by Ming Wang
After nearly twenty years of laser physics and medical training, I was now working in and contributing to my chosen medical field, just as my father, mother, and the long line of doctors in our family had done. I felt deep gratitude that I was continuing this honored family tradition of healing.
I arrived in Nashville, Tennessee as the newly appointed director of the Vanderbilt Laser Sight Center. My job was to build the center from the ground up. During my tenure at Vanderbilt, I performed the first LASIK procedure in the school’s history. For about five years, I served as a consultant to the FDA Ophthalmic Device Panel for the first LASIK approval in the U.S. and worked for the FDA on approvals for a wide range of innovative refractive surgery technologies. I later started my own practice and became the first surgeon in the state to perform bladeless all-laser LASIK, then laser cataract surgery, and most recently the laser Kamra procedure.
Before I moved to Nashville, I didn’t know much about the city besides its reputation for country music, but as I settled into my new life, I grew to really like the area. The scenery around Middle Tennessee reminded me of my hometown of Hangzhou, with its rolling hills, deep valleys, rivers, and lakes. When I first arrived, Nashville was still a small city centered almost entirely on West End, which turned into Broadway on its descent into a kitschy, neon downtown full of honky-tonks and souvenir shops. But I loved that there also seemed to be churches on almost every corner. Between my work at Vanderbilt and my life in this Christian community, I saw not only opportunities for professional development, but also for personal and spiritual growth. Now I just needed to convince Gwen to move to Nashville.
By 1997, Gwen and I were into the third year of our relationship. I was certain she would love the warm weather and Christian community in Nashville. She could find a job as an ophthalmologist, perhaps in my own department at Vanderbilt, and we could finally be together without the control of her parents.
While I was trying to convince Gwen to move, she was having major discussions with her parents. She didn’t mention all the details, but I could tell the arguments were intense. No matter how much our relationship solidified, one thing would never change—I could never stop being Chinese—and as long as I wasn’t Caucasian, her mother’s attitude toward us wouldn’t budge. Despite her mother’s continued objections, Gwen and I wanted to get married, and we continued to move slowly but surely in that direction.
In October of 1998, a little more than a year after my move to Nashville, Gwen and I decided to get engaged. We went ring shopping while we were both in Chicago for an ophthalmology meeting. The one we both loved the most had a beautiful round diamond weighing a little over a carat, set in white gold. Unfortunately it was way beyond what I could afford at the time, as I had just started my first job, and was paying heavily on student loans.
We stood there staring down at the rows and rows of diamond rings, sparkling against the darkness of the black velvet-lined glass cases.
“I’ll buy it first, and you can pay me back later!” Gwen suggested.
I looked at her, partly shocked and partly amused. “What? Are you sure? Why don’t I just save up for it? You still haven’t even announced this to your mother anyway.”
“I know you’re just starting out, but I’ve been working for several years now so I can do this.”
“It’s not very manly of me, you know.”
But Gwen was eager. She obviously wanted this marriage as much as I did. I was moved by her gesture, and I felt convinced that she was as committed to our being together as I was. Gwen bought the ring, and I promised I would pay her back as soon as I could. We were both thrilled to be so close to an official engagement. I reflected back on seeing her years ago in the elevator at Wills Eye Hospital, meeting up with her after her trip to China, and keeping our long distance relationship alive from distant corners of the country. After nearly five long years filled with love and pain, joy and stress, it looked like we were finally going to make it!
Following the trip to Chicago, I wanted to give Gwen some space to discuss the impending engagement with her mother. I knew the ordeal put a strain on her, and even though we had already bought the ring, she still wouldn’t fully commit until her mother had given us her blessing.
I didn’t see Gwen again until November, a month later. We met in Columbus, Ohio for a dance performance that I’d told her she just couldn’t miss. At the Columbus airport, we stood there holding each other closely before I headed back to Nashville. I was about to be late for my flight, but she didn’t want me to leave. Her face was streaming with tears, cutting streaks through her makeup and causing her mascara to run down her cheeks. I couldn’t understand why she was so emotional, but she looked beautiful—albeit comical—with her messed up makeup. I stopped to take her photo before I rushed to catch my flight.
It turned out to be the last photo I would ever take of her.
After that visit, she stopped talking to me and wouldn’t return my calls. I wanted to go up to Ohio and find out what was wrong, but I waited. I wanted to give her time, but I was also afraid to know the truth. After weeks of silence, Gwen finally reached out and confirmed what I had feared all along.
One day in January of 1999, I received a bulky letter in the mail. When I opened it, I found a long, crumpled letter written in Gwen’s handwriting, page after page smeared with tear stains. She wrote that she couldn’t marry me after all—not without her family’s blessing—and her mother simply would not give her consent. After nearly five years, she didn’t want to keep my life on hold anymore, nor cause any further hurt for me or for us.
It was over.
The very first letter I had received from Gwen back in Philadelphia when she returned from China in 1994 had been so full of promise … and her last letter dashed all hope.
Five years gone, just like that. Five years of enduring her parents’ objections to our relationship, all because I was an ethnic minority and not Caucasian. I felt so defeated. Throughout those years, Gwen and I had arrived at several moments where we were ready to give in to her parents and give up on our relationship. But our love was stronger than the challenges, and we had fought against her parental objection and persisted through them all. After we bought the ring, I thought we had finally figured things out. Gwen seemed resolved to marry me in spite of her mother’s hostility toward me.
We had come so close, so close! The expectations that had been mounting, the hope of finally being together, came crashing down. I was awash in grief.
A few days later, I received a very different type of letter. This one was from the U.S. Patent and Trademark Office, notifying me that I had been awarded the first of two patents for my amniotic membrane contact lens invention. A process that had been conceived more than a decade ago in medical-school, for the good of all my future patients, was finally coming to fruition. I approached Vanderbilt University about starting EyeVU—a joint-venture biotechnology company—to create prototypes of the lenses, with the hope of an eventual commercial launch.
The two letters—from the patent office and from Gwen—rested on my desk for months, representing two extremes of emotion from elation to despair. Between the two letters, hovered the memory of my dinner conversations with Gwen’s father, who had given me so much encouragement to keep moving forward with both science and faith. God had finally granted me the wisdom I needed, but it was bittersweet because I longed to be at Gwen’s family table again, sitting across from her father as his son-in-law, sharing the good news about how we had persevered until we found the solution to our moral dilemma with fetal tissue research, and now we were enjoying victory with the amniotic membrane contact lens patent.
But now that would never happen. I would never be able to tell Gwen’s father that he had been right all along.
I didn’t write Gwen back, and I never called, no matter how much I missed her. I knew her mother wouldn’t ever change her mind. At first I couldn’t understand how Christians could discriminate against others like that
. Christianity was supposed to be a religion rooted in love, so such blatant prejudice seemed downright ungodly. But when my relationship with Gwen failed, I came to a painful realization that the faith itself—and how people live out that faith—can sometimes be two entirely different things. Just because Gwen’s mother was controlling and unloving didn’t invalidate the Christian faith that the rest of her family and I shared. Learning to separate the faith itself from the behavior of some believers was a slow and painful process, but it also inspired me to live out my own Christian life more honestly, to be more open, and to embrace people different than me. I resolved that I would never treat anyone in such a discriminatory and unloving manner, no matter what a person’s ethnic background was.
While my relationship with Gwen didn’t culminate in marriage as I had hoped, the sense of failure was as poignant and arduous as it was at the end of my first marriage. Though the reasons for the failure of those two relationships were very different, my coping mechanism was the same—I retreated into the refuge of work. My research and clinical practice were more measurable and controllable, and less disappointing than the messiness of relationships.
While my romantic relationships seemed to always end in heartbreak, my work on the other hand had lasting and positive effect on people’s lives. It was through my patients that I would find my true calling and a certain selfless drive that ultimately would lead to love. One specific patient, a Mexican teenager named Francisco, altered the course of my career and he gave me a gift that I thought I would never be able to receive.
Part Four
Giving Back
Chapter 15
The Sight Foundation
“He’s been blind since he was ten,” said the woman on the other end of the line. “A chemical burn severely damaged both of his eyes. It’s really tragic. He’s already had surgeries at several major medical centers, all of which have failed, and doctors have said there’s nothing more they can do. But I’ve heard of your groundbreaking work and thought you might be able to help.”
It was the summer of 1999 when I received that call from Carole Klein, a former nun who taught visually impaired students at a high-school in Chapel Hill, North Carolina. She told me about one of her blind students, Francisco Salazar, a seventeen-year-old from Mexico whose mother, Clementina, had brought him to the States in search of a miracle to restore his eyesight. After multiple failed surgeries, numerous doctors had told them that Francisco’s eyes were beyond repair, but Clementina refused to give up hope.
Carole related to me what had happened to Francisco. Seven years ago in his hometown near Monterrey, Mexico, Francisco and a cousin were walking past a drainage ditch near a factory, when they came across a shiny glass bottle that stood out like a gem among trash. When Francisco pulled the stopper from the mouth of the bottle, sulfuric acid streamed out. When the acid hit the water in the ditch, it exploded into a gas cloud that seared both of Francisco’s eyes. He was blinded instantly.
Several months later, an ophthalmologist in Mexico City performed a corneal transplant on Francisco’s left eye, but its restored sight lasted only two days, and the cornea soon clouded over. His right eye was deemed too damaged to be repaired. Now permanently blind, Francisco retreated into himself over the next several years, no longer the fun-loving, outgoing boy he once was. Clementina, a woman of deep faith, was determined to save her young son’s eyesight. So in the spring of 1998, she and Francisco came to the U.S. to seek medical help. They joined relatives in Chapel Hill, North Carolina, carrying about as much luggage and cash as I did when I first arrived in the U.S. in 1982. Hearing their story took me back to my earliest days in America, when I was trying to find my way in a foreign land. Deep down, I could relate to Francisco’s struggle, and I was moved by his mother’s love and resolve.
In North Carolina, Clementina met Carole Klein, who was so taken with Francisco’s tragic situation that she began helping his mother search for possible restorative medical care for him. A local surgeon who examined Francisco said that the injury from the chemical burns was too severe to proceed with any restorative surgery. He directed them to a surgeon at Duke University, but that too turned out to be a dead-end, as he too felt Francisco’s eyes were damaged beyond repair. There was no chance for the left eye, and since the right eye was so badly damaged, if he received a corneal transplant in that eye, it would soon scar over with an aggressive regrowth of dense blood vessels and become blind, just like his left eye had done back in Mexico City.
“What he needs is a rare and special microsurgery,” advised the surgeon from Duke. “But only three doctors in the country perform this procedure. We recommend the one in Nashville.”
That’s when Carole called me. “You are our last hope,” she said.
I told her I would do my best to help. I was anxious to meet this young man, so I asked them to come to Nashville as soon as possible.
They arrived a week later. I examined Francisco’s eyes and discovered that his left eye, which had already received the failed corneal transplant, had already shrunk. It had no light perception and was indeed irreparable. So our only hope was to try to restore sight in his right eye, which could only see light due to severe scarring and blood-vessel growth. The special microsurgery, which was what the Duke doctor was referring to, would involve a complex stem cell transplantation. However, it would be extremely risky in Francisco’s case because if it failed, the right eye would shrink just as the left eye had, and Francisco would be plunged into total darkness for the rest of his life. As Carole translated, I explained to Francisco and his mother the difficulty of this special microsurgery, the limited benefits, and the risks. After praying together, Francisco and Clementina decided to proceed.
I resolved to do my very best as an eye surgeon to help Francisco.
As he sat across from me, I told him honestly, “Your sight restoration process will be a very long and difficult journey, like walking all the way from Nashville to New York City on foot. But I’m going with you every step of the way.”
By this point in my life, I was quite acquainted with long, hard journeys, so I knew I would honor the promise I made to Francisco.
On August 11, 1999, three weeks after his initial eye exam with me, Francisco returned for the first stage of surgery on his right eye. I removed the scarring and blood vessels that had formed over his right cornea, and sutured an amniotic membrane in place to prevent his eye from scarring again as the tissues were healing.
Francisco was then to return to Nashville a few months later for a corneal transplant and stem cell graft from adult donor tissue, but before we had a chance to perform the surgery, things went horribly awry. The chemical injury had damaged his right eye so badly that the cornea actually perforated, producing tiny yet dangerous fluid leaks. Consequently, we had to perform two emergency corneal transplants in his right eye within a matter of months just to salvage the eyeball itself. As we anticipated, vascular scar tissue quickly grew over the eye again in the same disorderly scarring process that had repeatedly blinded countless number of patients with such severe corneal injuries.
At this point, the only way we would have any chance of restoring sight in Francisco’s right eye was to perform a complex corneal stem cell transplantation surgery, a procedure which was only being performed in a few centers in the country. The stem cells are found in a ring of tissue that surrounds the cornea, and they are the key to the eye’s ability to heal. The chemical burn in Francisco’s right eye was so severe that it had destroyed all of Francisco’s own corneal stem cells, which was why his eyes healed abnormally with such aggressive, repeated formation of scarring and blood vessels. Though the odds were against us, we were able to successfully perform the surgery, and for several months it seemed that his eye might actually heal and his vision finally be restored.
But by late November of 2000, Francisco’s eye was rapidly deteriorating again. On Friday, November 24th, I told Carole and Clementina to bring him back to Nashville so w
e could attempt an unprecedented quadruple-step surgery that would include another corneal transplant, another corneal limbal stem cell transplant, a cataract removal, and an intraocular lens implantation. Francisco and his family arrived the following Friday, and we scheduled the procedure for the next Tuesday.
“Where will the donor tissue come from?” Carole asked.
As I considered her question, an eerie feeling crept over me.
“I don’t know yet,” I admitted. “Since the corneal transplant is scheduled on Tuesday, we’ll get the fresh tissue on Monday, which means the person destined to donate his or her eyes to Francisco is still alive right now.”
On Tuesday, as Francisco was prepped for surgery, I waited anxiously for the shipment of donor cornea. At 8:00 am, the air-freighted shipment finally arrived. When I looked at the return address, another chill went through me. The donor was a twelve-year-old boy from Chapel Hill, North Carolina, the very city from which Francisco had come. The moment was charged with a sharp duality of feelings. I was immensely grateful for young tissue to restore Francisco’s sight, but also deeply saddened that his hope came through the tragic loss of someone else … from his own local community.
With the donor cornea tissue in hand, we could now finally begin this groundbreaking quadruple procedure. The surgery began well, but halfway through, something unexpected occurred. The assisting surgeon and nursing staff grew very quiet and tense as they witnessed an impending disaster unfold on the large monitor. As I attempted to remove the old corneal graft, the inner matter of Francisco’s eye clung to it stubbornly, threatening to spill out. If this occurred, there would be no possibility of reconstructing the eye at all, and all hope for any sight in his right eye would be permanently lost.