From Darkness to Sight

by Ming Wang

  I was sweating from the severity of the situation. I had to do everything I could to prevent this disaster from happening. My heart pounded as I moved quickly and decisively. Finally after an intense moment, during which I felt I wasn’t even breathing, I was able to successfully reposition the content back into the eye that was threatening to come out.

  I paused and took a deep breath of relief. At least the eyeball itself was saved, for now. I asked a nurse to wipe the beads of sweat from my forehead, and give me a sip of water. Francisco was still sleeping deeply under general anesthesia. Looking at his young face, images flashed through my mind of myself at the beginning of my own long journey out of the darkness of the Cultural Revolution. Over the decades of medical training and growing faith, I knew without a doubt that I had been called and was equipped to help blind kids just like Francisco. I had experienced my own darkness when I was his age, and now with everything in me, I wanted to pull him out of his darkness into the light.

  With a bit of rest, and renewed determination and mental clarity, I resumed Francisco’s surgery, starting with the risky process of trying to remove the old graft, while doing all I could to avoid repeating the problems experienced in the last attempt. I tugged delicately and slowly at the old graft, elevating and gently pulling it, like the ancient Chinese micro-sculptors did when they would carve a line of poem in Chinese characters onto the side of a strand of hair. After what felt like an eternity, the old graft was finally separated and removed from the underlying tissue. I then removed the cataract, implanted an intraocular lens, sutured the new cornea into place, and transplanted adult stem cells around the new cornea. After four long hours, the unprecedented and intense quadruple-step surgery was finally completed, and Francisco’s eyeball was saved. I dropped my shoulders and exhaled.

  The following morning, Francisco returned to my clinic with Carole and Clementina to find out the results of his surgery. Both Carole and Clementina were unusually quiet and looked as if they had been carrying the weight of the whole seven-year journey on their shoulders for longer than their strength could bear. I felt anxious, not knowing whether my best efforts had been enough to save this teenager’s sight.

  Before I removed the bandage from Francisco’s eye, we gathered in a circle and held hands—a Dominican former nun, a Mexican mother and son, and a Chinese-American doctor—and we prayed.

  “Dear God, we know you have the power to heal this young boy who has lived in darkness these last seven years,” I said softly. I had done my utmost, and I had no idea if God would allow Francisco to see again, but I trusted Him. “Thank you, God, for bringing us this far. Thank you for Francisco and his courage. Thank you for all that Carole and Clementina have done for him. God, please help us to accept whatever your will is for this outcome. Amen.”

  I reached forward and peeled back the tape to remove Francisco’s bandage.

  He opened his right eye slowly, blinked and looked around in bewilderment. Then a broad smile appeared across his face.

  “Can you see?” I asked.

  He nodded. “Who do you recognize in the room?” I added.

  Francisco looked around. He didn’t recognize me or Carole, since he had only known our voices over the past several years. Only one person in the entire room of a dozen people had been part of Francisco’s life before he became blind seven years earlier.

  “My mother,” he said.

  I turned toward Clementina, who was standing in a far corner. She burst into tears, made her way to Francisco and embraced him tightly.

  Carole jumped up and down, her hands raised up toward the ceiling, and thanked God over and over.

  I let out a huge sigh and said my own prayer of thanks. We had made it!

  Francisco could now see!

  After years of many failed surgeries, this final and critical microsurgery was the one that was finally successful! In the ensuing several months, Francisco’s vision in his right eye improved to 20/40. He threw away his Braille books and replaced them with regular school books. He could now go on to live more independently than ever before.

  After seven years of being locked in darkness, Francisco came into light. He got his life back, he was overjoyed with happiness!

  While I helped restore Francisco’s sight, he also gave me something very precious in return. Back in Chapel Hill with his newfound sight, Francisco read about my life story online, about the hardship and danger of the Cultural Revolution that had threatened to destroy me when I was around his age. Francisco then shared with his high-school principal how my education had been cut short at age 14, how I faced deportation, poverty, and hard labor, how I later fought hard to get into college after years of no education, and in all the chaos, how I never actually received my high-school diploma back in China.

  “Dr. Wang helped me wake up from my long sleep of darkness,” Francisco told the principal. “In return, can we give him the one thing he deserves but has never received, a high-school diploma?”

  So in 2000, twenty-three years after finishing high-school in China, I finally received my diploma, an honorary graduation certificate from Chapel Hill High-school in North Carolina.

  It now hangs on the wall in my office, right beside my undergraduate and graduate degrees. More than a piece of paper, these certificates represent to me the blessings that I have experienced against so many odds. From college in China to medical training in America, influences from both the East and the West have made me who I am today. I have realized that life is truly a circle of give and take, and of helping and allowing yourself to be helped by others.

  On a wall in the Wang Vision Institute hangs another special memento from Francisco, a plaque with a thank-you note in Braille at the top (the last time he ever used Braille) and below it, a thank you note in Spanish (the first time he had written since before his accident seven years ago).

  Out of my gratitude for all the opportunities this country has offered me, I waived my surgeon fees for all of Francisco’s surgeries, and out of his gratitude for sight, Francisco helped me complete a missing link in my own education. His gift was and still is special to me, and every time I look at it, I think of the wooden plaques that grateful patients had given my grandfather back in China some seventy years ago, and I’m proud to know that I’ve followed in his footsteps down this very rewarding path of helping the needy.

  * * *

  I experienced a revelation through caring for Francisco. I found that nothing excited me more than witnessing a patient emerge from darkness into sight. This ability to change people’s lives was both a heavy responsibility and an immense blessing that I got to enjoy nearly every day I went to work.

  After Francisco, I had many other cases like his, but insurance companies weren’t willing to pay for these experimental sight restoration surgeries. Not everyone had a special person like Carole in their lives, who had gone above and beyond to raise money for Francisco’s care. Even though I waived all my fees as the surgeon, there were still other expenses involved, such as lab testing, donor tissue, surgical facility and travel and lodging cost.

  After five successful years at Vanderbilt, I took a step back and looked at the bigger picture. It became increasingly clear to me that God had a purpose behind the suffering of my early years in China, and the incredible trajectory of my career since then. After twenty-five years of education, training, and clinical practice, I was now in a position and had a unique set of skills that could make a significant difference in other people’s lives, people who had been told there was nothing more that could be done to restore their sight.

  I wanted to donate my medical care to more patients like Francisco, but working at a large university meant that I didn’t have much say in the matter. I wasn’t the owner of the business—I was merely an employee—so I couldn’t waive charges to deserving patients at will. As long as I worked for a larger institution, I was constrained in how much charity care I could offer. However, if I started my own private practice, then it would
be a different story.

  So on April 1, 2002, I left the university and opened my own business—Wang Vision Institute (WVI)—in the Palmer Plaza on West End Avenue, near downtown Nashville. Our practice focuses on highly customized laser vision correction, cataract surgery, and complex sight restoration procedures, always using the most innovative technologies available. In 2002, WVI became the first center in Tennessee to offer bladeless all-laser LASIK, which improved the accuracy and precision of LASIK to an unprecedented level. WVI has since been the site of many other groundbreaking eye surgeries, including the world’s first 3D LASIK procedure and laser-assisted artificial cornea implantation, the country’s first laser Intacs procedure for advanced keratoconus, and Tennessee’s first 3D laser cataract surgery, 3D Laser Kamra procedure, and 3D Forever Young Lens surgery. Besides my paper in the world-renowned journal Nature, I have also published eight textbooks regarding the corneal and lens surgeries and hold several U.S. patents for inventions of new biotechnologies to restore sight. My work was recognized with an Achievement Award from the American Academy of Ophthalmology and a Lifetime Achievement Award from the Association of Chinese American Physicians.

  Starting a private practice wasn’t just about more freedom—it was a calling. My discovery of faith through hardship reinforced the notion that everything I had been given held the larger purpose of helping those most in need. With my dual specialties in laser physics and ophthalmology, I feel blessed to have had a unique opportunity to conduct research to develop novel laser eye treatments for even the most dire cases.

  As my practice grew, people started contacting us from nearly every state in the U.S. and from countries around the world. I have performed more than 55,000 procedures, including over 4,000 on fellow doctors, which earned me the distinction of being the “doctor’s doctor.” Since many of the critically injured patients I saw had been to other surgeons who told them that they would never be able to see again, I became these patients’ last resort, something I didn’t take lightly. But many of them did not have insurance, nor the finances to pay for advanced care. The success of my private practice allowed me the freedom to provide such care, but I couldn’t do it alone. I needed an organization and a team to help me realize my vision of offering free sight restoration surgeries to those who needed them the most, but couldn’t afford them.

  So in 2003, one year after I started my private practice, I created the Wang Foundation for Sight Restoration, a 501(c)(3) nonprofit organization. The foundation enabled me to organize a group of doctors who could each devote a small portion of their time to caring for charity patients. This care would represent a commitment of only five percent or less of a participating physician’s overall clinic time. Nearly thirty doctors signed on to help, many of them inspired by their faith and intrigued by the technology available for these complex sight restoration cases. In addition to the volunteer doctors, medical companies donated supplies, and a board of directors of the foundation consisting of community philanthropic leaders helped to ensure adequate funding for our activities.

  The first Wang Foundation for Sight Restoration patient was Joel Case from Crossville, Tennessee. Joel was in his early forties and had been blind since he was young. A rubella infection in utero had scarred both of his corneas so badly that they were cloudy white, which meant that from birth onward he would look at the world as if through wax paper. In his earliest years, Joel could see the big “E” on the sight chart, but by the time he was eight years old, he could only perceive light and shadows. His mother, Anna, had taken him all over the United States to major hospitals, and Joel underwent several transplant surgeries on both of his eyes, but with no success. Joel’s doctors told him that he would never be able to see again. Though he had been deprived of sight his entire life, he lived independently and worked alongside his father in the family vending business.

  Joel first came to see me in 1997. His eyes were covered in white scar tissue, ribboned with tiny blood vessels. He had already suffered a retinal detachment in his right eye, so his only hope for restored vision rested on treating his left eye. Over the next several years, I performed three major surgeries on that eye, including a corneal transplant and two amniotic membrane transplants, but Joel’s immune system rejected the transplanted corneas. I held onto hope, however, because I had been witnessing medical treatments advance enormously in recent years. By 2003, an artificial cornea had been invented, and I was anxious to see if the new technology could benefit Joel.

  In early 2004, eight years after I started taking care of Joel, he came in for a checkup and made an exciting announcement.

  “I’ve found the love of my life,” he said. Joel introduced me to Beth Ann Dahl, a darling young lady. “I love her, and I’m going to marry her.”

  I realized that Joel had actually never seen Beth Ann. I was moved by their love for each other, particularly that of Joel for Beth Ann, since his feelings could not have been based on any physical attraction having never seen her. I was happy Joel had found someone with whom he could share his life. Their wedding would be eight months later, in September of 2004. I began to think how marvelous it would be if we could restore Joel’s sight before his wedding day. I wanted Beth Ann’s groom to see her walk down the aisle, beaming in her beautiful wedding dress. Was that possible now that we had artificial cornea technology?

  I was thrilled to tell Joel that after years of testing, the U.S. FDA had finally approved AlphaCor, a new artificial cornea implant designed especially for patients whose eyes had rejected traditional corneal transplants … patients just like Joel. Artificial body parts reduced the chance that the body’s immune system would reject them, which was the number one issue with organ transplantation and was precisely why all Joel’s previous corneal transplants had failed. The artificial implant was clear and flexible, and resembled a small contact lens. Joel would become our foundation’s first patient, and the first in the state of Tennessee to receive this new artificial cornea. If the surgery was successful, Joel might be able to finally see the world around him, and most important of all, he’d see his bride, Beth Ann, at their wedding!

  We discussed the surgical plan, which was to create a pocket in his cornea and embed the artificial cornea. Next we would wait three months for his eye to heal around the implant, and then remove the outer flap of the corneal pocket so Joel could see through the new cornea. Joel and Beth Ann were both thrilled and decided to proceed with the artificial cornea surgery.

  Unfortunately, I was unable to complete the surgery because, during the surgery after I removed the scar tissue, I could see through the microscope that his cornea was too thin and misshapen to withstand any blade dissection in order to create the pocket for the artificial cornea. The irregular and unevenly thin cornea meant that I had to completely abandon the blade pocket dissection. I didn’t dare cut any further, for fear of perforating his eye and causing him to possibly lose the only eye that he had left.

  After the aborted surgery, I met with Joel, Beth Ann, and Anna to explain the situation.

  “I’m so sorry, but I couldn’t proceed with the surgery as I had planned because Joel’s cornea is just too thin and irregular, so it would have been unsafe to move forward with blade dissection to create the pocket for the artificial cornea,” I said.

  We were all very disappointed, but none more than Joel, who realized that even though the new artificial cornea technology was available now he still would not be able to benefit from it and hence still wouldn’t be able to see after more than forty years,

  “I have another idea,” I said, “but it might be a long shot.”

  I explained to Joel and his family, who were now very intrigued, that I had the only bladeless laser eye surgery device in Tennessee, a femtosecond laser, which has an ultrashort pulse and replaces the microkeratome, a surgical blade typically used to cut into the cornea. I believed the femtosecond laser would be much more precise in the pocket creation and would allow me to much more safely control the l
evel of cutting than is possible with a blade.

  While the idea sounded wonderful, there was a catch—no one had ever used the femtosecond laser for the purposes of creating a corneal pocket and implanting an artificial cornea!

  So if we did choose to use this powerful new laser instead of a blade, Joel would become the world’s first patient to undergo a laser-assisted artificial cornea implantation. The thought of being able to utilize a laser in such an innovative manner to possibly bring Joel’s sight back brought me an immense feeling of gratitude and hope. Back at the University of Science and Technology of China and the University of Maryland, I would have never guessed that my years of training in lasers would one day be so useful in medicine. I now understood why God had allowed so much hardship and learning in my life throughout my early years. I believe He wanted me to not only build character, resilience, and resourcefulness, but also to learn both parts of the knowledge to treat patients like Joel successfully, namely both technology and medicine. I also realized that treating these patients, for whom all traditional technologies had failed, was God’s calling for my life. I could now possibly help Joel and other terminally blind patients by combining medicine with the laser technology that I had spent decades learning.

  I explained to the Case family the high risk involved with this laser artificial cornea surgery as it had never been done before, so even though Joel was excited about the idea, I asked him to go home and think about it carefully. Throughout that weekend, I thought a lot myself about Joel and the procedure. His left eye was his only hope, but because of the thinness and deformity of his cornea that we have just discovered, the surgical risk was now even greater than I had originally anticipated. If anything went wrong—with either the new laser or the surgery itself—Joel could lose his already very limited light-perception vision in that eye, which was all what he had left. The surgery could only go one of two ways—it would either be a success, and Joel then might possibly be able to see after forty years, and see Beth Ann on their wedding day, or it would be a failure, and then Joel would be thrust into pitch darkness for the rest of his life.