TRACED ON THE RETINA

About a month ago around suppertime I got a phone call from my eye doctor. This was so disconcertingly unique that I couldn’t hear what he was saying for a few minutes. Even then, it seemed simply a call to see how I was doing because of having precursors to glaucoma: diabetes, a skewed visual disc where the optic nerve attaches to the eyeball, a mother with glaucoma, ocular migraines, and marked nearsightedness -- plus the fact that I developed holes in my retinas while I was in Saskatoon. Several years ago this was the doctor who could see I had diabetes because in the eye one can see a tiny sample of the circulatory system traced on the retina.

But I was alerted that something more was going on. I made an appointment which was yesterday. A week ago I got a phone call from office staff (which is not unusual) to confirm my appointment and also to tell me that the doctor had quit the Great Falls Clinic and would be found at a new address, a far more modest building than the GF Clinic’s architectural monstrosity. (You can see my bias already.) When I got to the office, it was in a state of chaos.

The doc had moved out sooner than he had expected, so he was in a small suite while waiting for a larger suite to be remodeled for him. The computers had not been delivered. A quick walk up and down the hall (looking for the ladies’ room) revealed suites in every state of deshabile -- newly vacated, half-rebuilt, and one or two actually occupied. The doc’s waiting room at that point (lunch time) was empty but the small space behind the check-in window was crowded with staff. I settled down to read magazines while the waiting room filled up with older rural guys, mostly overweight and full of quips at the expense of Democrats. This doc’s practice is crammed with people whose eyes have been damaged by constant outdoor exposure to intense sunlight with a high UV component. The best plant catalogues will list the UV resistance of the various plants because the high clear air lets so much of it through.

Again I had to INSIST that if they put lidocaine in my eye to put the glaucoma instrument against it, they must be prepared to wash the stuff right back out again or my eyes will swell shut. The allergy is on my file folder or should be, but most of my records are still back at GF Clinic. The tech again argued that I was wrong, I was being unreasonable, there was no record, etc. but in the end she did what I said. The exam was the fastest on record, done with handheld instruments, and showed that my eyes were unchanged. Perversely, I always feel as though I’ve wasted time and money when there’s no change!

BUT, in the past in other places, I’ve always asked for my prescription to carry in my wallet as a safeguard against smashed glasses. I also carry a spare, but I feel better if I have my prescription. Besides that, it is possible to order glasses through the Internet for a fraction of what oculists charge. As well, the selection of frames is much broader than any oculist could carry and what the oculists DO carry is always trendy, what will sell, so attuned to fashion-conscious young people. What I want next is “Harry Potter” glasses: round. I’ve been wearing an old pair of big-lensed glasses which is fine, since fashion is not a concern. The big lenses make enough area for “graduated” bi-focals so I can read and work onscreen without having to get a crick in my neck. The GF Clinic refused to give me my prescription. My doc, now making his own judgments, wrote it out for me on the spot.

This is all trivia. I am far more interested in what’s going on with these doctors and the Great Falls Clinic. Everything in Great Falls is driven by money and most of the money is concentrated in Malmstrom Air Force Base, education, and medical care. The aluminum and copper refineries are long gone as is the railroad. However, there’s a strong nexus of cultural centers: the Russell Museum, the History Museum, the Lewis & Clark Museum, the Children’s Museum, and many smaller groups. There is also a undertow of crime, though nothing like the major Canadian cities close to the border or, say, Butte, or increasingly Missoula. So far there is not the sudden influx of violent opportunists that are plaguing the northeastern oil patch, but there are way too many murders in the newspaper, too many child abuse cases, too much underground (sometimes literally) deal-making going on.

March is the month of ice breakup and often other shifts as well. Malmstrom is going from fighter planes to transport. That means the streets will be safer and the bars will not be quite so boisterous. (I always joke that Tenth Ave S is dangerous because half the drivers are jet pilots and the other half think they are.) The legal status of things like the big electricity generating dams is changing.

But medical is where there is always action, not least because of the McLaughlin Center for mouse research which does crucial work with knock-out genetics -- the protocols where mice are bred to be mutated and then tested to see what the knocked-out genes did.

At one point there were two major hospitals who competed against each other. Involvement in both the hospitals and local higher education was strongly based in religious orders which have shrunk over the years and finally found they had to sell out. In theory steps were taken to restrain monopoly, but the buyers soon found ways around that. A large pool of aging people with rich land-based estates, and absentee progeny who never came back after being sent to all the best schools, is a cash cow, as the lawyers have known for decades. Now, with mineral leases acting like cocaine, predators who can figure angles are thriving. Not so many are doctors as are medical administrators. I couldn’t prove it, I couldn’t point to individuals, but it’s just under the surface all the time. The newspaper is dependent on the huge advertising stream of the hospitals and clinics.

I interpret my eye doc as moving out of that context. He looks enormously stressed. His staff, operating practically out of each other’s laps and without the computers they need, was cheerful. They know something. They are looking at a bit of the economic circulatory stream.