in parentheses

Brian Huba’s essays have appeared in the Wilderness House Literary Review, bioStories, Men Matters Online Journal, the Superstition Review, and the Satirist. His creative nonfiction has been published on 101 Words, in Reed Magazine, The Griffin, Down in the Dirt, Literary Juice, and The Storyteller. Brian has placed op-eds in the South Florida Sun-Sentinel, the Democrat & Chronicle, New York’s Journal News, the Syracuse-Post Standard, the NY Daily News, and the Utica Observer-Dispatch. Check out Brianhuba.com for more.

B. Huba was previously published by In Parentheses

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The Eye Surgery That Wasn’t

Self-improvement is a journey. And sometimes that journey is derailed by unforeseen obstacles. This is the stranger-than-fiction story of my lifelong battle with an eye condition called strabismus, and how I set out to correct that condition in 2023, but ultimately failed. Despite the fact I work a professional job that provides top-notch medical coverage, I was unable to successfully navigate the post-Covid healthcare system.  

I

I was born with strabismus, a disorder in which the eyes do not line up in the same direction. At six months old, I underwent corrective surgery. Afterwards, I was required to wear a patch over my right eye–the dominant eye–in order to stimulate and straighten my left eye–the weaker eye. According to my mother, I did not do well with the patch. “You’d scream and cry and rip it off,” she told me. “I couldn’t keep it on,” and because I wasn’t made to follow a strict patching plan, my left eye drifted up and out.

Growing up, I suffered all the predictable indignities that kids plagued with unaligned eyes have always suffered. I was called cockeyed. I was routinely asked what I was looking at. Kids may not be creative but they sure can be cruel. This did irreversible damage to my self-image. It altered my identity. I saw myself as a freak, a mutant. I was prescribed goggle-sized glasses with a thick prism in the left lens, as contact lenses were not an option for me, thanks to a stigmatism. When I was photographed, I’d insist on being shot from my right side. While sitting in the cafeteria or classroom, I’d hold a hand at my forehead, sun-visor style, to mask my left eye. I wouldn’t meet people’s gaze when they spoke to me, giving the impression I was being deceitful. It wasn’t deceit. It was shame.     

Thankfully, I was blessed with friends who never made me feel self-conscious about my condition. But there were times when my less-than status was plain to see. Girls didn’t want to date me or attend proms with me. In the rare case when they might’ve considered doing so, I lacked the guts to put myself out there. By the time I graduated high school and began taking courses at the local community college, I decided it was time to change the story of my life.

In the autumn of 1998, my mother and I sought out an eye surgeon at Albany Medical Center, the hospital where I’d had my surgery at six months old. A moment after entering the examination room where my mother and I waited, the gray-haired, stoop-backed doctor, whose name I no longer remember, looked at me, and said, “Wow, that eye’s way out there.”

At the time I couldn’t understand why his words, “Wow that eye’s way out there,” didn’t motivate me to sign up for surgery. In retrospect, I think I get it. Consider this…if you tell a heavy-set person, “Wow, that waistline’s way out there,” they might not join a gym. Instead they might go home and inhale a pint of Haagen-Dazs. That’s self-hatred. And self-hatred is a terrible thing. Trust me, I know. After that appointment, I no longer wanted to fix my condition. I wanted to punish myself. And the best way I knew how to do that was to continue living with my left eye as is. 

II

In 2003 I earned a bachelor’s degree in English, then, three years later, a master’s in adolescence education. I began working as a high school English teacher. Every once in a while some wisecracking kid would make a comment about my eye. Nothing I hadn’t heard a hundred times. Like I said: kids aren’t very creative. Over the years, I’ve had a few students with strabismus or lazy eye. I could see they were struggling the same way I’ve always struggled, but I never said anything, never offered advice. I assumed they didn’t want their condition called out by anybody, not even a trusted teacher, not even if it was meant in the most-constructive way possible. In 2010, I married my longtime girlfriend, Lynda, who is also an English teacher. And, in 2016, we had our daughter, Annalee.

Shortly after Annalee’s birth, I asked the nurse about my daughter’s eyes. “Are her eyes okay? Are they straight?”

“Perfect,” she assured me.

Age and experience have sharpened my perspective. I’m able to recognize that a wandering eye isn’t the worst thing. Some people have missing limbs. Others are confined to a wheelchair. With that said, I still struggle with eye contact. I still shy away from photos. From time to time, I have those same old feelings of shame and inadequacy. And when that happens, Lynda helps me through it. As a child, my wife was diagnosed with a rare form of kidney cancer. Every two weeks for a year, Lynda’s mother drove her from Malone, New York near the Canadian Border to Manhattan, so she could receive treatment at Sloan Kettering. “New York is where the angels are,” Lynda said when I asked why she and her mother traveled seven hours each way when there were countless cancer hospitals closer to home. To this day, Lynda periodically goes into New York for follow-ups and various tests at Sloan, even though Albany is only two exits away. She’s been in remission for thirty years, but fighting cancer through adolescence takes a heavy toll. Lynda knows what it’s like to suffer. She knows what it’s like to feel less-than.

Ironic as it may seem, along the way, I’ve had two frightful episodes involving my right eye. At twenty-one years old, I was ambushed by a group of guys behind a bar. To this day, I have no idea who they were or why they targeted me. The assault concluded with a knockout punch to my right eye. The end-result was a shattered orbital bone, the fracture so bad it ensnared the muscle that controlled the eye’s up and down movement. Surgery was required. Then, about fifteen years later, in what can only be described as a freak occurrence, one of my dogs, a beagle named Pepper, uncharacteristically nipped at me when I snuck up behind her, sinking a tooth through the lid of my right eye. Blood poured, red and heavy, soaking the kitchen floor. Lynda rushed me to Urgent Care where I received a row of stitches to close the wound. Any damage to my right eye would be debilitating, as I am legally blind in my left eye, routinely scoring 20/400 on the eyesight chart. (Because I wasn’t made to wear that patch as a baby, my vision did not develop normally through childhood, so my unaligned left eye soon became lazy.) Multiple doctors, along the way, have conveyed to me the importance of protecting my right eye.               

In the summer of 2018, I went in for my annual optical exam. I use a chain-place called Visionworks. If you live anywhere in America, you’ve probably seen Visionworks. You might even be a Visionworks patient. The regular doctor wasn’t there, so I met with his replacement, a man named Kuan Chan O.D.  After dimming the lights and doing the eyesight chart, Dr. Chan asked why I hadn’t done anything to address my strabismus, and I told him the whole story: surgery in 1980 and how I struggled with the prescribed patch afterward, the grade-school teasing, that humiliating consult in 1998, “Wow, that eye’s way out there,” and that’s when Dr. Chan stopped me to say, “Okay, I can’t even begin to tell you how inappropriate that was.” Then he said, “You know, Brian, there’s been some interesting research around patching in adulthood.” If I was willing to wear an eye patch for two hours a day, I could “possibly” see “minor” improvement in the look and function of the left eye. I told Dr. Chan I was willing to try anything, short of surgery. He repeatedly emphasized that nothing was guaranteed. “Not at your age,” but it might be worth a try.                   

So that’s what I’ve done every day for the past five years. When it’s time, I fish a faded patch out of my eyeglass carrier, unfurl its twisty, knotted string, then wrap it around my head, finally securing the patch between my right eye and glasses. I usually do two sixty-minute sessions per day. Lynda demands I conduct this exercise out of sight, meaning I can’t walk the dogs or be seen by the neighbors while patching, as people might suspect I have a glass eye or harbor some sick pirate fantasy. (I’ve gone out as “Number Two” from the Austin Powers movies every Halloween we’ve brought Annalee Trick-or-Treating.) So, in a strange way, the patch itself, like the eye it’s trying to salvage, is a source of shame.

I most often complete house chores when patching, being careful to stay clear of windows while I work. And if Annalee has friends over for a playdate, I’ll lock myself in a separate part of the house, or pull the patch off, which brings forth another problem. Once the patch is removed, a pronounced mark is left across my forehead and through the hair at the side of my skull where the pulled-tight string had been. I’ve seen more than a few people do a double take when I’m in public after undoing my patch, likely thinking I’d suffered some horrific accident that required cranial reconstruction. And now, after so many years of the same routine, that post-patching mark across my head, which used to fade out within an hour, is becoming permanent.

At some point in the recent past, one of my colleagues happened to mention that his four-year-old son suffered from strabismus. The child’s optometrist had prescribed some sort of drop that blurred the strong eye while forcing the weaker one to work. I called Dr. Chan to ask if these eye drops were an option for me. Chan said, “He’s talking about atropine drops. I believe, for you, the patch will be more effective. Trials for atropine drops found visual acuity can be more negatively affected in the sound eye, your right eye, when compared to patching. Not a risk I want to take. Besides, things are going well with the patch.”      

Here’s the good news: despite the logistical complications and myriad restraints, patching has worked. Every day, I can feel it making my left eye stronger, straighter. I can feel the eye “waking up,” as Dr. Chan would say. Before I began patching, trying to read text messages or emails with my left eye alone was impossible. Now I can kind of, sort of make these missives out. I’ve even started reading large-print books to Annalee at bedtime while patching!

I’ve been back to see Dr. Chan five times since our initial meeting, and the data suggests my left eye is working better. Two years in a row, I’ve scored a 20/60 on the eyesight chart. While my progress is promising, Dr. Chan says, “Remember, overall improvement will be minimal.”

III

In July of 2022, we were invited to vacation with three other families on the Outer Banks in North Carolina. The plan was to rent a decked-out house by the beach. Lynda was excited. Annalee was excited. I was petrified. How would I patch while cohabitating with a house full of people? Would I have to hide in our assigned bedroom with the door shut, pretending to take a nap or read a book? Would I have to come clean to our friends, then patch in front of them and their kids? Lynda suggested I take the week off, “Don’t patch for a few days, Brian, it won’t kill you.” By then that patch had become my master. I was afraid if I missed even a single day, my left eye would drift back out, and all my progress would be wiped away. 

Long story short…that trip didn’t happen. For Lynda this was the last straw. She would no longer bow at the altar of my almighty patch. She said, “Brian, we can’t live like this. It’s unfair to me. It’s unfair to our daughter. You need to find a sustainable solution, or I will,” and I wasn’t sure what this meant. Was Lynda threatening separation? Divorce? I imagined my future without my wife and daughter, alone in some starter apartment, vacuuming and re-vacuuming its threadbare carpet while I patched.

No, I would not let this happen. It was time to give up the ghost of that demoralizing consultation in ‘98, “Wow, that eye’s way out there.” Surgery was the answer back then, even if I was too full of self-hatred and shame to see it. And now, twenty-five years later, it was still the answer. My left eye might be the story of my life. I wouldn’t let it be the story of Lynda and Annalee’s life.

Once the holidays came and went, I contacted Dr. Chan at Visionworks to seek his advice on pursuing surgery. “Yes, do it,” he said. “It’s a fairly-minor procedure, minimal risk, no real cons at all.” I did extensive research before choosing a highly-accredited surgeon named Peter Kassad, M.D. out of Saratoga Springs. When I told Lynda I’d scheduled time with Kassad, she said, “Are you sure you don’t wanna go to New York City for this?”

I went to see Dr. Kassad over the school’s winter recess in February 2023. Lynda wanted to accompany me, but I told her I was going alone. I had no idea what Kassad would say when he saw me, and I didn’t want my wife to bear witness to a repeat of ‘98, “Wow, that eye’s way out there.”

After taking my temperature with one of those pistol-shaped thermometers, an assistant shepherded me through the showroom that housed standing racks of eyeglasses for sale, then down a short corridor to an exam room. A half-hour later, Kassad entered, donning an N-95 mask and lab coat. He was very average looking. This surprised me. I’d imagined him a big, hulking guy, an ex-basketball type. Skipping introductions, he clicked into his tablet. “Okay, Mr. Huba (pronounced Hubba), tell me about your double vision.” 

“I don’t have double vision.”

“That’s why you’re here.”

“No it isn’t.”

He turned from the tablet.

“Then why are you here?”

I pointed to my left eye.

“Because of this.”

“Because of what?”

“I have strabismus. I want you to fix it.”

Kassad lowered his mask and studied my left eye. “I don’t notice it,” he said. He rolled his stool closer. “Okay, I see. It’s a few degrees off. Not something I’d recommend for surgery.” He slid his mask back on. “You notice this when you look in the mirror? People notice this?”

“I mean…I don’t go around polling people.”

“Of course not.”

“The eye used to be worse,” I said. “But I’ve been patching it every day for the past six years, and–”

“Patching,” he interrupted. “Waste of time at your age.”

I should’ve known right then, despite the online reviews and testimonials, Peter Kassad, M.D. wasn’t the surgeon for me. I’d come to believe that patching had been a game-changer in my life, and hadn’t Kassad proved this true by saying, “It’s a few degrees off”? A far cry from, “Wow, that eye’s way out there.” I should’ve thanked Kassad and walked out. But I didn’t. And considering how things with him ended, some sixty days later, I wish I had.

Kassad dilated my pupils, then disappeared. While he was away, the office lights grew progressively brighter and my vision progressively blurrier. When he returned, his once-cold disposition had softened. He agreed to perform the surgery. His plan was to pull a muscle outside my left eye straight. “With time,” he explained, “your eye will drift, so I’m going to ever-so-slightly overcorrect.” The procedure would last forty-five minutes, and I’d be given anesthesia to ensure my body, and by extension my eye, would remain “perfectly still” throughout.

“Recovery?” I asked.

“A few days.”

“Restrictions?”

“None really. No driving that day, of course. Try not to shower or swim for twenty-four hours after. I might want you to keep the eye dressed overnight. ”

“Risks?”

“Success rate is high. But there’s a chance it won’t work. We’ll know more about that four to six weeks out. As far as risk factors: infection, retinal detachment, total loss of the muscle, all unlikely. More likely: redness, some swelling, discharge, a bit of pain when moving your eye. I’ve never prescribed anything stronger than Advil.”

The procedure was set for April 7th, Good Friday. Less than two months away. And for the first time in my life, I let my guard down. I unabashedly discussed the upcoming surgery with my students and colleagues. If anyone said they’d never noticed my left eye, I’d remove my glasses and let them stare straight at it. This was a kind of freedom I’d never known. Why bother hiding now? What was the point? I was doing this surgery. My left eye would soon be perfect.

I spent the rest of February and all of March on the move. I took time from work to see my primary physician for a pre-op appointment. I had blood drawn, a ritual that makes me queasy to the point of almost passing out. I spoke with my insurance company at least a dozen times. Although I work a professional job that provides top-notch medical coverage, I’ve heard too many horror stories about sucker-punch medical bills wiping people out. If the insurance had determined my strabismus surgery was elective and/or cosmetic, rather than a medical necessity, I could be left footing the bill. This possibility haunted me. I made the claims rep assure me, in writing, that the procedure was preapproved and covered.

I suppose there were warning signs along the way. But I had tunnel vision: April 7th, surgery, better life. I couldn’t see anything else.

I should’ve.

At the end of March, we purchased a new grill for the back patio, then put our old grill on Facebook Marketplace. A few hours after we placed the post, a young woman came to take it. I loaded the grill in the rear hatch of her Kia and we got to talking. She told me she worked in an Emergency Room. I asked what that was like, and she said, “Healthcare is a mess. People quitting left and right. Screw-ups all the time.” Then she said, “Unless you’re about to croak, avoid doctors and hospitals at all costs.”

Then, another warning sign. As surgery day drew near, I began having the same dream over and over. In this dream, my childhood friend, a guy named Rick, who was killed ten years earlier on a construction site, came to me. He told me not to go through with the surgery. I wrote these dreams off as a manifestation of my own anxiety.      

I shouldn’ve.

In addition to the logistics of having surgery, albeit a “routine” surgery, I grappled with the reality that I was going under anesthesia for the first time in twenty-three years. And while mishaps involving anesthesia are statistically rare, they do exist, meaning I had to at least consider my mortality. I was, quite literally, putting my life in Dr. Peter Kassad’s hands, a man I’d only met once.

On April 6th, the day before surgery, I received a call from a representative on Kassad’s team. He told me to be at the surgical center by ten a.m. As far as food and drink went, “A piece of toast and jam when you wake up, a small cup of black coffee, nothing past eight in the morning.”

After the call, Lynda said, “You can eat before surgery?”

“That’s what the man said.”

The next day, at seven a.m., I ate toast with jam as instructed, then sucked down a small cup of coffee. Three hours later, I arrived at the surgical center in Saratoga Springs, Lynda and Annalee by my side. The building itself looked like a glorified doc-in-the-box. I expected an actual hospital.

“Still not too late for New York,” Lynda said.

Inside, I registered with the receptionist. She latched a medical bracelet around my left wrist, before sending me to wait with my wife and daughter in a row of stiff chairs. For the next fifty minutes I stared blankly at the flat-screen TV that showed some daytime talk show. I remember being so hungry, so thirsty, so uncomfortable, daydreaming of the first bite of food I’d have when this surgery was finished.

Finally, a masked nurse materialized, and called, “Brian?” I hugged Lynda, then Annalee, then followed this nurse through a set of double doors to a large ante-room, three walls of which were lined with unoccupied hospital beds. I was brought to a bed on the right side. After taking my temperature, the nurse moved to a computer cart. Feeling a twitchy need to chatter, I mentioned how I hadn’t eaten anything since that toast with jam at seven a.m., and the nurse looked up. I could see the computer screen reflected in her glasses.

“You ate today?” she asked.

“Toast and coffee. I was told I could.”

“Who told you that?”

“The person who called yesterday. From Dr. Kassad’s office.”

“You weren’t allowed to eat or drink anything after midnight. Do you remember who you talked to? A name?”

“No name. Just…he was a guy.”

She excused herself to the nurses’ station. I peeked around the privacy curtain, watched her lift a phone and dial. After explaining the situation, she said, “No, Caleb, no…midnight…yes, general…no, I don’t mean to trigger you…okay.” Back at the bed, she confirmed I’d been given improper instructions, “…he was under the impression you were being sedated. Toast and jam is for patients being sedated. Not for patients who are receiving general anesthesia.”

“What happens now?” I asked, hoping this child-sized nurse, in her brown-framed glasses and baggy scrubs, could get things back on track. But all she did was shake her head, and say, “I don’t think we can move ahead. It takes at least eight hours for the body to process food. Right now we’re at four hours, give or take. If you were to aspirate on the table, that could be very bad, even fatal.” There was a tinge of irritation in her tone. Was she irritated with me? How could that be? I’d done exactly what I’d been told to do. “I’ll see what our anesthesiologist recommends.” She slathered a dollop of sanitizer between her hands, then pressed a blue button on the wall, before disappearing through a second set of doors.

Left alone, I wondered what would’ve happened if I’d never said anything about that toast and jam. Would they have wheeled me into the OR and put me under, assuming I’d been given proper pre-surgery instructions and had in fact followed those instructions? “Very bad, even fatal,” the nurse had said, meaning I might’ve actually died during “routine” surgery? Maybe I should’ve known better. Maybe I should’ve asked questions. But the rules around modern anesthesia were foreign to me. This Caleb person had told me what I could and could not do. I’d accepted his directives at face value. It never dawned on me to fact check him.

“I relayed everything to our anesthesiologist,” the nurse reported when she returned. “I’m truly sorry, but she’s not comfortable enough.”

I sighed, then said, “Could it maybe be later today?”

“Would you be willing to wait–” She did some quick math in her head. “Until four, four-thirty? That would be the soonest-possible time.”

Nothing sounded worse than sitting in that too-bright waiting room until late afternoon, savaged by thirst and hunger, but I’d spent my whole life fighting this fight with my left eye, and I’d spent the past two months preparing to have it corrected. I needed to be on the other side of this. 

“Yes,” I said. “I can.”

“Dr. Kassad’s in surgery,” the nurse said. “When he finishes, I’ll ask him to come out and speak to you.”

Again we waited. Lynda was annoyed. Annalee was restless. I was dehydrated and my empty stomach ached. Every few minutes, the nurse returned to update us on Kassad’s status. On her third go-round, Lynda snapped, “What is this man doing?” The nurse eked out some sort of apology, but my wife wasn’t having it. “I’ve never seen anything so unprofessional,” and everyone in the waiting room now watched us. “Someone from your office gives the wrong protocol. And we’re left sitting here for God knows how long.”

“I am sorry,” the nurse said before scurrying off.

Dr. Kassad emerged a short time later. Lowering his mask, he said, “I’m not sure what you want to do here, Brian.”

“I want surgery. Today. I’ll wait.”

“That’s not an option.”

“Why not?” Lynda asked.

“As  Madison, my nurse, said, it won’t be safe until four. Our anesthesiologist is off at three,” and Lynda snickered. Without acknowledging my wife’s reaction, Kassad continued, “Contractually, she can’t work past three.”

“So much for staying until the job is done,” Lynda said.

“Brian, you’ll recall, I tried talking you out of this,” Kassad said.

“Then you agreed to do it,” Lynda said. “We’re here. We’re ready. We’ve scheduled our whole lives around this.” 

“We can set up something down the road.” Kassad fished a phone from his scrubs, thumbed the screen for a few seconds. “We’ll have to consider vacations, and time off, and personnel conflicts,” he said with his eyes aimed at the screen. “September, October at the earliest.”

“That’s six months,” I said.

“This is your screw-up,” Lynda added. 

“No food or drink after midnight is pretty common knowledge,” Kassad said.

“Maybe you should tell your staff that,” Lynda said.

“It was human error.” Kassad slid the phone away. “We’re still trying to figure out our pre-op policies. We might look to make some changes…,” and Lynda bolted upright out of her seat, so fast Kassad took an instinctual step back. “Still trying to figure out policy? Are you serious?” From the corner of my eye, I saw the receptionist turn away and pretend to take a phone call. To me, Lynda said, “Brian, this is amateur hour.” To Annalee, “Come on, baby, we’re leaving.” She slid Annlee’s coat on and stormed towards the front door. I stared at Dr. Kassad. He stared back. Neither of us spoke. There was nothing left to say.

IV

Lynda drove. I sat in the passenger seat, trying to make sense of what had just happened, or more accurately, didn’t happen. I thought I’d done everything to avert failure. I’d advocated for myself with the insurance. I’d game-planned against every potential road black. And it wasn’t enough.

“You didn’t know, did you?” Lynda asked.

“Know what?” I said.

“That you couldn’t eat after midnight?”

“I followed their orders.”   

Later on, from the backseat, Annalee asked if my “broken eye” was better.

“Not yet,” I answered.

“When then?”

“I don’t know when.”

“You still gotta wear your patch, daddy?”

“I do.”

“No,” she whined.

“But he won’t wear it for long,” Lynda said. “Only until we take daddy to New York City and get him all better.”

“Yay,” Annalee cheered.

The radio was tuned to a news station. It was the start of a new hour, and an anchor read headlines, “US admits Afghan withdrawal should’ve started sooner, IRS unveils 80-billion dollar plan to overhaul tax collection, Tennessee GOP punishes two Democrats…” I rested my ear against the door. Its window was rolled down and the wind whipped against my forehead. Through the smudged side-view, my eyes stared back at me. What if I’d been forced to wear that patch as a baby, screaming through the whole thing? Would I have been a more-confident child and teen? A stronger husband? A better father? There’s no way to know. It didn’t happen. And now, at forty-three years old, my left eye is still the story in my life.

“I’ve never been so hungry,” I said. “Hang on,” Lynda said, “we’re almost there.”

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