by Ming Wang
The magnitude of that responsibility weighed heavily on me. But just as I had done at other crucial times in my life when my own capabilities did not seem to be sufficient, I sought God’s guidance and strength.
“God, what should I do? Should I allow Joel to take this risk?” I prayed repeatedly throughout that weekend.
By Monday a peace had come over me, and I sensed that God had answered my prayer. I felt confident that laser artificial cornea surgery was the right thing to do. Joel returned and decided to proceed with the surgery, fully understanding the risks involved. The historic femtosecond laser part of the artificial cornea procedure went beautifully. Joel was then immediately transferred to St. Thomas Hospital for the implantation of the artificial cornea, which also went well.
So the first two steps of the world’s first laser-assisted artificial corneal implantation were a complete success. Three months later, Joel returned for the final step of the surgery—the removal of the corneal pocket’s outer flap, which would hopefully allow him to now see through his new artificial cornea.
The day after the surgery, Joel, Beth Ann, and Anna returned to my office for Joel’s post-op visit. Just as we had done with Francisco, we stood in a circle and held hands to pray before removing Joel’s bandage. I felt that my inner strength alone was insufficient to cope with the consequences of the surgery’s outcome, so I asked God again to help us all accept His will, whatever it would be. I submitted my will to God and I was at peace.
I slowly peeled off Joel’s bandage, feeling both nervous and excited. I had been treating Joel for more than eight years by then, but I knew that his own journey out of darkness had lasted more than four decades, and now the moment of truth was here.
Joel opened his left eye tentatively, then looked around, blinking rapidly. Suddenly a smile burst across his face as he cup his hand over his eyebrow and gazed out the window.
He could see! I anxiously pushed Beth Ann toward him. He turned and saw his future wife … for the very first time.
“Ah, you have brown hair!” he squealed. “And you’re beautiful.” They hugged and both cried with joy.
As Joel looked around the room, he was deeply moved when he finally recognized his mother. Anna walked over and put her arms around him. Since losing his sight, he hadn’t seen her in more than thirty years. She had aged in all the years he was shrouded in darkness, but love transcends time, now Joel was thrilled that he could once again look at his mother’s face and see the love in her eyes.
Joel and Beth Ann were married four months later. Unfortunately, I was out of the country on their big day, but they sent me photos. Joel gazed at his new wife lovingly in every one of them. I felt blessed that God had given me the very special honor of helping bring sight to Joel just in time for him to fully enjoy such an important event in his life.
But as I continued to look through the wedding photos, I felt a tightness develop in my chest. Although my patients were experiencing joy and happiness, those emotions eluded me at that time because my short-lived marriage to my second wife, Suyuan Liu, had failed.
I met Suyuan while she was pursuing a master’s degree in communications at a university in San Antonio, Texas. Suyuan was extremely beautiful and intelligent. She shared my ethnic background, as well as many of my interests and passions, including dancing. As soon as she completed her graduate program, she moved to Nashville. We were engaged shortly after that, and we got married in 2001. But our marriage lasted only two years.
I couldn’t believe I was facing another divorce. I had come from such a solid, devoted family and I was able to help my patients enjoy their family lives more fully, so I couldn’t understand why I wasn’t able to create a loving, stable family life for myself. I was a hard worker, an honest citizen, and a good Christian. What kind of weaknesses kept me from developing better personal relationships and building a family? It would take time for me to find an answer to that question, but not before my inner shortcomings would continue to render personal happiness an unobtainable goal.
Whenever I suffered setbacks in my personal life, I would escape by submerging myself more and more deeply into my work. I knew it wasn’t the solution to my relationship issues, but it had always been my refuge in hard times. I justified it because I was driven to succeed, and I also greatly enjoyed the entire process of helping patients like Francisco and Joel. The lengthy and exciting task of bringing someone out of darkness inspired me. Ironically, as restoring the human experience for others became all-consuming, I allowed it to repeatedly rob me of what I consider one of the most important aspects of my own life. Sadly, the second failed marriage wouldn’t be my last, and many years would pass before I would finally find strength and maturity in this area. As long as the foundation had patients to serve, I would have an outlet to which I could devote my time, while continuing my search for deeper love and meaning.
Chapter 16
A World’s First
“Wear something cute tomorrow because your husband might be able to see you for the very first time!” I said to Jackie Barnes, whose husband Brad had truly never seen her. From the start of their marriage several years earlier, Jackie had tirelessly cared for her blind husband and sought the best medical treatments available in America, all to no avail. Now, after two years of treatments at the Wang Foundation for Sight Restoration, she was hopeful that the man she loved so dearly would finally be able to see, and see her for the very first time.
I first met Brad and Jackie Barnes in the fall of 2004. Brad was in his early forties and had been blinded a dozen years earlier in an industrial accident. Behind his dark glasses were eyes so severely damaged that his eyelids looked like they had been melted shut. Ten years ago, just fifteen days before his thirty-second birthday, Brad’s life was altered in an instant as molten aluminum exploded from a container at the factory where he worked. Eleven hundred pounds of burning metal fluid, flowing at a blazing 1,550 degrees Fahrenheit blasted upward and splashed all over him, obliterating his protective goggles and severely scorching both of his eyes. He was left with near total blindness and could barely perceive light. Over the ensuing decade, he had undergone many extensive surgeries at major medical centers including Harvard, the Mayo Clinic, and Washington University, but all with no success.
Brad spent his time working with the God Squad, a group of men who performed feats of strength as a way of sharing their faith with young people. Being blind didn’t prevent Brad from smashing bricks, bending bars of metal, and tearing phone books in half. But it wasn’t just his physical strength that kept him going; he also had the love and strong support of his devoted wife, Jackie. Despite his condition, Brad fell in love and got married four years ago in 2000. His wife was dedicated to his care, and her faith inspired her to continue seeking medical help for her husband.
Four years later, Brad’s doctors at Washington University in St. Louis, Missouri referred him to the Wang Foundation for Sight Restoration. Word had spread about the work we were doing through the foundation, including the world’s first laser artificial cornea surgery I had performed on Joel Case. Brad’s doctors at Washington University had heard about the success of that surgery, which was why they referred Brad to us.
Despite our new laser technique, I feared that we still wouldn’t actually be able to help Brad, given how extreme the nature of his injury was. Although I specialized in difficult sight restoration surgeries, Brad’s case for me was at the farthest end of the spectrum. He had already been declared irreversibly blind, and his previous multiple failed surgeries made any subsequent procedure an impossibility.
His corneas were covered with flaps of skin and scar tissue so thick I couldn’t see his eyeballs at all. Additionally, his conjunctiva—the tissue that covers the surface of the eye and inner eyelid—was acutely inflamed due to severe dryness, because Brad’s tear glands had been completely destroyed in the accident. Without the tears normally secreted by these glands, there was no way the extremely dry eye would eve
r heal properly following any surgery. Additionally, Brad’s right eye was too damaged for any surgery. So his left eye, which could only barely see light, was our only hope.
“The artificial cornea implant requires a moist and stable ocular environment to support it after surgery,” I explained to Brad. “Unless we can somehow come up with a magical way for you to produce tears again, we’re unfortunately not going to be able to do any reconstructive surgery for your eye, as it would never heal after the surgery.”
Brad and Jackie had traveled a long way from St. Louis to Nashville, so the result of the consultation was very disappointing for all of us. What made the situation even worse was that Brad’s dry eyes were also causing him to be in a lot of pain. He said it felt like glass was constantly cutting his left eye. So if we couldn’t come up with a way to provide sustained lubrication to his left eye in order to substantially reduce his pain very soon, his only remaining left eye would have to be removed altogether, plunging him into irreversible total darkness for the rest of his life.
Since Brad’s tear-secreting glands were all dead, we immediately began a treatment to keep his eyes as hydrated and comfortable as possible using medication, tear drainage duct blocks, and around-the-clock artificial tear instillation.
“We need to somehow find a way to make your tear glands secrete tears themselves again,” I told them. “If we don’t, not only will we not be able to do any reconstructive surgery, but the left eye itself may also have to be removed.”
The winter of 2004 was especially cold in Nashville, with an ice storm that blocked the roads for days. But my heart felt even colder, and hopeless. Once again, the impending threat of total darkness over one of my patients deeply affected me. I was familiar with that darkness, one I felt as a teenager and almost didn’t escape. I reflected on what it was that had helped me pull out of that darkness and survive.
“Never give up.” My father’s voice once again rang in my ears. I realized I had survived the darkest days in my life through my own determination and through the constant support of others.
I did not want to give up on Brad. I would never give up.
For months, I spent many nights poring over scientific literature to find out if anything had ever been done in the past for a dry eye situation as severe as Brad’s, but I found nothing. I then called many colleagues from around the world including my mentor, Dr. Tseng, to ask for advice and help, but to no avail. I still did not want to give up, so I kept searching and praying to God to help me sustain hope, and to allow my efforts to eventually point me in the right direction.
In the spring of 2005, Brad called me one day with the exciting news that he himself might have found the answer we were looking for! He had found an ear, nose and throat (ENT) specialist at Washington University in St. Louis, the facility that had originally referred him to me. The pioneering ENT physician, Dr. Randal Paniello, had performed the world’s first procedure in which a saliva gland was taken from a patient’s jaw and re-routed to the temple area to lubricate the eye. Saliva has a similar chemical composition as tears, so if we could transplant Brad’s left saliva gland to lubricate his left eye, we might just have a chance to perform restoration surgery to bring back his sight!
I was fascinated by this idea. I called Dr. Paniello and asked him if he could evaluate Brad. Dr. Paniello agreed and called me after the evaluation to tell me that a saliva gland transposition on Brad would be very difficult, but he was willing to give it a try. The surgery was new, and there was no guarantee of success, but Brad had nearly nothing left to lose.
In March of 2005, Dr. Paniello performed the novel surgery. The thirteen-hour procedure was a success, and Brad became the second person in the world to undergo this saliva gland surgery. The funny thing about this procedure is that the saliva gland will still react to olfactory stimulation, rather than debris or dryness in the eye. So if Brad walked into McDonald’s, the French fries just might make his eye water!
When I saw Brad at his next appointment in Nashville, his left temple was swollen to the size of a golf ball. It would take some time for the swelling to recede and for the gland to produce moisture. If it didn’t work, we wouldn’t be able to proceed to the eye reconstruction surgery. We all waited nervously to see if the gland surgery was successful. Finally, after waiting for nearly a year, the glad reduced in size and started producing saliva again, which alleviated the pain in Brad’s eye significantly.
So by the summer of 2006, the stage was set for the eye reconstructive surgery portion of the world’s first combined saliva gland transposition and artificial cornea implantation surgery. My plan was to use the femtosecond laser to create the pocket in his left eye for the implant, just as I had done for Joel Case. Creating the corneal pocket and then put in the implant is like burying a treasure. We would leave the implant in the pocket for a few months, and then remove the corneal flap to reveal the treasure that will hopefully give Brad back his sight. Our goal was to bring him from nearly total blindness to enough vision that he could function more independently and take care of himself at home.
In reality, being part of such a ground-breaking surgery like this really isn’t result of confident masterminds meeting together to devise a plan. Such events tend to be the result of going step-by-step toward whatever options exist next to best help our patients. I really had no idea whether this combination surgical approach would work, and the stress of the uncertainty weighed on me from start to finish for that entire over two years process of helping Brad.
The first stage of the laser-assisted artificial cornea implantation surgery took four hours. Jackie was sitting patiently in the hospital waiting room when I came out of the operating room to give her the results. In the course of creating the corneal pocket and inserting the artificial cornea, I had located his pupil—which had been displaced during his accident—and I re-centered it.
“I rebuilt the front part of his eye, placed the artificial cornea into the pocket, and then sutured everything together,” I explained to Jackie.
She jumped up and hugged me tightly. “This is so cool! Thank you!”
“This has been a long process, but we’re off to a good start,” I said.
After many months of healing, Brad returned on March 28, 2007 for the second stage of the surgery. I opened the outer flap of the corneal pocket, which would allow him to see through the artificial cornea.
The next morning, Brad was back at Wang Vision Institute for the moment of truth. In cases this extreme, it is impossible to predict the outcome. After two years of surgeries through our foundation, Brad and his family weren’t the only ones anxious to know how it would all turn out. News teams in Nashville and St. Louis had documented the entire two-year process, and whole communities of people were on the edge of their seats to watch the results revealed live on television.
The presence of so many friends, colleagues, and news crews streaming results to thousands of people was nerve-wracking. My ritual is to pray with every patient who permits me to do so, but this time Brad himself was the initiator. He had brought his Bible, and he held it in his lap. He bowed his head to pray as Jackie and I stood on either side of him, each of us placing a hand on his shoulder.
I also said my own prayer to God in my heart. “God, I pray it is your plan to bring Brad out of darkness to see the world he has been missing for thirteen years. Will you please allow him to finally see his wife, Jackie, for the very first time? Amen.”
Brad tapped his thumbs nervously on the cover of his Bible.
“Are you ready?” I asked. He nodded.
I carefully removed the patch, cleaned out Brad’s left eye, and slowly pried open his swollen eyelids.
My entire office had shut down to witness this special moment. The staff joined Brad’s supporters, who were crowded around the door of the exam room and down the hallway. The room was completely silent, and the entire crowd seemed to collectively hold its breath in anticipation.
As I examined Brad’s
left eye, it looked good but I couldn’t yet tell if he would be able to see or not. I turned to face the team and gave them a thumbs-up to indicate that at least the surgery itself had gone well. As I began to talk to my staff, Brad’s voice rang out unexpectedly behind me.
“I see a thumbs-up!” Brad exclaimed. “Yeah, I see it!”
The entire room gasped all at once.
“Yes!” Jackie shouted.
Amazed, I turned around to face Brad again.
“Hang on! Don’t move!” Brad requested excitedly. His right hand reached forward slowly, and eventually touched my face. “Is this your face? Yeah, I can see your face over there.”
We were all stunned.
But my face wasn’t the one I really wanted Brad to see. I stepped back and nudged Jackie forward. This was the moment we had all waited over two years to witness. Would Brad be able to see his wife finally for the very first time?
Jackie moved her face closer to Brad’s, looking at him intently. She seemed nervous.
“I can see you now!” Brad said, smiling broadly.
Brad and Jackie gazed at each other, their faces radiating happiness. Tears came to my eyes and I glanced around to see many others moved to tears as well.
I handed Brad a mirror so he could see his own face.
“Yeah, that’s me!” he exclaimed, seeing himself for the first time in thirteen years.
Brad was so enamored of his newfound sight that even simple things fascinated him. “This is incredible! I can’t even believe this!” Brad marveled at a piece of white tissue he had been holding in his hand … and everyone laughed with joy.