Dear Cyndy,

In my appointment book, I've set aside Wednesday, July 28, at 4 p.m.
for our telephone conversation, but I have, in fact, no commitment
any time for Wednesday July 28, or Thursday July 29. Please feel
free to change the time. On Tuesday July 27, I have appointments
with patients beginning at 11 a.m. and ending at 4 p.m. I also
have a tentative appointment that day at 5:30 p.m. which I could
easily change.

My practice, as you know, has been dwindling, and although many of
the patients who are left to me have macular degeneration in its
various stages, - all seen in consultation by Peter Lou -, none have
been advised to have intravitreal injections, just maybe because 
Peter has an inkling of my attitude and wants to stay on good terms
with me.

I'm embarrassed that I've not, until now,  kept up with latest
developments in macular degeneration treatment, but I'm trying hard
to catch up. I think the burden of proof should lie with the
pharmaceutical company that promotes treatment at $1000 per injection.
I'm searching for the evidence of effectiveness. Until I find it,
I consider anti-VEGF intravitreal injections as 21st Century Mesmerism,
no matter how popular they are, or perhaps because they are so popular.

I'm mindful how difficult and how stressful your eye problem must be
for you, and I want to do everything I can to mitigate, and to do
nothing that will increase your distress. If you've decided not to
have any injection on Wednesday, no matter how much you are cajoled
or threatened, then there's time for us to talk on the 'phone after you
come home from the retina specialist. If on the other hand, you think
you might want to have an injection (or laser treatment) on Wednesday,
and you want to understand my thoughts on the subject, then it would 
be reasonable to call before the Wednesday appointment, whether from 
Hilliard tomorrow or on Tuesday July 27, in the late afternoon, 
or from Heyshott on one of the intervening days.

Best to you and Ned.

Jochen