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The Light of Seven Mountain Suns Surrounded by the beauty of the world's highest range, thousands of people live without sight. The Himalayan Cataract Project is curing blindnessliterally overnightin the most remote villages of Nepal and India. And, hey, as long as you're performing mass miracles, why not run up a 21,000-foot peak? By Nick Heil
On a warm mid-April day in northeastern Nepal, on the outskirts of the village of Phaplu, scores of Nepaleseall of them blind or partially blindlined up at a screening table in the grassy courtyard of the Solu Regional Hospital. They had walked or been carried here by the hundredsBrahmans, Chetris, Rai, Tamang, Sherpas, Newar, members of the many tribes and castes commingled in the countrysideto undergo a form of treatment that they considered not so much modern as mystical. Around them, radiant sunshine strafed the crenellated, 20,000-plus-foot peaks of Khatang and Karyolung; schoolkids skipped along the hardpan main street past a convoy of porters hunched under their loads; teenage soldiers from the Royal Nepalese Army idled by the airstrip in blousy blue fatigues, rifles slung low like guitars. But the patients were oblivious to all that. They waited, clutching their pre-op paperwork and the hands of their relatives, looking nervous or bewildered, lost inside themselves.
"This one's like a 5.12," Geoff said brightly, peering through his microscope into the milky cataract of a 76-year-old Nepali woman named Chandra Maya. "I'm going to take it real slow."
Geoff swabbed the woman's eye with a cotton ball soaked in Betadine, then propped her eyelid open with a speculum. The procedure required only local anesthesia, and the woman squirmed on the table. "No, no," a nurse trainee barked in Nepali. "Don't move." Geoff hooked a needle through the rectus, the gossamer-thin muscle that controls eye movement, then immobilized it with a suture. Next he angled in with a narrow scalpel called a crescent knife, making a small incision along the side of the cornea and working his way carefully toward the cataractthe eye's opaque, calcified lens. The air was pungent and antiseptic, stoking my light-headedness as Geoff talked cheerily about his profession. "Medicine is one of the great bastions of risk-averse overachievers," he said. "You're virtually assured money, a job, respect in the community. But how does that become meaningful? How does that make the world a better place?" It was 7:30, almost dark, by the time Geoff started in on his 21st consecutive, and final, operation. He'd been at it for seven solid hours. No food. No water. No bathroom breaks. Johnny Cash piped in from an iPod plugged into portable speakers on a small desk, where Geoff's 18-year-old stepdaughter, Ali Demarchis-Tabin, logged patient data into a laptop. (Geoff and his ophthalmologist wife, Jean, have a brood of five, including three kids from Jean's first marriage.) Once again, Geoff reached the crux of the procedure: coaxing the lens through the small incision, a move about as easy as extracting the yolk from a hard-boiled egg without removing the shell. After a few tense minutes, the lens slid out cleanly; Geoff nonchalantly brushed away the wasted scrap of tissue. The nurse handed him a small blue case, which contained a replacement interocular lens, or IOL, produced at a lab in Kathmandu. Using tweezers, Geoff carefully removed the tiny, pliable plastic disc. It was shaped like a miniature galaxy, with two curved spurs, called haptics, sticking out from opposite sides to secure it in place. He slipped it through the incision, which would seal without stitches, and leaned back from the table, his latexed hands floating in the air like a conductor's. "This morning she saw only light and dark," Geoff said. "Tomorrow she'll have 20/20. "Take a look," he added, nodding down at the microscope. "It's perfect."
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