The King’s New Eyes

When I finally worked up the nerve to hand “Hank” some cash, he drew back as if I was coming at him with a knife. This startled me, and for a moment I wondered what kind of fix my attempted charity had gotten me into. Would he lunge back at me in self defense? Or would he start to channel the cacophony of voices inside his head and yell profanities at me instead? I braced myself for just about anything. I suddenly wished I had just left well enough alone and dropped off the money at the checkout counter, just like everyone else did.

If you’ve ever bought a Diet Coke, picked up a can of almonds or printed pictures at the Walgreens down the street from my office, chances are you’ve seen him. Once long and lanky, around 6’3″ if I had to guess, his upper back has now adopted the sloping, C-shaped bend brought on by osteoporosis and a catch-as-catch-can diet. His salt and pepper hair spikes upward like an over-the-hill punk rocker, and the wrinkles on his weather-worn, leathery face far outnumber his years. He seems to wear the same long, ratty coat whether it’s below freezing or triple digits, and he shuffles along lugging all his earthly possessions around in a large khaki pack. Occasionally, he stops long enough to converse quietly with the chattering demons inside his head.

Hank is King of the Corner of Longwood and Whitesburg, and from what I can tell, his dominion extends outward to about a 4-5 block radius from the front door of the Walgreens. But I have absolutely no idea where he sleeps at night.

On that corner, loose change from the steady stream of customers flows more freely. Like a savvy angler, he’s scoped out his “favorite spot,” and there he patiently bides his time, waiting for a nibble or two, or even the occasional strike. Sometimes he wanders inside the store, and since he never bothers anyone and always pays for his small items in cash, the employees and patrons there tolerate him and go on about their business as if he wasn’t even there.

But we see him. We’ve all gotten in the habit over the years, especially on those 100 degree days, of occasionally leaving our spare change at the counter for Hank. “Make sure he gets one of those extra tall bottled waters,” someone might whisper conspiratorially to the checkout person. “Here. Give him this bag of beef jerky,” another might add as she points over her shoulder toward the front entrance where Hank usually stands and then rushes past him and bolts for her car.

Still, that there is a pang of social consciousness at all is no small thing. In these parts, pulling oneself up by one’s own bootstraps is as sacrosanct a philosophy as holy writ itself. But something happens when a piece of honest-to-God, down-and-out flesh and blood shuffles past you near the intersection of the oral hygiene and feminine products aisles.

Suddenly, there is community inside those four walls and on that corner, and with it, the weight of responsibility. Whether yuppie lawyers in crisp, monogrammed shirts, retired Tea-Partiers in Dickies coveralls, doctors and nurses in scrubs, earth mommas in jeans skirts or aging hippies in tie-dye, we all feel it pressing down on us like an extra dose of gravity. Sometimes, we even step up, lift our part of the load, and do the right thing.

But on this day, I wanted to place the money in his hand myself, to establish some sort of connection with him and to let him know that I saw him and cared enough to speak to him and try to look him in the eye. I knew from watching him over the years that he was likely schizophrenic and wouldn’t be interested in carrying on an extended conversation, but I didn’t expect him to act as if I was trying to rob him (which, looking back, I figure has probably happened many times before).

Contrary to my worst fears, though, Hank didn’t freak out after his initial start. Instead, he leaned closer and struggled to focus on the faded, creased bill in my palm. He then held out his cupped hands, genuflected ever so slightly, and bowed his head, the universal posture of beggars from Calcutta to Caracas and beyond. “Thank you,” he mumbled under his breath as I placed in the money in his outstretched hands.

I was halfway expecting some kind of feel-good afterglow, but there was none–unless you count the cherry-red blush of my cheeks. All I wanted was for him to recognize me as his equal, but he had to go bow and scrape like that and make me feel like some kind of pampered potentate. There was no pleasure in giving him all the money in my wallet when I knew he was right all along, that all I had to do was go to the ATM next door, punch in a few numbers, and get some more.

Still, that’s not the worst part. My most profound embarrassment resides in a momentary lapse in medical judgment. I’d like to think that I was simply out of my element, blinded temporally, by a lack of clinical context. Nevertheless, I’m deeply ashamed to say that the most obvious reason for Hank’s initial confusion and reticence never once occurred to me. Maybe, Hank just plain couldn’t see.

A few weeks later, I rounded the corner into my exam room and there in the chair (which I sometimes refer to as, appropriately enough, “The Throne”) sat Hank, King of the Corner. An old high school classmate of his was with him. I knew in an instant from his well-coiffed hair, bright Ralph Lauren Polo dress shirt and neatly-pressed khakis that he was “old money.” But he was apparently a Christian too, Methodist or Episcopalian if I had to guess, and he had followed his conscience an extra mile or two from his well-manicured, historic, Twickenham District home over to the Hank’s part of town, scooped him up, and brought him in for an exam.

“He says he can’t see anything,” his friend said. “I figured that was as good a place to start as any.”

“You figured right,” I replied, trying to remember not to gape too much, the way I usually do when I’m dumbfounded and caught completely off guard. I was fully awake now–no more postprandial lag–and keenly aware that heaven and earth were were about to pass very close to each other, if not outright collide.

Hank literally couldn’t see the hand in front of his face, which explained a lot. He had cataracts so dense that I couldn’t even see into his eyes much less him out of them. These were “Third World” cataracts, the kind you see often in sub-equatorial climes but not in so-called “developed” countries like ours. This type is overly-ripe and rock hard, not amenable to modern ultrasound techniques. Instead, they must be taken out the old-fashioned way, excised ever so carefully in one piece, as if removing the inner core of a petrified fruit from it outer shell.

I spent a lot of time that afternoon explaining all that to Hank and his friend. I was surprised at how sharp Hank seemed and at the quality of the questions that he asked. I eventually learned that he had once been a good student and star athlete at Huntsville High many years ago, and that he had even attended college for a couple of years before dropping out to join the Army.

He never quite settled in there, and it was during his stint in uniform that the voices started up. He eventually used ear plugs to try to block them out, and even though he denies hearing voices today, it’s a habit he’s retained. Which, of course, made his crossing busy intersections all the more dangerous, since he could neither see nor hear.

The Army didn’t put up with him long after that, and a short time later he received a medical discharge and began to wonder from job to job. Eventually, though, the expectations and structure of a steady job became too much for him, and he quit work altogether and began his life on the street. His parents disowned him and never spoke to him again for as long as they lived.

That was 40 years ago. I explained to him that we could help him get the surgery he needed and that he would likely see again. But he would have to go to our main facility in Birmingham to have it done and stay in a halfway house there for several weeks. He wasn’t thrilled about that, but with the encouragement of his friend who promised to help get him there, he finally consented.

I never for a second thought that cataract surgery would make the kind of profound difference which would enable him to “get a job” or settle into a more normal life. I knew we would be doing well if we could get him there and get him to stay long enough to get one eye done, much less two. But one eye would be better than none at all.

I called the chief of ophthalmology at our main facility. He immediately understood the difficulty of the situation and assured me that he would fast-track Hank’s appointment and personally serve as an attending while the resident on surgical call that day performed the procedure. We enlisted the aid of a social worker who agreed to manage the logistics of appointments, reservations with the halfway house and rides back and forth from there to the hospital.

A week later, as I looked out into our waiting area one morning, I saw Hank and his friend who had made sure that he was there, dressed in new clothes, and on time for the ride to Birmingham on the courtesy bus. Over the next few weeks, I followed Hanks’s progress by reading the various notes in his electronic chart. His first eye went well, and at the one week postoperative visit, he was seeing 20/20 with no complications.

After that, though, the voices in Hank’s head became louder and more rowdy. As he waited for the first eye to heal so that he could move ahead with the second surgery, Hank began to act out at the halfway house, talking to himself, shouting at other residents and making threatening gestures toward them. Just like he did during his Army stint, he would go AWOL for days at a time, and the director at the halfway house told him that if he didn’t settle down that he would have to leave.

The platoon of social workers and psychiatrists managing his case at the hospital went into overdrive to try to lengthen his stay. They prescribed an antipsychotic medication to try to quiet the voices, and for awhile, long enough as it would turn out, he settled down. A few weeks ago, he successfully underwent surgery on the second eye, and once again, attained perfect 20/20 vision.

Shortly afterward, Hank had apparently had quite enough of all that “be here, do this” structure and routine and disappeared again from the halfway house. This time he didn’t come back. A social worker wrote her final entry in the chart, meticulously documenting her attempts to find him. She deemed him a suicide risk, that everything possible had been done to contact him, and that no further attempts would be made.

I didn’t think for a moment that Hank would kill himself. Hank had missed his vision badly enough that he ventured far beyond his kingdom and comfort zone in order to get it back. After all that, I doubted that he would waste his new-found gift so readily. I figured that he was somehow making his way north, back to his corner at Longwood and Whitesburg, to the familiar and comfortable cracks and crevices of his concrete dominion. I knew it was only a matter of time before I saw him again.

And when I did, just this past week, the new clothes were long gone, replaced by the familiar rags and long, ratty coat. He still shuffled slowly and lugged around his khaki pack, but his head seemed a little higher now and his eyes were focused on the horizon and the sidewalk ahead rather than on his feet. I suppose that one of these days when I see him in Walgreens, I’ll ask him how he likes his new eyes. But I wouldn’t be a bit surprised if he doesn’t remember me. And even if he does, I doubt that he would ever say so.

I’m thankful for many things this year: that I am still married when so many in my circle are not; that my sons, while scattering from me like fall leaves caught up in a good wind, are, on this morning at least, all here, just like it was 1999 again; that my 48th birthday came and went without so much as a single pang of chest pain; that I managed to bury my mother and manage her estate this year without completely falling to pieces; that Number Three Son merely wrapped the front end of his truck around a fire hydrant the other night and not a real person (and that he’s okay); that Bama’s prospects against Auburn in tomorrow’s Iron Bowl are particularly good this year.

But as much anything, I’m thankful that Hank, King of the Corner of Longwood and Whitesburg, can see again. Maybe the next time someone hands him some money, or perhaps even today if he somehow manages to make his way over to the City Rescue Mission for his turkey dinner, he’ll look his benefactor in the eye with a little extra clarity and confidence and be thankful too.