Current Jennilog for 9 / 23 / 2003: Angsty

The Death Of The Light

I went to the Ophthalmologist today. For some time I have been noticing small, quite minuscule actually, problems with my vision; things just are not crystal sharp even with my glasses, and there is an odd striped pattern to the specular effect when I look at the moon or a streetlight at night using my right eye. It is a good idea to have ones vision checked every few years anyway, especially after one has passed the age of forty.

At forty-three years of age, it is expected that a cascade of physical changes should occur, some fairly rapidly in fact. The forties are a passage of life of sorts, in that the biological clock that ticks within our cells, part of the senescence program inside the code of our DNA, begins switching circuits of genes, some on, and some off. This process is the primary reason for aging, and ultimately results in complete shutdown: we are evolutionarily ordained for self-termination. We call this aging and death.

There is no actual biological necessity for aging and death; many, many cells and simple organisms are biologically immortal. Indeed, if measured purely in terms of numbers of individuals, the biologically immortal vastly outnumber the whole of life that is doomed to self-destruct. There is some fascinating evidence that at least some dinosaurs were almost certainly biologically immortal, dying only when killed, or when their size caused the inverse-square law to make their bones crumble under their own weight, killing the animal in a great thudding collapse. Clearly, there is some evolutionary value to animals that reproduce often and die early; most likely it is generational adaptability and increased turnover of biomass -and thus increased opportunities for mutation and thus evolution. Whatever the reason, our bodies begin to fall apart, because our cells are programmed to gradually, slowly, degrade over time.

I am told I look very young for my age, and perhaps I do, so it is easy for me to blithely overlook, ignore, the inevitable. Sometimes I even fantasize that maybe I might be a mutant freak with biological immortality reinstalled. That fantasy is not a very likely one, however pleasant.

I have been noticing, for some time now, the inexorable proof of my own disintegration: my overall energy is less with every passing decade, my muscles and ligaments more easily torn or damaged. I have been spared any hint of  wrinkles, thus far, but, without question, my eyes are not being spared.

The lens of the eye is a convex, rounded disk made mostly of dead proteins and water, surrounded by a layer of live, transparent cells. Every year, the lens gains another layer of dead protein, the previous generations of that outer layer of cells. The human lens is rather like a tree...the majority of a tree is dead wood, and only a paper thin layer under the bark is actually alive in the body of a tree, and every year, the tree gains new 'rings' within it...made of the last generation of that living matter.

Over time, the lens gets thicker and thicker. This makes the lens less flat and more round, and also makes it harder for the tiny muscles that hold it to flex it, which is how we focus the camera of our eyes. The result of this is a need for stronger glasses, or even bifocals for some, to compensate for the inability of the lens to change shape as effectively.

Pity any poor real 'biological immortals' out there, for they would have long ago gone effectively blind, with giant bulging lenses shaped like marbles, useless and rock hard. That would be the inevitable fate of any human immortal. But that is not the ultimate reason for this rant, I do not need bifocals, and my prescription needs only slight adjustment...I am very picky about my sight, and the doctor was amazed that I had noticed changes so mild.

The real problem is that I was diagnosed with the faint, wispy beginnings of cataracts today. Cataracts are the single greatest cause of blindness in the world.

A cataract robs sight by clouding the lens of the eye. Progressively, inexorably, the lens grows more and more milky, yellowed, or perhaps amber, and less and less transparent. At their worst, cataracts render the entire lens like a piece of white-yellow barely translucent glass, impossible to see through, admitting only faint, dim, formless light.

The exact cause of cataracts is unknown, but genetics are very clearly implicated in studies with twins, and with generations within families. They are most likely another programmed self-destruction routine in the body. A cataract forms when the proteins in the solid mass inside of the lens begin to collapse, and fold incorrectly. 

Proteins are nanomachines. The are mechanical devices, which make up the majority of our bodies. Cells use proteins for most things...they can be scaffolds and braces, processing units and calculating engines, repair machines, construction machines, chemical factory workers. It all depends on the shape of the protein, which is a chain of atoms, and how that chain is folded. Folded correctly, a protein works like a little clockwork machine to perform a function, so long as it is given chemical energy to work. In the lens of the eye, the function is to 'be transparent', which is far more amazing when you realize that the lens proteins are made of the same stuff that solid, dark, juicy red meat is made of. Folded one way, these proteins are clear as glass. Folded another, they are opaque.

Every person is doomed to get cataracts eventually: it is only a matter of time. If everyone lived to be 150 years old, everyone would have cataracts. By age fifty, about half of all people have early cataracts, by age 70, almost everyone does. Cataracts, once started, are inexorable: they always get worse, and nothing we know can reverse or change the rate of degradation. The big issue in all of this is not escaping cataracts, but rather how fast our flesh is programmed to make them degrade, once they begin.

Some people can go for decades and decades with very little change once diagnosed: the degradation is very, very slow. For others, the loss of vision is swift, and within a handful of years, they are blind, clawing at dim, blurred twilight. For most of the planet, this is a sentence without any hope, a doom from which there is no escape. When humans were cursed with a lifespan of 35 years on average, cataracts were almost never a problem. But now, as we live longer and longer lives overall, the damnation of cataract blindness is inevitable to most.

But for the happy few, there is hope. Modern, expensive, elite medicine, first-world medicine, medicine for the rich who live in the industrialized world (and however poor you are, if you live in the industrialized world, you are rich compared to the planet as a whole), it is actually possible to surgically replace the lens entirely, inserting instead a bionic device, an artificial lens. This is a fairly safe and usually successful operation, that can be done in 30 minutes under local anesthesia. It, like all surgery, has risks, so it is not performed until the loss of vision is so great that blindness is imminent. But it is possible, and millions have had it done.

So, whatever happens to me, I am greatly fortunate in that I can expect that if my eyes go blind from my cataracts, I can have almost-as-good-as-the-real-thing artificial lenses put in. The technology is pretty good, and certainly better than being blind.

So what, really is my rant here? What am I to bitch about here, seeing that if the worst happens, I have some recourse, that is reasonably good?

It is the awful realization that I can no longer blithly ignore my process of aging. It is happening, and it is only going to become more and more troublesome as time goes on. As hopefully, time goes on. With any luck.

And that is the problem. For some, it is their first grey hair. For others, it is their first wrinkle, or their first liver spot, or their sagging breast, or drooping buttocks, or bulging gut.

For me, the first issue of aging ever truly impacted me was...cataracts. "To see is to Be" said the artist Vaughn Bode. Sight is everything to me, it is life, it is being, it is joy and wonder and the most important sense. Sight is my soul to me. And my sight just received a death sentence today. It may come in two years, or it may be decades in coming, but there is no escape from it, only surgical intervention, that will hopefully be Good Enough to suit my very fussy needs.

And of course, with the death sentence of my sight made clear, I see also a hideously sharp image of my own mortality implied within it.

And this is one vision, I wish I could be blind to.