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Cataract
surgery these days doesn't sound like a big deal.
Still, when you're the one answering a nurse's questions about what
prescription drugs you take, whether you have any allergies and
when you last ate or drank anything, you become somewhat more attuned
to the situation at hand. Even so, when it comes to medical procedures,
cataract surgery is the grown-up Baby Boomer's equivalent of wisdom
teeth extraction. Only having your wisdom teeth pulled is much more
bothersome than getting a clouded lens replaced.
What all this has to do with Texas
history we'll get to shortly, but for anyone who's been putting
off getting cataracts fixed, go get it done. My appointment at the
day surgery center was 8:15 a.m.; surgery began 10-ish that morning
and by mid-day I was home eating barbecue for lunch. Oh, as soon
as the dilation lessened, it was readily apparent that I no longer
needed prescription glasses for distance vision and only over-the-counter
readers for close-up work. Not only that, I'm able to drive at night
again just like a big boy.
However, regaining good vision by undergoing a medical procedure
has not always been so easy. My grandmother had cataracts removed
in 1961 and was in Austin's
old Seton Hospital for at least a week, her head held immobile by
sandbags so the incisions could heal properly. (Apparently doctors
did both eyes at once back then. Too, her surgery came only nine
years after the first successful implant of artificial lenses in
the U.S.) Grandmother did not enjoy the experience and despite going
through all that, she was never able to drive again.
Her treatment was cutting edge for the day, if witch-doctory by
today's standards. And obviously, the farther back you look, the
more complicated and risky eye surgery was.
The earliest procedure, believed to have been developed by the ancient
Egyptians, was called couching. Basically, a surgeon just scooped
out the opaque lens. It worked sometimes, but the success rate was
low and the likelihood of complications or even death was high.
Then, in the mid-1700s, French opthalmologist Jacques Daviel pioneered
extracapsular cataract surgery in which he removed clouded lenses
by suction.
One
of the first documented cataract procedures in Texas took place
in the late 1840s in the Hill
Country.
The surgeon was Dr. Ferdinand Ludwig von Herff, who had immigrated
from Germany a few years before and settled in what is now Llano
County. Trained in Berlin and Giessen, the doctor had plenty
of work in the new Republic
of Texas. A look at Herff's long career-he went on to practice
in San Antonio for
decades and lived until 1912-demonstrates that no matter the relatively
primitive state of the medical art in the 19th century, a cautious,
intelligent physician capable of deductive thinking could do patients
some good.
Herff was what today would be called a general surgeon. He did develop
one specialty-removing Indian arrows and treating gunshot wounds.
In contrast to dealing with the medical aftermath of conflict along
the frontier, the doctor had an affinity for language and learned
to communicate with both Apaches and Comanches.
Word of his linguistic and medical prowess spread among the Indians,
and one day an older Comanche chief came to the doctor complaining
of poor vision. Herff examined him and diagnosed advanced bilateral
cataracts. He said he could possibly restore his sight and the Indian
agreed to surgical intervention.
Ahead of his time in understanding on some level the importance
of clean water to a medical procedure, Herff decided to use cistern
water rather than the more readily available but highly mineralized
ground water. Examining a specimen of the cistern water under his
microscope, the doctor saw that it was alive with small creatures
he called "animalcules." So before proceeding with his operation,
he boiled the water.
On the cutting edge of 19th century medical technology, the doctor
used ether for anesthesia. Knowing the high flammability of the
knock-out chemical, he planned to do the operation outdoors to take
advantage of natural light, thus avoiding the fire danger posed
by a lantern. Finally, to lower the chance of dust getting in his
patient's exposed eyes, he waited for a sunny, windless day.
With bystanders warding off flies with palm fronds, Herff used some
of the instruments he had brought over from Germany to remove the
opacified lenses from the unconscious Indian's eyes.
The operation proved successful. Amazed and deeply grateful for
his restored eyesight, the chief promised to bring Herff a gift.
Six months later, the chief returned to the German settlement with
a token of appreciation-a captured Mexican girl the Indian offered
as a slave. The doctor politely accepted the "gift," but as soon
as the Comanche headman left he freed the young woman.
My eye surgeon, Dr. Todd Smith of Austin,
was content to accept my insurance and Medicare for services rendered.
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