:::R U OK?

I am waiting for my husband to answer my text, gripping my phone behind the steering wheel where I am parked in the chaotic and cramped customer lot of the Hawaiian Eye Clinic. His text, sent from inside Dr. Lee’s jammed waiting room, finally arrives. After years of minimal growth, hyper-kinetic blood vessels have now begun to leak and pool behind his retina.

:::dr to give me shot in eye, he writes.

A sudden urge to heave. I roll down the window. Is that even possible? I am naïve. Unstudied. Intravitreal injection for the patient with “wet” macular degeneration, I learn from my frenzied internet search, is the latest treatment. Yet the thought of a needle penetrating the white of my husband’s left eye feels absurdly barbaric. The eye is no place for sharp objects.

:::gotta go, his last text reads.

The patient is reclined in the exam chair. The physician numbs the patient’s eye with a 2% solution of lidocaine.

Do I trust Dr. Lee to stick a needle in my husband’s eye? The young specialist flies in from Honolulu twice a week and is the only opthalmologist taking new patients on our outback island. I don’t have a choice.

A sterile speculum is inserted to make sure the patient doesn’t blink during the injection.

Did my husband just blithely agree to the procedure without asking any questions? He would never interrupt Dr. Lee to slow him down or make him repeat something. If it was me in there, I would politely interrogate and only then consent.

Needle length should be 5/8 inch or shorter but long enough to allow for complete penetration of the vitreous.

The eye is filled with oozy jelly. That’s where Dr. Lee’s needle aims to stab. I suffer a sympathetic twinge for my husband and my buttocks squeeze involuntarily. Years ago I attempted to prune the overgrown Sago Palm in our backyard. But as I lopped at the spiky circle of fronds, a thorn accidentally poked my right eye and made me see fireworks. It hurt like hell and left a floater that still wafts through my vision from time to time.

After the sclera is penetrated, the needle is advanced toward the center of the globe and the solution is injected.

When we go to the doctor our physical boundaries are dismantled. Our own skin doesn’t seem to belong to us the way it should. Stripped of our visceral moorings, we allow strangers to pry us open and insert peculiar things—cold steel instruments, drills, lasers, Q-tips. Needles. I imagine Dr. Lee jovially saying to my husband as he jabs him, “Don’t worry. I’ve done this a thousand times.”

The needle is removed, and a sterile cotton swab is immediately placed over the injection site.¹

I see my husband walking down the ramp and I choke up. But he’s upbeat as he slips into the car and tells me that Dr. Lee is on top of things. Then he reclines his seat and leans back his head, his eyes invisible behind those awful wraparound sunglasses.

I tell him I’ve done some research about his treatment. He says maybe later.

I ask him, Did it hurt? He says, I’m okay, honey.

Sometimes the needle breaks a blood vessel on the surface of the eye at the time of injection.² This can cause the white of the eye to temporarily turn completely red.

I start the car but leave it in park.

He reads my mind and to prove that he’s fine, turns toward me and removes his glasses. Don’t worry. See?

I expect demon eyes, a horror show.

He blinks in the sunlight, uses his hand to shield his face, then opens his eyes to me—and the dreamy hazel of his irises looks exactly the same.

Footnotes:

1. Quoted from “Peri-injection Risk Management” in the article “How to Give Intravitreal Injections” by Michelle E. Wilson (BS) and Adrienne W. Scott (MD) in Eyenet Magazine, American Academy of Opthalmology:
https://www.aao.org/eyenet/article/how-to-give-intravitreal-injections

2. Quoted from “What to Expect After the Injection?” in the article “Injections for Wet Macular Degeneration: What to Expect” by Joshua Dunaief (MD, PhD), published at Bright Focus Foundation:
https://www.brightfocus.org/macular/article/injections-wet-macular-what-expect

3. Sources for other italicized text in this CNF include:

“The short-needle intravitreal injection technique” by Zafer Oztas, Cezmi Akkin, Filiz Afrashi, and Serhad Nalcaci, in International Journal of Opthalmology (18 June 2016). Article includes four photos of the procedure:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4916155/

“Intravitreal Injections” in Retina Health Series: Facts from the ASRS (American Society of Retina Specialists):
https://www.asrs.org/content/documents/fact-sheet-30-intravitreal-injections.pdf

“You Want to Stick a Needle in My Eye?!” at Bond Eye Associates:
https://www.bondeye.com/you-want-to-stick-a-needle-in-my-eye/

(Links above were active and retrieved on 28 April 2020.)

Linda Petrucelli

For most of her adult life, Linda Petrucelli has lived on islands—Taiwan, Manhattan, and Hawaii. Being surrounded by water suits her. She writes from her tin-roofed ranch house on the Kohala Coast of the Big Island. Her story “Figure Eight on the Waves” won first place in the WOW! Women on Writing Fall 2018 Flash Fiction Contest. Her fiction and personal essays have appeared in KYSO Flash, Flash Fiction Magazine, HerStry, and Sky Island Journal, among others. Her article “Listening for the Tao in Eight Tones,” a personal essay about learning how to speak Taiwanese, appeared in the book Language Crossings: Negotiating the Self in a Multicultural World.

Linda posts her flash fiction at: jackrabbitfiction.com

More on the Web: By, About, and Beyond

⚡ This Is Not a Drill, flash fiction by Linda Petrucelli in KYSO Flash (Issue 11, Spring 2019)

⚡ Genus: Fabella, ekphrastic micro-poem and a semi-finalist in The DavenTree Writing Challenge, in KYSO Flash (Issue 11, Spring 2019)