Eyeball Developments

 

A number of years ago (I can't even guess how many.), my ophthalmologist informed me that I had a condition in both eyes called Fuchs' Dystrophy. The good folks at the Mayo Clinic describe the condition this way, "In Fuchs' (fewks) dystrophy, fluid builds up in the clear layer (cornea) on the front of your eye, causing your cornea to swell and thicken. This can lead to glare, blurred or cloudy vision, and eye discomfort.

"Fuchs' dystrophy usually affects both eyes and can cause your vision to gradually worsen over years. Typically, the disease starts in the 30s and 40s, but many people with Fuchs' dystrophy don't develop symptoms until they reach their 50s or 60s.

"Some medications and self-care steps may help relieve your Fuchs' dystrophy signs and symptoms. But when the disorder is advanced and your vision is affecting your ability to function well, the best way to restore vision is with cornea transplant surgery."

Gradually, the effects of this condition have become more pronounced and onerous.  A few weeks ago, during a regularly-scheduled exam, I told my doctor that I'd like to consider a surgical remedy.  He informed me that during the years since I was initially diagnosed, some new techniques had been developed for dealing with the condition. There happen to be a couple of expert corneal surgeons in Birmingham whom he would be happy to refer me to.

Thus it was that last Wednesday I drove to Sheffield, Alabama, to meet with Dr. Jack Parker, M.D. and Ph.D. Dr. Parker is the son of a father-son surgical team specializing in corneal surgery. Dr. Parker's credentials are impressive, as described on the Parker Cornea Website: "Jack Parker is considered one of the world’s foremost authorities on the treatment of keratoconus and Fuchs dystrophy. He is currently the only U.S. eye surgeon fellowship trained at NIIOS–the Dutch institution that developed modern corneal lamellar surgery (DMEK, DSEK, and Bowman layer transplantation).

During medical school and residency at UAB, Jack collaborated with world renowned corneal surgeon Gerrit Melles of Rotterdam. Following completion of a UAB ophthalmology residency, Jack completed a joint fellowship with NIIOS in Rotterdam and his father at Parker Cornea in Birmingham. Jack’s PhD thesis Recent Innovations in Minimally Invasive Anterior and Posterior Lamellar Keratoplasty was co-promoted by Dr. Melles and Dr. Martine Jager and was accepted by Leiden University on July 4, 2017. Jack currently serves on the board of Directors of NIIOS USA."

Needless to say, I feel extremely fortunate to have made contact with such a highly qualified practitioner.  He greeted me most cordially on Wednesday and then examined my eyes.  He confirmed that I have a mature case of Fuchs, but the good news is that my corneas are not yet scarred (a condition that can result if the disease progresses long enough).  He suggested that I would benefit from a procedure called Descemet Membrane Endothelial Keratoplasty (DMEK). In this process, the back layer of cells on the cornea is removed, after which the same layer of cells (called the Descemet membrane and endothelium) from a donor cornea is implanted on the back of my cornea.  Talk about micro-surgery!  Sources on the internet describe the procedure in much more academic terms, "DMEK is a partial-thickness cornea transplant procedure that involves selective removal of the patient's Descemet membrane and endothelium, followed by transplantation of donor corneal endothelium and Descemet membrane without additional stromal tissue from the donor. The graft tissue is merely 10-15 microns thick. Similar to DSAEK, direct contact with the DMEK graft tissue should be avoided to prevent endothelial cell damage and graft failure. A clear corneal incision is created, the recipient endothelium and Descemet membrane are removed, and the graft is loaded into an inserter. After injecting the tissue into the anterior chamber, the surgeon orients and unscrolls the graft, and a bubble of 20% sulfur hexafluoride (SF6) is placed in the anterior chamber to support graft adherence. A variation known as Descemet membrane automated endothelial keratoplasty (DMAEK) utilized an automated preparation of the donor tissue that left a rim of donor stroma peripherally for easier tissue handling, but the procedure is no longer performed due to advances in DMEK that have allowed for easier insertion and manipulation of the graft tissue."

There's a really informative animation of the procedure at https://youtu.be/7Ai8PxaXE2s

Dr. Parker suggested that we start with my right eye, which would benefit the most in visual acuity.  Today, I had a call from his scheduler and I'm scheduled to have the first procedure on Tuesday, July 6th.  I'm really excited.

Reading the comments from people who have undergone this surgery is enlightening and encouraging.  People talk about almost instant results, "miraculous" changes in clarity of vision, and amazing changes in color perception.  I'm incredibly grateful that we have such procedures and dedicated specialists available in my lifetime.  Recovery will take about a month before we repeat the process on my left eye.

David Page Robbins February 14, 1940 - September 25, 2018

Dave Robbins in the 1960s

A few days ago, I was explaining to someone how I became a member of the Sigma Chi social fraternity.  When I left my home to attend the University of Rochester, I wasn't certain that I wanted to join a fraternity.  My brother Bill had been a member of the Chi Psi fraternity at the University of Michigan, but there wasn't a Chi Psi chapter at Rochester. My father had been a member of Delta Sigma Delta at Michigan, but that was a dental society. Thus, there was no legacy tradition that would motivate me to become a member.

I had looked through a list of fraternities at Rochester, and could relate to three of them. Our good friends, the Gardners, had two sons at Rochester who were members of the Alpha Delta Phi fraternity.  My father's insurance broker, Chick Heckenburg, had been a Psi Upsilon brother. My "Aunt" Betty's late husband, "Uncle" Ned (Edward McGrew) had been a Sigma Chi at Northwestern.  I decided I'd visit these houses during the Fall rush period and see if the idea of fraternity membership might interest me.  I don't think I realized until I had arrived on campus that one of my sister's high school friends, Dave Robbins, was attending Rochester and had become a brother in the Sigma Chi house.

When rush week rolled around, I visited these and several other houses.  The group that I seemed to "connect" with was the Sigme Chi brotherhood. I decided I'd go back for a second visit if I was invited.  Shortly thereafter, I read something in the Campus Times that dampened that idea. It seems that the Sigma Chi national consitution had a "White Clause" stating that only white males were eligible for membership. That ran directly counter to my personal culture and belief framework. I prided myself on my non-racist attitudes.  I then decided that even if I were invited to the Sig house, I wouldn't respond. I could navigate four years at Rochester perfectly well without a fraternity.

I received an invitation to return to the Sigma Chi house for a follow-up Rush Smoker (Doesn't that term sound archaic?). I ignored it. The next day, I received a phone call from Dave Robbins, asking if we could meet to discuss Sigma Chi.  I explained my reason for ignoring their invitation.  He was persistent and we met for coffee at the student union.

Dave presented it this way. He, too found the white clause to be abhorrent. There was a "Grand Chapter" coming up the next summer at which he was quite sure it would be removed.  There were several undergraduate chapters, including the Rochester chapter, that had been informed by their host universities that the clause must be removed by a specified deadline or they could no longer be recognized by the institutions. You could do a whole lot more to bring about change from within an organization than from the outside.  Would I please reconsider?

Dave, in his extremely low-key approach, had changed my view. I subsequently pledged and was initiated into Sigma Chi. The white clause was removed the next summer. Our chapter survived. I eventually served my chapter as its Social Chairman, Pro-Consul (Vice-President), and Consul (President). The brotherhood and its principles have been a most powerful and meaningful influence in my life.  I have never regretted my decision to become a brother.

Today, the fraternity is a remarkably inclusive organization, celebrating its diversity. In 1995, Sigma Chi adopted its Statement of Policy on Human Decency and Dignity. Sigma Chi’s Executive Committee approved the formation of a Diversity and Inclusion Commission.  When the Commission was formed, the international Grand Consul stated, "The commission is charged, foremost, with listening. They will listen to anyone who wants to speak. All opinions, thoughts, perspectives and recommendations are encouraged and needed. They will be responsible for organizing the thoughts of the collective and distilling those thoughts into a series of recommendations to be brought forward to the Executive Committee. Recognizing the urgency of this work and the importance of tackling the subject of diversity and inclusion in our Fraternity,"

Dave Robbins was right.  I owe him a debt of gratitude for his wise counsel.  Unfortunately, I recently learned of his passing.  His obituary speaks volumes about his character.  All Honor to His Name!

Obituary for David Page Robbins:

David P. Robbins, 78, of Fredericksburg, passed away on Tuesday, September 25, 2018.

David was born in Schenectady, New York. He spent his school years there and his summers in York Beach, Maine. In 1961, he graduated from the University of Rochester with his fiancée, Martha Lightbown. They were married later that year. David served in the US Army Reserve 1962-68. In 1965, he graduated from UC Riverside and returned to the east coast. He and Martha raised their two daughters in New Hampshire and later retired to Virginia.

David was a lifelong learner. He was a passionate public educator (US history and geography) at New York and New Hampshire schools for many years. A cheerful, friendly man who was full of wit, he loved talking with and learning about others. He treated everyone with equal respect and interest, touching the hearts of all who met him. He was deeply committed to helping the overlooked and the underprivileged. David was exceptionally musical: he sang, played the piano, listened to music all day long, and collected vintage sheet music. His other special interests included baseball, maps, current events, statistics, and religion. He was a lifelong Christian—a Presbyterian as a child, an Episcopalian as a young adult, and then a member of The Church of Jesus Christ of Latter-day Saints, where he served as a pianist, teacher, and leader for almost 40 years.

Above all, David adored his family. He delighted in his beloved wife, children, grandchildren, and great grandchild and spent many hours communicating with treasured extended family. He kept a journal, wrote his personal history for his posterity, researched family history, and covered his walls with family trees and pictures of his ancestors and descendants.

Left to cherish his memory are his devoted wife of 57 years, Martha; children, Beth Austin (Gary) and Meg Andrew (Bruce); grandchildren, Michael (Rachel), Sarah, Becca, and Daniel Austin and Wil, Amy, Henry, and Martin Desposorio; great-grandson, Clive Austin; brother, Doug Robbins; nephew, Joseph Robbins; niece, Deborah Speckhard (Jesse); cousins, Joanne Smith and Paula Page (Lee); and many other cousins, nieces, and nephews. David has now joined his parents, Barbara and Ralph Robbins; aunt and uncle, Muriel and Clayton Robbins; niece, Sarah Robbins; nephew, Thomas Robbins; and cousin Joanne’s husband, Bruce Smith.

A service to remember and celebrate David’s life was held privately, per his wishes.

In lieu of flowers, memorial contributions may be made to Doctors Without Borders (https://donate.doctorswithoutborders.org/onetime.cfm), the American Indian College Fund (https://collegefund.org/make-a-gift/?source=website), and the United Negro College Fund (https://www.uncf.org/ways-to-donate).

David P. Robbins (1940-2018)

Marvin Collins, Doctor of Motors

Collins Garage as it appeared in the 1960s. Entrance on the right.

I moved to Norman, Oklahoma, in August of 1965.  My only transportation was my 1932 Plymouth Model PB business coupe, which I drove from my former Navy duty station in Groton, Connecticut, to Norman. I went by way of Milwaukee, where I had to attend a Navy indoctrination training program at Marquette University. Within a few weeks of my arrival, I decided to find a mechanic whom I would trust to work on my prized vintage car.

I spoke to a number of newly-made friends and colleagues at the University of Oklahoma and concluded that my best bet might be Marvin Collins, the owner of Collins Garage at 420-422 East Main Street in Norman.  The following Saturday, I drove my old Plymouth to that location and ventured through an open door.  I saw a lone mechanic bent over the front fender of a fairly new car.  I spoke after a short delay, "Would you happen to be Mr. Marvin Collins?"

   The man emerged and greeted me with a cigarette locked between his lips, "I sure am, and who are you?"  This began a friendship that would last many years.  He admired my car, asked how long I had owned it, told me that the early Plymouths were fine machines, and agreed to help me maintain it.  He was amazed that I had chosen to drive the car halfway across the country.

I learned from Marvin's business card that he jokingly referred to himself as "Marvin Collins, Doctor of Motors." I also realized that the trademark Chesterfield hanging from Marvin's lips was a permanent fixture.

Over many years of employing him to work on my cars, I realized that Marvin was a walking encyclopedia of automotive knowledge.  A specific example that comes to mind was the day I walked into the shop and he was working on a late 1940s Lincoln with its flathead V-12 engine.  The owner had rebuilt the carburetor, after which the car refused to start.  Out of frustration, he had towed the car to Collins Garage to see if Marvin could help.  Shortly after I walked in, Marvin got in the car, hit the starter, and the car burst into life.  He fidgeted with the carburetor to get the idle speed where it belonged, then turned off the key.  "Poor fellow that owns this didn't realize they made a design change halfway through the model year.  All it needed was a different economizer valve."  That's the kind of obscure information that resided in Marvin's head.  Keep in mind that this was a 20-year old car at the time.

Marvin was outspoken. He didn't mince words.  One day, I happened upon an early Saturday morning estate auction being conducted on a front lawn in an older neighborhood in Norman.  I registered as a bidder "just in case."  Before the auction concluded, the auctioneer announced that the family had owned three cars.  The first to be sold was a 1957 Cadillac Sedan de Ville with only 35,000 miles on its odometer.  It soon was mine at a hammer price of $735.00.  As a proud new owner, I immediately headed down to Marvin's to show off my new acquisition.

Marvin saw me pull in, walked around the car surveying its merits, then asked, "Is this yours?" I nodded. "Didn't talk to me before you bought it, did you?"  I didn't like what I was hearing.  "You're gonna pay me a lot of money if you keep driving this thing." 

It turned out that the 1957 Cadillac engine, a 365 cu. in. V-8 (shared with the Oldsmobile 98, I was to learn) had a fatal design flaw.  The webbing around some of the valve seats in the cylinder heads was too thin and would develop thermal stress crack over time. Marvin and I scoured the junkyards in and around Oklahoma City and acquired three spare "good" cylinder heads for each side of my engine, "just in case."

Sure enough, within a few months, I started to notice a rough idle and a compression check revealed which cylinder head had cracked.  Upon removing it, the crack was easy to spot. We retrieved one of the good heads, made sure everything was nominal, and installed it.  

I was at the garage just as Marvin was about to start the rebuilt engine for the first time.  It cranked over, started, and then produced a horrible loud metallic clattering sound.  Marvin instantly shut down the engine. His character as an honest man was then displayed. "There's something in one of the combustion chambers. That's my fault. Any costs from this point forward are on me," he said.

We later reconstructed what probably happened. After the cylinder head was installed, as well as the intake manifold, we concluded that a small washer on the workbench had adhered to Marvin's sweaty arm.  When he reached across the engine it dropped off of his arm and into one of the openings in the intake.  When the car started, that little washer was ingested through an intake valve and was bouncing around inside the combustion chamber. 

Marvin used a borescope to spot the culprit, removed the appropriate cylinder head for a through inspection and to remove the battered washer.  After completion of the reassembly, the car ran beautifully.  I had to replace one more cylinder head before I decided to sell that car.  Marvin, as usual, was right.

Marvin Collins was a rare breed -- incredibly knowledgeable in his chosen profession, honest as the day is long, and one of the most decent human beings you could ever ask for. He passed away in 1987 at the age of 66 and is buried in Norman.  I feel privileged to have benefitted from his skill and knowledge as a Doctor of Motors.  Even more, I feel blessed to have called him a friend. 

† RIP †