‘I Can See Clearly Now’ — An American cautionary tale

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A selfie photo of the writer, taken three days after he had undergone his left eye cataract procedure at the SGH in Kuching.

JOHNNY Nash’s hit song ‘I Can See Clearly Now’ has been playing in my head ever since I had my second (left this time) eye cataract procedure at the Sarawak General Hospital (SGH) last Saturday.

I have been wearing correctional spectacles for both eyes since about my early 30s, which means almost over four decades of being ‘four-eyed Joe’ since around the 1980s.

I eventually had my first cataract procedure done last June 19.

The results, to say the understated, were amazing!

I had to wait for full two months for my left eye surgery due to various personal reasons, but at long last, clarity is the end result. I recommend anyone with such an ailment to proceed to see his ophthalmologist for a consultation if he is suited and ready for this procedure.

Briefly there are two main kinds of eye specialists – an ophthalmologist and an optometrist. If you are confused, here is how they are different although they do work together and a team approach is usually the best option going forward.

An ophthalmologist offers medical and surgical eye care: he would have gone to medical school and be able to perform vision services including eye examinations, medical eye care for conditions like glaucoma, iritis and chemical burns; surgical eye care for trauma, crossed eyes, cataracts, glaucoma and other problems; diagnosis and treatment of eye conditions related to other diseases like diabetes or arthritis; and plastic surgery, namely to raise droopy eyelids or smooth out the wrinkles.

On the other hand, an optometrist takes care of primary health care of the eye: some do specialise. Normally they perform eye examinations, vision tests, and prescribe and fit eyeglasses and contact lenses. They also monitor medically-related eye conditions like dry eye and glaucoma, and provide low-vision aids and vision therapy.

Unlike, say in the 1990s when there were only a couple of private hospitals and clinics and eye specialists to supplement SGH’s Medical Department’s Specialist Clinic where they would have a dedicated eye clinic with its complementary ‘Eye Day Care’ ward and standard ward, you will find a wealth of dozens of private clinics that specialise in both these disciplines today (ophthalmology and optometry).

On top of that all the ‘Big Four’ privately owned and operated public hospitals, namely Normah Medical Specialists Centre, Timberland Medical Centre, Kuching Specialist Hospital and Borneo Medical Centre, have their own eye specialists in-house and they all offer excellent services to those who can afford.

Our own public health system offers one of the world’s best, most efficient and professional services, and of course since any and every Malaysian citizen is qualified to make use of such comprehensive services, the queues can often be lengthy and daunting.

Their priority too is another consideration: they will ensure that the most needy and serious cases get attended to first, as is rightly so. So there can be quite the waiting game here.

But if you are willing to wait in line, then also be prepared for a most pleasant surprise when you land yourself with their government invoice after your procedure, to find that you have made a rather massive saving compared to what you can expect to pay at a private facility.

It is basic capitalism at work here, guys!

As to be expected there are bound to be pros and cons to both – private and public medical services.

From my own personal experience I can tell you that with public health service, you will often get different specialist/doctors attending to you; even your actual surgical procedure may not be undertaken by your regular attendant doctor.

However, it also means that you also get a range of consults/examinations and varying diagnosis and analysis from more than just one doctor’s single account and opinion.

When you see a private practitioner, it is usually just that one and the same doctor attending to you, from the beginning till your discharge as well as your after-care. Unless, of course, he had decided for one reason or another to bring in a second or third opinion; at which point it would also be added on to your final bill.

It all adds up!

With my own both eyes cataract procedures, I found that the most difficult decision that I had to make was on the choice of the ‘new replacement lens’.

There are three types of lenses for cataract surgery – monofocal, toric and presbyopic-correcting, and you have to decide which one suits you best.

I would recommend that before you decide, you have a lengthy in-depth discussion with your specialist doctor and come to a well-thought out decision.

It is also very important that you listen to and abide by all the instructions given to you after the surgical procedure as it will take time for your eye to heal properly.

There are many normal everyday rituals and habits that you are not allowed to do and perform.

Nowadays, there is always Google out there to guide you as well.

I am extremely happy that way back in April this year, I had made the right decision to go for both cataract procedures and having gone through both by now, I can and will readily recommend this procedure if you are thinking about it right now.

Oh yes, I definitely can see clearly now! Thanks be to God!

An American Cautionary Tale

One of last year’s most watched and most awarded television series was Hulu’s ‘Dopesick’, which had the tagline “’Inspired by the true story of how America got hooked on a lie’.

It had won the Golden Globe, Emmy and for Michael Keaton the coveted Screen Actors Guild Award for Best Actor.

I was hooked for over eight hours 12 minutes (it was an 8eight-part series) and had binge-watched the entire series over two nights.

On Aug 10, 2023, Netflix had premiered ‘Painkiller’, a six-episode series lasting four hours 46 minutes using the same storyline, from a slightly different perspective and based on best-selling author Patrick Radden Keefe’s book called ‘Empire of Pain’.

I had bought the book late last year, and had just finished reading it.

In reviewing the book, TIME Magazine had said:
“An engrossing and deeply reported book about the Sackler family, the owners of Purdue Pharma. Their company created oxycontin, the opioid introduced in the mid-90s that sent a wave of addiction and death across the country. The book focused on the wildly rich, ambitious and cutthroat family that built its empire first on medical advertising and later on painkillers.

A most revealing book, ‘Empire of Pain’ by Patrick Radden Keefe, from which the TV series ‘Painkiller’ was based on.

“In Radden Keefe’s hands, their story becomes a great American morality tale about unvarnished greed dressed in ostentatious philanthropy.”

Until a year ago I had never heard of oxycontin and had never heard of the Sackler family.

So I checked with and asked around my own circle of friends and family within the medical community about oxycontin: some of the local pharmacists and practising GPs and doctors.

Thank God for our extremely strict and tightly controlled drugs and pharmaceutical ordinances and their enforcement, I had gathered that we never had any issue with oxycontin, although it is still available mainly as a prescribed painkiller for cancer patients.

It would appear that our problems and issues with drug addiction are more towards the illegal use and abuse of amphetamines, methamphetamines, cough syrup and tablets with codeine and dextromethorphan.

All of us have used painkillers at various times and stages of our lives and the usual common ones that are safely available over-the-counter (OTC) without any prescription would be paracetamol, ibuprofen, aspirin, naproxen, acetaminophen, codeine and others similar to them.

Anything stronger than this like opioid analgesics, morphine, hydromorphone and oxymorphone are, of course, only available upon prescription and for very specific uses only.

If you have an interest at all in morals and business ethics and how systems and bureaucracy can be manipulated and corrupted in a supposedly ‘First World Nation’ like America, you won’t need to look further than just sit down, search for and watch these two highly-recommended television series, ‘Dopesick’ and ‘Painkiller’.

Better still, read ‘Empire of Pain’ to be shocked and awed and totally disgusted with how greed, manipulation and a total disregard for the sanctity of human lives can be disregarded with such ease and a total lack of conscience.