Dear Cyndy,

Thank you for your sympathetic letters. I feel better now.
My melancholy was only severe enough to interfere with my writing.
I was not otherwise uncomfortable at all. It's obvious cause
was a visit which I paid last Monday to the Ophthalmic Consultants
of Boston's operating room to observe some of Dr. Bradford Shingleton's
operations. I myself stopped operating in 1995, and in recent
years I've referred to him all my patients requiring cataract
surgery, and I've been impressed with the quality of his work.
What prompted Monday's visit was a relative who thought she might
need cataract surgery - it turns out she doesn't, - but before
sending her I thought it prudent to make sure the hands of
Dr. Shingleton, who perhaps 10 or 15 years younger than I
is himself no longer a spring chicken, had not started to
shake. - They haven't. He's a very fast surgeon, 15 minutes
per cataract, and has learned to cut a lot of corners, apparently
getting away with it. I noticed on the operating schedule, -
I didn't count, - but there might have been as many as 20
patients, for at least three he had listed "retina backup".
I asked one of the nurses what this meant, and was informed
that there is somewhere in his office upstairs a retinal
surgeon ready to do a vitrectomy if Dr. Shingleton's phaco-
emulsifying probe accidentally pushes a lens into the liquid
vitreous. Ordinarily considered a major complication, 
here it's obviously something that is taken in stride.
I wonder how often it occurs, and what the long term
consequences of vitrectomy might be. I began to
understand that one of the reasons for Dr. Shingleton's
stellar reputation is that he handles complications so
efficiently that - dare I write it - they appear almost
routine. I asked him while he was scrubbing, how he selected
patients for whom he lined up retina backups, - and
speaking in a very rapid staccatos he listed: loose zonules
(how could one tell?) iridodonesis, asymmetry of the anterior
chamber. I asked him specifically whether I was in error
when I advised my patients to defer cataract surgery until
it became functionally imperative. No, he said, deferring
surgery was not a mistake and did not increase the risk of
complications. I'm sure he knew that he was telling me what
I wanted to hear. All the while he was very polite and
solicitous, shuttling between the two operating rooms
he was using, making certain I had a stool to sit on,
making comments and giving explanations so rapidly that
I couldn't understand. Finally at 3:05 p.m.  when the
patient whom I had referred was being wheeled into
the operating room, whose operation in fact had been the
pretext of my appearance, and who had been assured in a
letter that I would attend her surgery, one of the nurses
informed me that for this case I was not to be in the
operating room, but that I might watch the procedure
on the television screen in the waiting room. (The tv
obviously, can be turned off if there's a problem.)
My feelings weren't hurt at all. Clearly if my presence
made the surgeon nervous, it was essential that I not be
in the operating room. I didn't stay to watch, but went
back to the surgeon's dressing room, changed into the
khaki work clothes, - which are the only apparel I own,
and walked down Charles Street, past all the gigantic opulent
gleaming high rise architecture that Mass General Hospital
has erected, past the old Charles Street jail which has
been refurbished as a hotel named, guess what, "Freedom House" -
a novelist couldn't have done better. I took the subway
from Charles Street. While I was waiting for the bus to
Belmont in the underground Harvard Square station, Klemens
came up to me.  He had apparently been on the same subway
train. I told him the story.

The real reason for my visit to inspect Dr.  Shingleton's
cataract surgery is my own left eye, whose cataract has
become so dense that the eye is functionally blind, and
I keep pondering whether it wouldn't be wise to have it
operated on now by a surgeon whose skills and limitations
I can assess, than to risk some catastrophic change in the
right eye - which is at present very good, but which might
suddenly become blind, as from a retinal detachment or a
vascular occlusion, - and then to require surgery on
the left eye under essentially uncontrollable conditions.
The uncertainty about what I should do, is what threw me
off balance emotionally. I still don't know, I'm still
meditating, but the odds are now 2:1 that sometime in the
winter I'll have the cataract removed from my left eye -
by Dr. Shingleton.  I'll let you know.

It was at about 4:30 p.m., seventy years ago today that the train
which we had boarded that Sunday morning in Washington, pulled into
the station in Marion, Virginia, where we were met by Fred Kirsch.
He was the "little brother" as we would come to call him, of the church
politician dignitary Paul Andrew Kirsch in New York who had sponsored
our relocation - or dislocation into the Virginia mountains. We packed
ourselves into the small grey Ford sedan, my father next to the
Mission Superintendent in the front seat, my mother, Margrit and I
in the back. There was little room for our luggage, much of it
would be picked up later by the mission factotum, Tom Blevins.
On a narrow two lane road, then Highway 58, we trundled across
the mountain into Sugar Grove, then across a second mountain range
into Troutdale, - which prides itself on being the loftiest incorporated
town in Virginia, then on the single lane dirt road to Fairwood, -
in those days the moonshine liquor capital of Southwest Virginia.
There, waiting for us at a parishioner's house was the Reverend
John W. Ott who had conducted the church services at the Fairwood
chapel earlier that afternoon. I remember that it was very, very 
crowded with six people in that four passenger car. We must have
sat on each others' laps during the long half hour that it takes
to drive from Fairwood to Konnarock. We were lodged that night
in two of the vacant dormitory rooms at Konnarock Training School,
a very large, bark-shingled box that then stood, and today still
stands albeit at the threshold of total collapse, - at the
foot of White Top Mountain. It was a long way from Bach and Mozart,
from Schiller and Rilke, and in a way, I've spent a whole life
trying to find my way back.

Stay well and give my best to Ned.

Jochen