butterfly she tried to tell me what it might be. She remembered that at one time a butterfly had been described to her, so she said it might be one, although she was not sure. The memory of the form of an object explained to her really helped her to see it. She was placed before a mirror and immediately she saw what it was.
When I first saw Anna, I never dreamed that we could accomplish so much. In her home she helps with the housework and picks up things and places them where they belong. She sees the steam from the boiling tea kettle and reads the large bead-lines and the next size type in the newspapers. When she first learned to write with crayon for me, she wrote something in a notebook which I hope to have photographed so that those who are interested may see what she learned to do. Perhaps not all blind patients could have accomplished what Anna did. Such an extraordinary mind as she has is very rare. Her cheerfulness, her hope of seeing, helped me to help her. Her smile was with her all the time and her gratitude to me and her faithful sister was unbounded.
She does not come for treatment any longer, but her letter of February 11, 1924, reads:
"My dear Mrs. Lierman:
It pleased me greatly to receive your letter
and I appreciate your interest in me very much.
I am not caning chairs any more, but am taking
a commercial course.
With kindest regards, I remain,
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