The situation brought to mind "the advice given to the Earl of Gloucester by Regan, one of King Lear's . . . daughters, after the unhappy Gloucester had had both his eyes plucked out:
" 'Let him smell his way to Dover.' "
The paragraphs above were written two years ago by Dr. DeWitt Stetten Jr., a proud, witty and also blind 65-year-old doctor and scientist and one of the stalwarts of the National Institutes of Health in Bethesda.
When he was in his forties, Stetten -- a biochemist, a student of diabetes and other metabolic diseases and an incisive scientific administrator -- learned that his eyesight was failing. The diagnosis: macular degeneration, a breakdown of part of the retina, the cells at the rear of the eyeball on which the eye registers images and "sees."
Before long he had to stop driving. Five or so years ago he found he could no longer read. Today he sees nothing and says that "simple chores such as finding the cap of the toothpaste tube when it falls or carving a piece of chicken at dinner have become formidable."
Throughout his years of disappearing sight, he says, "no less than seven distinguished and highly qualified ophthalmologists . . . reviewed the condition of my retinas." This included "several skilled physicians" at NIH's National Eye Institute.
None told him anything about how to live. None (he has written in The New England Journal of Medicine, as well as in Ophthalmology and Pharos) suggested any device that might help him. None mentioned "any of the many ways in which I could stem the deterioration in the quality of my life."
All, he says, shared more or less the same attitude "expressed by a young resident in ophthalmology after examining a clinic patient: 'This man is blind and I can do nothing for him.' "
"Such a statement is simply unacceptable," Stetten fumes. "The young physician might have stated with some precision, 'This man is blind and I can do nothing for his vision, but there are a number of things that I can do for him.'
"These things are not inside the eyeball," Stetten says. "They have to do with the whole person." But "because they are not inside the eye, they are not seen by the ophthalmologists as their domain."
The inquisitive and indomitable Stetten began discovering them on his own. For a time he was able to use a machine (made by Visualtek, 1610 26th St., Santa Monica, Calif. 90404) that "enormously" magnifies printed or written materal.
When he could no longer read, he found he could join the Library of Congress' free Talking Books program to borrow tapes, records and a player. (For information, call 287-5100 or 800 424-8567.) Through Recorded Periodicals (919 Walnut St., 8th floor, Philadelphia, Pa. 19107) he could subscribe to recorded magazines. The Washington Ear (681-6636) provides him with a radio with which he can hear volunteers read from daily newspapers and other material.
"It may not be generally recognized by the sighted," he points out, "that as one loses vision one becomes disoriented not merely in space but also in time." Stetten now has a "talking watch," much like a thin little calculator, that tells him the time when he opens it, as well as a talking calendar/timepiece/calculator. He gets them from a White Cane Center run by the Volunteers for the Visually Handicapped (652-4347) at 4405 East-West Hwy., Bethesda.
"These things are lifesaving," he says. "At least I'm oriented in time." And "many suggestions can be made that may transform the life of the blind from a living hell to a moderate inferno or, perhaps occasionally, a heaven."
Since he first wrote of all this, he has spoken at ophthalmologists' meetings. Some medical centers do aid the visually handicapped. Georgetown University Hospital is developing such a clinic.
But "I still hear from many people" that they get little or no such advice from their eye doctors, Stetten says, and many fail to refer them to the places that could help.
He spoke at a church to 30 visually handicapped people. "I asked how many used Talking Books. All but one did. Then I asked how many had heard about them from their ophthalmologists. None had."
There is "the sad case of a young woman who suffered blindness for 18 years and was seen by a dozen ophthalmologists" before anyone told her of Talking Books.
An elderly friend with both a cataract and a grossly obvious hand tremor had cataract surgery. "His eye doctor then ordered him to get contact lenses. He called me, upset, saying, 'There is no way I can put in contact lenses!' This had never occurred to the ophthalmologist."
"It's not right to put all the blame on the ophthalmologists," Stetten believes. "You find practically no references to blindness in any textbook of ophthalmology, but you also find few or no references to deafness in a text on the ear. It is the general problem of disassociated specialism in medicine, and ophthalmology is only an example."
As for himself, he insists, "I am not bitter." But for all the newly blind and visually handicapped and for all of medicine's patients, all of whom should have doctors for the whole person, he says, "I am frustrated. I just don't know what to do."