he patient lay on a cot, anesthetized, her eyes held wide open by wire specula. A beam of bright light shone on the area. Her sons, a pair of giants wearing tooth necklaces that rivaled the number of feathers on their headdresses, waited outside. Inside, Yana and Bernadine were serving as operating room staff.

It wasn’t an operating room and didn’t even resemble one. The gloves they’d worked so hard to import from Australia turned out to be unusable, and the Care Corps people had turned somersaults in the air to get a new shipment of proper, sterile surgical gloves to Wewak on time. Dr. Heller, the senior member and leader of the surgical team, wriggled his scrubbed hands into a pair and carefully scrutinized the Papuan woman’s right eye.

“Are there adhesions?” Yana asked.


Dr. Heller thought for a moment. The nurses waited for his orders. Just like the two previous patients, the clouded lens of this woman’s eye was stuck to the iris.

Bernadine plucked up her courage and asked why all the patients here had this complication.

“Because they’ve been eating betel nuts all their lives,” he answered patiently, searching for something in his own tool kit. “And in addition to inducing euphoria, betel nuts cause shrinking of the pupils and adhesions within the eye.”

Bernadine almost vowed on the spot never to touch a betel nut again. She promised herself that if she ever did get a craving to chew one, she’d remember all the milky, impervious lenses she’d seen in these elderly people’s eyes, and resist the temptation.

“But betel nuts also prevent glaucoma,” Yana remarked boldly. “You’ll rarely see a case of that here.”

“Yes, they do appear to have a protective influence against glaucoma,” the doctor conceded. He found the instrument he was looking for and turned back to the patient. His assistants watched intently as he slipped the scalpel under the surface of the patient’s right eye, and gently, with endless patience, cut through the adhesions, scooping out the natural lens and removing it. With a buzzing little vacuum pump, he sucked away the remains of the cataract tissue.

“Lens,” he said.

Yana silently handed him a wide syringe, in which a lens of soft plastic lay folded. Dr. Heller positioned the syringe in the gaping cut in the vitreous and with a sure hand, pressed the plunger. Bernadine watched in breathless awe. This was the third operation she was witnessing here, and she was still overcome by the power of modern medicine.

The lens hesitated for a moment in the syringe, and then it popped out decisively, falling open over the hollow space in the eye. A barely audible sigh of relief filled the tent.

Dr. Heller completed the procedure and removed the speculum from the right eye. “Left eye,” he said, and all the steps were repeated on the sleeping woman. Then the nurses moved her to the recovery tent and brought in the next patient. Four more operations were performed that morning. Bernadine came out feeling drained but very happy. It was the first time she’d seen an IV drip administered to a patient’s eye, and the first time she’d ever witnessed surgery from so close up.

And then it came time for the patients to open their eyes.

(Excerpted from Mishpacha, Issue 723)