On Capitalism

Capitalism is doomed. Is that a shocking statement? For me, it’s simply an obvious and logical statement.

Let’ s go with this simple definition of capitalism. “Capitalism is an economic and political system in which a country’s trade and industry are controlled by private owners for profit, rather than by the state.” The defining feature is that capitalism is for profit, and it is the main downfall of the system.

It is smart? is it for the betterment of society? Is it sustainable? Will it damage the environment in such a way as to limit or destroy life on Earth? None of these issues are considered in capitalism. In fact, in the capitalist system, if a company is not maximizing profits the shareholders can sue the board of directors to make them maximize profits whether or not it is good for the company in the long run or good for humans in general.

The capitalist system maintains wealth in the upper echelons of society. Shareholders invest in companies and thus promote the profit making and profit taking aspect of the company rather than its benevolent side. The capitalist system can turn a perfectly beneficial company into a pariah.

The capitalist system allowed the tobacco industry to lie and withhold important research from the public in order to make profit for the shareholders. The capitalist system has allowed petroleum companies to sell vast amounts of their product even though CO2 emissions from petroleum are the main driver of climate change.

It’s a stupid system. Either we kill capitalism or it will kill us. What will take its place? My guess is it will be a hybrid system that promotes initiative and creativity, while having checks and balances that maximize the chances of betterment for society.

Writing

I have been considering renewing my interest in writing. The tendency to read and write a lot has always been there, but my practice of writing ebbs and flows. I just finished a book by Stephen King called_On Writing: A Memoir of the Craft_, which has been an inspiration.

There is the question of what type of writing. I tend toward natural science, and of I have a doctoral degree in Vision Science which gives me more of a solid background than most. I enjoy reading science fiction and fantasy, among other genres, but I’m not sure I’d be good at writing it myself.

True natural science can be a lot like science fiction and fantasy. I have a Ph.D. in Vision Science but I am not sure I come close to understanding how vision really works. I could describe to you some of the components of vision, say the anatomy of the retina, and we all agree that the retina is essential for normal vision. Disease processes such as age-related macular degeneration can disrupt the retina causing visual impairment. But vision does not occur in the retina. What we think of as vision begins at the retina and undergoes layers of visual processing resulting in what we think of as vision. There is a lot to delve into here including how our psychology affects vision and the ever popular phenomena of optical illusions.

Here’s another interesting aspect. The light from relatively close star Vega (Alpha Lyrae) left the star 25.5 light years ago. The actual photons that come in contact with your retina originated at a very different time in your life, or if you are young, from before you were born. The light from the Andromeda galaxy (M31) is 152,000 light years away. When the light left the Andromeda galaxy human beings like ourselves were relatively new to the Earth. Almost all of human history, known and unknown, has occurred during the time the light has traveled to your retina. I feel blessed to receive such a rare gift.

Willcox Flyer

Saturday, September 3, 2022. Willcox Flyer Bike Ride.

I am riding my bike fast, slightly downhill, along a two-lane asphalt road. There is a stiff tailwind with occasional crosswind gust. These are the grasslands west of the Chiricahua Mountains of Arizona. I am in a sea of thick, waist-high grass up to the edge of the road. I fly by the undulating waves of yellow green.

For more than two hours I battled the same wind as I made my way to the turnaround point. I stopped, drank blue Gatorade, and ate watermelon.

I dip down into a ravine and up the other side. I begin the uphill section to the western shoulder of Dos Cabezas Mountain. My legs feel thick, the seat is unforgiving. I am alone. My breath turns labored. There is a long steep section coming ahead.

I hear voices behind me. The voices are getting louder, two women chatting. They are talking about everyday things. They are passing me. One turns to her right and says, “Hi there! Beautiful ride isn’t it?” “Beautiful ride!” I say. And it is, just not right at that moment for me. There is a pang of envy. Why can’t I go faster?

Then I remember. It’s true in cycling, it is true in life. I must never compare myself to others. Sometimes I will feel good, and then I won’t feel good. At times it will feel inexplicably easy, fast, smooth, and effortless. At times it will feel bogged down, slow, and uncomfortable.

What never helps is comparing myself to others. They are doing their thing, having their ups and downs, their successes and failures, just like me. Comparing is poison. When comparing, I am unable to appreciate the success of others. That’s bad, but even worse, it puts me in a place where I am less able to gather up my strength and push on.

I crest the last hill. From now on it is downhill and then flat. I take a big gulp of water. I put my head down and change to the highest gear. I hit 40 miles per hour and sustain 35 for many miles. I finish the ride in 4 hours, 17 minutes, just 17 minutes slower than my fastest time under much better conditions. I lay down on the cut grass of the park at the start/finish line. I hear others talk about their ride, the wind, and the hills.

My Dad’s Last Week of Life

My father, John Vernon Twelker, Jr. was born in San Diego, California on March 6, 1937. He died five years ago today in Tucson, Arizona, July 7, 2014.

Four or five years earlier, we had noticed important signs of memory loss. Medical testing had confirmed the diagnosis of Alzheimer’s disease. Dave and Hazel, my brother and sister-in-law lived in a different house on same Hawaiian property. For a couple years he was able to manage on his own with substantial help from family. Over time, it was clear that he needed daily in-home assistance. That worked well for a year or so but it was becoming clear that he needed 24-hour care. That type of service in Hawaii was about $6,000 a month while in Tucson I found excellent care for $3,000 a month, and my dad could afford that. We knew it could be a difficult transition, but we also knew that most of the time my father was not entirely aware of where he was.

Recommended by a coworker whose father also had dementia, in the summer of 2013 we moved my dad to a place called Desert Serenity. It was owned by Giselle, an experienced nurse and caregiver and located several miles to the south of my downtown Tucson home. It was a small, five bedroom, family-run operation.

Mostly, the transition went well. His entire life my father had been very social, and here was no exception. He made friends with the staff and other residents. I received several panicked telephone calls during brief moments of clarity. He said that he had been kidnapped and taken to an unknown location. He needed me to try and find him, rescue him, and take him home. I learned to comfort him and reassure that all was okay. I would come as soon as I could. The staff knew how to distract him with a conversation or task to do. Mercifully, soon he would forget.

We established a routine. I would pick him up after work on Wednesdays and take him out to dinner, and on Sundays we went to church and then out for lunch. We tried all of the local restaurants in South Tucson and determined that our favorite was Los Portales. It was a family-run business located just blocks from Desert Serenity. The food was excellent, and the restaurant staff treated him like a rock star. He loved the attention as he slowly made his way across the restaurant floor to his chair or booth. His favorite was Filetes de Pescado a la Veracruzana, grilled fish with a tangy sauce.

In the spring of 2014 we began having some difficulty. We liked sitting in one of the booths, but more and more often he would not be able remember how to sit down. He would stand next to the seat, perplexed on how to fold his 6 foot, 4 inch frame onto the bench seat. After ordering and being served, sometimes he just looked at his food and fork and back again with a perplexed look on his face. He was highly motivated, however, to take a bite. Oh, how he loved food! Usually all it would take was for me to remind him of how to do it. He would finish half of his plate, and the staff would wrap up the rest to warm up for lunch the next day.

We ran into a similar problem when getting into the car. I’d have to coach him on how to bend his knees and bend over to get in. He was very concerned about getting injured which left him paralyzed with fear, unwilling to move. On one evening, for five or ten minutes anyway, I was concerned that I wouldn’t be able to get him back into the car.

Almost always compliant and good-natured, he began giving the staff a hard time, only during bathing. He accused the staff of molesting him during the bathing process. Of course, I considered the possibility that one of the staff could be molesting him. But that seemed highly unlikely given that I knew the staff well and they all were exceptional. Most likely, he was misinterpreting their attempts to bathe him as an assault. Giselle told me that this was common towards the end of life. The barriers were coming down. He was revisiting childhood traumas. In a way, I was happy he was fighting back. He was finally able, in his last days, to say, “No! I won’t take it anymore!”

Monday, June 30th I received a telephone call as I was seeing patients in the eye clinic. “Do you have a few minutes to talk about your dad?” Giselle said. “Sure, no problem. I have a few minutes between patients,” I replied. “I believe it is time to request hospice care for your dad. Hospice care is not only for those who might pass away in the next weeks or months,” she continued. “We have seen steady declines in all of John’s functions. If he meets the entry criteria for the program, Medicare would cover a hospital bed, additional supplies, and staffing when needed. Just in the last few weeks, he lost the ability to feed himself on a regular basis.”

Giselle continued, “If you agree, what I could do is call Casa de la Luz Hospice Care. They will send a nurse to do an assessment. If he qualifies, Medicare will pay for a hospice care nurse and other necessary medical equipment,” Giselle said. “Yes, Giselle. Let’s do it,” I said.

By Tuesday afternoon the hospice care had been approved, he had an assessment done by a hospice nurse, and supplies had been delivered. I went over after work on Tuesday and made sure he had a comfortable chair to sit in and that his CD player, CDs, and headphones were working properly and accessible. One of his favorite activities was to listen to music. He loved relaxing music like Enya, Andreas Vollenweider, and probably his favorite, Phil Coulter.

I was out of town two days later when I received another call. Giselle said, “Your father has fallen into a coma. Is there any way you could make your way here?” “Of course,” I replied, “I’ll be there tomorrow.” I called my brother, sister, and nephew Sky. By Saturday we had all arrived, including my sister-in-law Hazel.

Once we were all there, my father woke up. It seemed like a miracle at the time, but anyone who knows my father knows he loved a get together, whether it be a meal with 15 or 20 people, or simply chatting in the late afternoon over a cappuccino or latte he had made. If we were there, he wasn’t going to miss the opportunity to enjoy the company and fellowship. By now, however, he had a very difficult time communicating. He struggled to speak. He would remain awake for an hour of or so before he needed to rest.

We took turns sitting with him as he slept, sometimes holding his hand. When he would awaken we would gather around. Saturday afternoon he asked to speak with his identical twin brother Paul. We dialed up Paul and put him on the speaker phone. I have experienced few things more touching and profound than witnessing the last conversation of two brothers so close, so similar in many ways, and yet of course quite different.

As Sunday progressed another dynamic developed. He would sleep for hours at a time and wake up and be able to communicate a little. But after a while his breathing would change and his body would begin to vibrate. I discussed this with the hospice nurse and she assured me that his was part of the dying process, at least with many Alzheimer’s patients. The amyloid plaques that caused the dementia were now attacking parts of the brain necessary for life. It was a small seizure. He was on pain management medication and we were doing all that could be done to keep him comfortable.

It felt like he could easily pass away during one of the seizures. It also felt like he was trying his very best to not pass away. After all, all of his children were there with him along with Hazel and Sky. It was a get together just like countless other get togethers we had enjoyed all of our lives. There was no way my dad would miss this, or at the very least, he was going to stay around for as long as he could.

This was the very intimate failing of the body, not asked for, not desired. And yet it was happening. It was the most open and exposed my father had ever been. All his life he was an intelligent and capable man that treasured his health and activity. He worked hard on his farm in Hawaii planting hundreds of native trees. He devoted a portion of his land to a 2.5 acre solar array to produce clean energy and provide an income. He was an avid windsurfer well into his 60’s which required a high degree of skill, agility, and physical fitness. He was a self-described health food nut. He was an author and speaker. He was father, and then loving grandfather, Papa Maui to his grandchildren.

For his body to be failing, involuntarily failing, in front of family and loved ones could have felt embarrassing. He was absolutely vulnerable, open, and unable to hide what was happening. This was his worst fear.

Thinking back on my youth, I remembered him as a strong and stern father, sometimes harsh and judgmental. I remembered how I worked so hard to seek his approval. I remembered how he cried when I announced to him that I was not a Christian. I did not believe the story was required for me to believe to be a Christian, I said. He cried, he said, because he wanted to be in heaven with me and other loved ones and with God for eternity. He did not want us to be separated. He did not want to see me suffer in hell.

In these last days, I would sit with him, just be with him. There was little else to do. Every now and then I would think, “There must be something more we can do.” But there was nothing. I was not in control of what was happening nor was he.

During the seizures, every few hours, Dave and Hazel who are also strong believers in the Christian way, would sometimes sing hymns. At any moment, it felt that he could breath his last breath. And yet over and over that weekend, we would gather and sing or sometimes someone would say a short prayer, and the tremors would subside. He would fall back into a peaceful sleep for several hours. Twice a day we would all leave the room and allow the hospice nurse and other health care workers to do an assessment, gently clean him up, give him his pain medications. We took turns sitting with him, holding his hand. We made sure to get rest ourselves.

It was on Monday afternoon that I realized that as long as we were constantly with him, my dad was going to stay as long as possible. In addition, even though he was on pain medication, he was suffering. His body was relatively strong and he could probably keep this up for quite a while, probably days, maybe weeks. I wasn’t sure he felt comfortable dying in front of any one of us, and certainly not a group of us. I recommended that we all take a break, let him rest. If he wanted to remain alive, he could rest and we could be together later. If he wanted to die, he could pass away in peace. We all agreed and left his room. We went over to an identical but uninhabited house next door. It was being prepared as another care home but wasn’t quite ready yet. We chatted. We got some food.

My sister wanted to sit with him alone Monday evening and she did that. Then we left him alone again. Perhaps a half hour later, Sky went to check on him. Sky came back with an astonished look on his face. He said, “He’s gone. I just went to check on him and he’s gone.” Immediately, I felt relieved. I felt we all, everyone involved, had done a good job, especially my brave father. He faced death courageously, with dignity.

I went over to his room to see my dad for the last time. In life, even in the last hours of life, there was a vibrancy, an essential presence. Now, only the form remained. I saw the form, the shell, for what it was. The essence that was my dad was no longer present, at least, not expressed through this body.

In the days that followed his death we arranged for cremation, and then transport back to Hawaii for a memorial service. We had a beautiful memorial service with friends, his church friends, and family. We scattered his ashes in the Pacific Ocean off of Oahu.

–  Dan Twelker

 

“When conditions are sufficient we manifest. When conditions are no longer sufficient we no longer manifest. It does not mean we do not exist. Like radio waves without a radio, we do not manifest.” – Thick Nhat Hanh, Buddhist Monk and Author, from No Death, No Fear

“If today were your last, would you do what you’re doing? Or would you love more, give more, forgive more? Then do so! Forgive and give as it if were your last opportunity. Love like there’s no tomorrow, and if tomorrow comes, love again. – Max Lucado, Christian Pastor and Author

The Hondurans Are Coming

I have worked doing vision and eye care in many developing countries. One of those places was Honduras with a non-governmental organization called Salud Juntos, Health Together. Perhaps more than any other place I have been, Honduras was uncomfortable for me. It wasn’t only that we were there in June, one of the hottest and most humid months. It was the overall feeling I got there. The people were hard working, generous, and warm-hearted. The tropical jungle was beautiful to experience. But we flew into San Pedro Sula, which was considered to be the most dangerous and violent city in the world. We traveled as a convoy. We were asked to stay in the hotel compound when not doing eye exams. When we went out we went as a group.

Honduras was the classic Banana Republic with businesses directed toward sales and export to the United States, mostly bananas, coffee, and clothing. The only presence I could see from the Honduran government was in the form of a police state, men in fatigues with M-16s. Even the cultural environment seemed impoverished. The way it was explained to me was that Honduras did not have a culture of its own so it borrowed its culture from its more developed neighbor to the north, Mexico. Mariachi bands frequented the local restaurants.

As you may have read, there is a group of about 4000 migrants moving north through Mexico toward the United States. This is one of those stories that could easily fade away in the constant barrage of new headlines. What are the odds they will make it 2000 miles through Mexico? The group has already faced Mexico’s military at its southern border but apparently they continue to regroup and progress.

Trump is portraying the migrants as thugs and criminals. He has already threatened to close the US – Mexico border and call in the military. He says he will cut aid to Honduras, El Salvador, and Guatemala. From the Republican perspective this would make sense. The moderate Democrat’s response would be strikingly similar. We must respect the border, they will say.

Think about it for a minute. Four thousand people with little to no money and very little food are walking across Mexico headed to our doorstep. They are scavenging plastic to protect themselves from the rain. They have suffered sprained ankles, foot injuries, and falls. What in the world could possible motivate them to do this? It’s crazy, right? If you ask the migrants they will say poverty, corruption, and violence have given them no choice. They must leave. And where will they go? They will head toward the economic promised land, toward freedom and security, to the United States of America.

It’s not clear to me if they really know what they are headed into. Do they know that the US is more isolationist now than ever? Do they know they are feeding into the paranoid rhetoric that fuels the right with images of hordes of brown people threatening to invade? Do they know that they would almost certainly be met with Trump’s military at the border with tear gas first then rifles and cannons?

What I do know is that this is an important occurrence. I know that the United States bears some responsibility in the social and economic injustice created in these countries. Americans from the Central Region work for a dollar or two a day with no benefits to provide food and clothing for Americans from the United States. US policies have fueled civil wars in Nicaragua and El Salvador. These policies have created the violence, corruption, and poverty they are fleeing. And yet most Americans from the United States remain largely ignorant of the policies and the effects of those policies promoted by both Republican and Democratic administrations for decades.

We eventually had to stop our vision development work in Honduras. We had teams of health workers there, undergraduate students from US colleges and universities, and stray bullets hit their small home in the community. Reports were that the national security situation was declining. So we made the reluctant decision to work elsewhere until there was a more stable security situation. It turns out, we might not need to go back, because the poor people of Honduras are coming to us.

My Ever Spinning Mind

I have realized something about myself. I have obsessive compulsive tendencies. I’d prefer to avoid the label of having obsessive compulsive disorder and I’m not going to visit a psychologist to get the diagnosis, but, oh, my mind can spin and spin. I have learned three techniques that help, and have saved me more than once.

Meditation. My meditation technique is very simple. I sit, back straight, feet on the floor, hands on my legs. I close my eyes and follow my breath. Breathing in, breathing out. Sometimes it goes like this, “Breathing in one, breathing out one, breathing in two, breathing out two…” I see how far I can go before my mind drifts off on another tangent. I rarely get to ten. And when I realize that I have lost the thread, I just start over.

This saved me once while sitting in a window seat on a hot plane. I was pinned against an airplane wall by an obese man in the middle seat. His flesh was heavy and sweaty and it flowed over my left side, pressing me into the warm wall and window. This was bad enough but suddenly the power went out. The air conditioning stopped working and I went into a claustrophobic panic attack. My heart was racing, breathing quickened, and I had the strong urge to flee. I wanted to jump out of my seat, claw my way across two people to the relative freedom of the aisle. I was able to follow my breathing and calm myself. Fortunately, after a few minutes the air conditioning started working again and I relaxed.

Letting go. I’d like to think I have control in my life. Sometimes I will intend to do something and then I do it, and I think to myself, “Wow, I am really in control of my life.” But just a little bit of reflection will show that that’s just not true. There are times when we have quite limited control, or no control. My dad’s death from Alzheimer’s showed me this. There was absolutely nothing I could do to prevent the situation. My only recourse was to take care of him, and love him, and let go of any sense of control.

Personal relationships, especially romantic relationships, have taught this to me. Sometimes, for whatever reason, the relationship just isn’t working out. I have been on both sides of a break up, more than once. While the dynamics can be different, there are times when it is best to just let go. The situation had become too messed up, too complicated, and the best thing to do was to separate, to walk away. I have had to accept that for the time being the unresolved issues, or hurt feelings on both sides, would just have to work themselves out in time, or not. I had to let go.

Love Everyone. Tell the Truth. If my mind is going to spin and spin, at least I can choose the topic, perhaps something worthwhile. I have found this teaching to be helpful. Rather than obsess about a situation at work or a personal relationship, I will contemplate this teaching by Ram Dass through his teacher Neem Karoli Baba.

There are many aspects to this teaching, starting with the definition of love. What does love mean? How does it apply in this context?

Many will say that this teaching is not correct. Why should we love everyone? Perhaps we should not. Perhaps we should love some people and hate others, choose sides. Where does that lead us?

Even if you accept this teaching as helpful, you will find it is impossible. I have been asked to love everyone, but the truth is I don’t. What do we do with that? This teaching always gets my mind spinning but I almost always come away from the contemplation feeling better, more calm.

I meditate. I let go. I try to love everyone and tell the truth. That is how I deal with my ever spinning mind.

Chicago

This Tuesday I woke up at three in the morning, cleaned up, had breakfast and coffee, and got to the Tucson International Airport by 4:30. At 5:40 the plane left nonstop for Chicago. It was quite a shock to go from warm, quiet, dark Tucson and in a matter of a few hours arrive in cool, loud, daytime Chicago. Even the train from the airport was clunky, jolting, and noisy. I exited at the Jackson station downtown to be greeted by slightly overcast skies with a pleasant crispness to the air. My idea was to walk a couple miles east to my hotel in Chinatown. I chose the hotel because it was affordable, got good reviews, and was a mile away from the optometry conference I was attending.

I prefer to walk whenever possible. I like to get the feel of a place. The best way to do that is to be on foot or in certain situations, on a bike.

As I walked east, dense downtown high rises with fancy restaurants, cafes, and bars gave way to light industrial businesses, large residential buildings, and a train relay and transfer station to the south. As I walked, the multi-ethnic diversity of faces and colors slowly changed to mostly Black residents. I was hungry and was looking for a place to eat lunch when I passed the Studio 19 Hair Salon with a sign showing a woman facing left, a man facing right, with the classic red and blue spiral on a white cylinder. I popped my head into the open door and asked if I could get a haircut. A young and friendly African American woman smiled and said, “Sure, I’ll let the stylist know.“

I took a seat near the window. The woman in front of me was getting some kind of treatment. It looked like her naturally black hair had been bleached blonde and now was being dyed red. Two televisions were going, each loud and on different stations. A few minutes later a man walked in, friendly, smiling, wearing an African Dashiki with a black goatee extending a couple inches from his chin. He greeted me warmly and invited me to sit in the barber’s chair. “How much is it? I asked. “Uh, thirty bucks. Hi, I’m Nathan.” “I’m Dan. Good to meet you. Yeah, that’s fine,” I said, and sat down. “How do you want it?” he asked. “I don’t know, just shorter,” I said. “I don’t like it when they cut it straight across in the back. Just follow the natural hair line, but shorter,” I added. “You mean, you want it rounded?” he said. “No, I don’t want it straight or rounded, just shorter and along the natural hair line,” I said. “Okay, got it,” he said. “You want me to trim your beard too?” he asked. “Sure,” I said.

He started in the top and back with an electric razor. I’ve had my hair cut countless times and by far the most common way to go is a scissor cut, with perhaps an electric razor along the edges. But he was passing the razor in wide swaths. It felt odd. At one point the razor grabbed a chunk of hair and came to a stop. He pulled back, regrouped, and then kept going. I could tell he was struggling but I sensed he was sincerely trying to do a good job. I wasn’t worried. I felt that what would be, would be. Whatever happened, if I didn’t like it, it would grow back.

Slowly, he seemed to find his groove. He moved with more confidence. I wondered if I smelled cannabis on his shirt. “Ha,” he said, “We’re gonna do something different here, something you probably have never seen before.” “Okay,” I said, “I trust you.”

Nathan’s phone rang. He put down the razor, “Hey baby,” he said in a deep seductive voice. “Uh huh. Uh huh. Well, come on by baby. I’m just here doing a hair cut,” he said as he put down the phone and picked up the razor again.

“That sounded like your girlfriend. Is that right?,” I asked. “Yeah, that’s right. She’ll be here soon. “You married or got a girlfriend?” he asked “I’ve been seeing someone but it’s not working out. I’m pretty sure we just broke up,” I replied. “She probably wants to get married, right? They always want to get married. I’ve been dating Rita for five years. She’s always be like why you gotta talk with those other girls when you got me? And then there are some trust issues, but that’s my fault,” he said. “No,” I said, “The woman I was dating does not want to get married. I am sure of that. She wants to be independent.” “Are you sure she doesn’t want to get married?” He said. “Yes, I am absolutely sure,” I replied. Nathan kept moving the razor over my head.

“How long are you in Chicago?” he asked. “Five days,” I replied. “Doing anything for fun?” he said. “I’m not sure. I will be pretty busy. Anything going on?” I said. Nathan got excited and put down the razor. “This is what you do. You got an iPhone? He asked. “I have a phone but it’s an Android,” I said. “You got Facebook on it?” “Yes,” I said. He grabbed his iPhone and showed me his Facebook page. “You press here, then here, see here it says events?” he said. “Yes, I see” “Now look,” he said, “Here’s a list of things to do this week.”

I looked at the events and I saw a list of three or four. Every event showed a photo of an attractive Black woman or group of people having fun. The first was a woman in a skimpy dress with a champagne glass. “Look right here. This bar is just around the corner. Ladies night tonight. That’s a good one. Ah, and here’s another,” he said. He scrolled down and it read, “All Black Yacht Party.” I looked in his eyes to see if he was joking or saw the humor in what was happening. Nathan was very excited about showing me how to have a good time. He thought it would be a good idea for me go to an all Black party on a boat where I knew absolutely no one. I admired his enthusiasm.

Nathan picked up the razor again and went back at it. He was doing very detailed edging along the sideburns and then the beard. He was an artist at work, paying great attention. He must have spent, I don’t know, twenty or thirty minutes on it.

At this point an attractive woman walked in and sauntered by in blonde suede high heel boots, the short ones, wearing tight capris and a business-style blouse buttoned all the way up. “Hey baby,” Nathan said, once again in his deep seductive voice. She sat down a few yards away in the corner of the shop and brought out her phone. She had black straightened hair, just above shoulder length, and wore metal rimmed glasses.

Nathan handed me a mirror. “Let’s see what we got here,” he said. He dropped the barber’s bib and rotated the chair to the side. I liked what I saw. He stepped back and took a look. “Oh wait, I’ve got to shape the back right there,” he said, pointing. He picked up the electric razor again, for thirty seconds, ran it across the back of my head once again. I looked down and saw a lot of white, fluffy hair on the floor. “There we go,” he said, “it’s just right now.” He put some shaving cream on the edge of my beard and used a straight razor to clean up the sides. “Perfect,” he said, and it was.

Rita came over and stood by the chair. “Sorry, baby, that it took so long,” he said to her. I said hello and she said hi. I handed Nathan two twenties, thanked him, and headed out the door. As I was leaving I heard him say, “Let’s go get something to eat.”

It had clouded up a little since I had entered the barber shop. A cool breeze had picked up from the north, from Lake Michigan a mile away. I continued walking east to my hotel in Chinatown, looking once again for a place to have lunch.

 

A Colorful World

I was preparing a lecture on color vision testing, looking up information on the internet, finding images, and putting it all together into PowerPoint presentation. I did a Google search on Ishihara plates. This was for a second year class on Clinical Optometric Procedures. Most of my students are from Western Kenya and in their early twenties.

The Ishihara color vision test is commonly used. These high-quality images printed on paper use circles of varying size and shades of colors to make patterns, usually numbers. When a patient has normal color vision a certain number stands out, say 8, but if you have a red-green color defect you will see a 3. The Ishihara test is popular because it can be done quickly and it is sensitive. Unfortunately, it is so sensitive that it often results in false positives, meaning that the optometrist might say a patient has a color vision defect when the patient does not really have one. About 1 in 7 males have a color deficiency, usually red-greed color confusion, much less with females, about 1 in 200.

Optometrists generally do not use the words “color blind.”  Monochromatism, or complete lack of color perception, does exist but it is very rare. We use the term “color vision deficiency” which is more accurate when describing the vast majority of patients who confuse shades of colors to varying degrees.

While preparing the presentation, I stumbled upon an image of Barack Obama that artist Tony Davis had created in the Ishihara style. Just to liven up the lecture, I downloaded it and placed it into my presentation. When the image came on the screen most students did not recognize the person in the image. This surprised me because Obama was well known and very much liked in Kenya. Obama’s father was Luo and from a region just south of Kakamega, land of the Luhya.

“The Ishihara plates test for perception of color and Barack Obama is a person of color,” I said. “What?” I heard murmuring and saw the students look at each other, then back at me. “Barack Obama is considered to be the first black president of the United States,” I said. Most students smiled and some laughed loudly. “He’s not black,” a student said. I said, “He’s a mzungu like me?” using the Swahili word for white person. “Yes,” several students said in unison. “Well, in America, Barack Obama is considered to be black, quite definitely black, although everyone knows he is of mixed race heritage,” I said. More laughter ensued. “He’s mzungu,” one student said loudly, ending the discussion.

I have been in Kenya since August, and have had many discussions about nationality and skin pigmentation. I hesitate to use the word race because there is debate, I have read, as to whether or not race even exists. Certainly there are historical, social, cultural, and physical differences among people across the globe. But what is race, especially in a world with migration, immigration, and increased mixing of people?

Kenya is complex in this regard because until December, 1963, the country was colonized and ruled by the British Empire. My guess is, if I had been here fifty years ago, I might have met some hostility based on my light skin. Not so anymore. The colonizers were kicked out and enough time has passed so that many have forgotten the pain of colonization. Some even look back fondly to the days when things were well-built, organized, bureaucratic but less corrupt.

When I walk down the street in downtown Kakamega, for example, I get a lot of attention. It is constant. I would guess that twenty or thirty times a day, people call out mzungu! to me. Children stare, and mothers lean down looking at me and then their child and say, “Mzungu,” which explains everything. The children nod and repeat, “Mzungu.” When mzungu takes the form of admiration, I feel like a rock star. At other times it feels more like I am being harassed.

When in Eldoret last Sunday I walked into the staging area where the vans and buses meet, called matatus. First one, then another, then another guy came up to me trying to get me to go in their matatu. It made no sense because many of the vans were labeled with placards to places I did not want to go. Within 30 seconds it escalated into a frenzy, with 6 or 7 guys around me trying to coax me into their van. Then one or two started to grab my arm, trying to pull me in this or that direction. I became angry and told everyone to stop and just walked away. While standing on the periphery of the area, a soft spoken guy approached and offered to help. He was looking for business too, perhaps a tip, but he went about it in a comfortable way. I told him where I wanted to go and he accompanied me to a matatu. I paid him a 50 shilling tip and got into a matatu headed for Kitale, paying the 250 shillings for the ride.

In the matatu I was sitting in the front next to a woman. She asked me to take our picture together, so I did. “Will you send it to me?” she asked. “Sure,” I replied. She gave me her mobile phone number and I sent the image.

A day later I got a phone call from an unknown number. “Do you remember me?” a woman said with a thick accent. She said more but I could not understand. I hung up. Thinking it could be work-related, I texted the number and wrote, “If you want to communicate, I recommend a text message. I sometimes do not understand the spoken word.”

The next day I got the message, “hi mr jambo. i am very happy at this particular time to say hi to you, showing you i love you so much. i’m sister rosemary from eldoret. remember the time we met going.”

I responded, “Hello Sister Rosemary. I am working in Kakamega, but will be leaving Kenya soon. Good to meet you.”

The next morning I got this message, “How can i meet you soon? I’m missing you so much. I feel having sex with you soon. pls consider me.”  I responded, “Leaving Kenya very soon. Bye.”

One cannot separate issues of skin pigmentation, or lack thereof, and economics. Most people are lucky to have 50 shillings in their pockets, maybe 100. A small bag of peanuts costs 30 shillings, a meal in an inexpensive but decent restaurant costs 200 to 400 shillings, a ride across town on the back of a motorcycle, 50 shillings. The people I associate with every day, the students for example, have almost nothing. You would not know it because they are friendly, clean, and well-dressed, but they have very little. Students skip meals all the time because they just don’t have the money to buy lunch. If they are lucky, perhaps they will buy a banana for 20 shillings. The local boys and girls in the street buy a chunk of raw sugar cane for 5 or 10 shillings and chew on that to keep the hunger away. Many will chase the fully-loaded sugar cane trucks trying to grab a stalk and pull it from the stack. Not only have some fallen under the wheels of the tractor trailers, they sometimes fail to notice the truck, automobile, or motorcycle coming in the opposite direction and get hit.

The good lady from Eldoret saw an opportunity. Maybe I would take her with me, she hoped. Maybe she would get pregnant and there would be a way to get support for her and her child. At the very least, a mzungu child might have a chance at a better life. Maybe her child would be the next President of Kenya, or even the United States.

The staff where I work, the two administrative assistants in our department, who show up to work Monday through Friday, 8 to 5, are paid very little. I think it might be about ten thousand shillings a month ($100) maybe fifteen thousand, I am not sure. The four Kenyan optometrists I work with have been without a contract, teaching and seeing patients, all without pay since January. When they ask, they are told it will be coming any day now, any week. Just one more signature is needed. They have family in the area, they love teaching and working with the students, so they hold on hoping the contract will come through. They borrow from friends and family to be able to pay rent and eat.

When a person from Kakamega, or anywhere else in the country, sees me walking down the street, they assume I have money. In comparison, they are correct. I almost always have enough shillings in my pocket to buy some groceries, or maybe have lunch at a restaurant for 400 shillings. Some ask for money directly and I usually say no. Most are trying to get my business in one way or another. I usually need to carry a day back, with a rain jacket inside and my laptop computer for teaching, which just makes me more of a target. That is why I get asked about forty times a day, “Where are you going?” by taxi drivers, motorcycle taxis, and matatu drivers. Constantly. “No, thank you, I am walking,” I reply. “But where are you going?” they say. “To the store then home. Asante, but no,” I say. “Where are you going? Where is home?” they insist. “Kakamega,” I say. I get frustrated.

When I get frustrated, I try to remember they are just doing their job. They are trying to get that 50 shilling ride across town so they can put some more gas in the tank of their motorcycle, or buy a bag of peanuts and a mango for lunch. I have not yet felt physically threatened. No one has robbed me. Well, actually, that is not entirely true. I brought a front and back light for my bike from the US. They only lasted two days before I noticed they were missing. But I have experienced worse in Tucson.

A couple weeks ago I went out to Kakamega National Forest for a beautiful sunrise walk. Stayed in the guest houses there and met Caiti from the US, Machiko from Japan, and Ana from Spain. They were here volunteering and traveling in Kenya and all were on a tight budget. We got along great and had a good time together. We came back to Kakamega and I offered to treat them to an early dinner. I chose a nearby restaurant called Sheywe that served very good Indian food. I had been there at least six or seven times, sometimes alone, sometimes with a group. I always have tipped ten percent, which is typical for foreigners and relatively generous here. Most Kenyans do not tip.

We ordered the food and drinks. I got a beer, while Caiti ordered a tequila. The server asked, “Single or double?” She said single and he brought her a glass with maybe a quarter inch of tequila in it. The food was excellent and we all had a great time. It rained but the covered outdoor patio was pleasant. As we were getting ready to leave, I offered to pay but Caiti and Machiko insisted on buying the drinks, so I agreed. When the bill came the server had charged 300 shillings for the tequila. That is a lot here. I asked why it was so expensive, and he responded, “300 for a double.” “Oh, that’s the issue,” I said, “Caiti ordered a single and you brought a single.” “It was a double,” he said. “But she ordered a single.” I said. “Sorry,” he replied. “So, you will charge 200 for a single?” I asked. “No. 300. Double,” he said. “But you made a mistake, and anyway, it looked like a single to me,” I said. “Look, I come here a lot. I like coming here and it is my favorite restaurant in town. Would you please just charge her a single?” “Double, 300,” he replied. “I understand. May I speak with your manager, please?” I asked. “It is Sunday afternoon, there is no manager,” he said. “Okay,” I said, “I am not going to leave my usual tip and I will not come back.” “Okay,” he said. I paid for the food, Caiti and Machiko paid for the drinks, and we left without giving a tip. I have not been back.

I have thought a lot about that interaction, trying to understand the server’s point of view. Why would he struggle so hard for that extra 100 shillings when it was not in his best interests? I believe I understand. Whether or not he intentionally served a double when asked for a single did not matter. Once he had written “Double tequila 300” on the bill he was committed to that course of action. It could and probably would be reviewed later by management. All he knew was that 100 shillings was at risk. If he admitted a mistake he might have to pay for it out of his own pocket. He did not know if we would leave a tip or not, or how much we might leave. He did not know if we would come back another day or not, but that was the last thing on his mind. All that mattered was that 100 shillings. Of that he was absolutely certain. If he lost the 100 shillings, it would be gone forever.

There is so much need here. Small issues get amplified into large ones. I even bought into it myself, perhaps out of pride, getting irritated and arguing over a dollar.

And yet, if you look around, there is clear evidence of abundance. The weather is mild, sunny, with almost daily rain in the afternoon and evening. The soil is extremely rich. Corn, spinach, kale, and fruits like mango and banana grow easily. People grow food on the side of the road, empty lots, and public land. Cows, goats, and sheep graze almost anywhere that is accessible. Chickens run all over the place and seem to belong to no one. I have to dodge full grown chickens and baby chicks when I ride my bike to work. I dodge cows and goats too.

In the homes here there is no need for extra heat or cooling. If you need it to be cooler, open a window. If you need it to be warmer, put on a sweater or blanket. The best home or apartment construction is made of stone with electricity and plumbing, and I live in such a dwelling. Many homes are made of timber and mud with a metal or even a grass roof, put up in just a few days to a week. If kept in good repair, they are quite comfortable in this climate. It would not take too much to make this place a paradise.

People are almost always friendly and often generous. A smile and friendly hand shake are the norm. “May I help you with this or that?” I hear. There is daily chanting or singing, from churches and mosques nearby, and even more on the weekends. The men often wear bright suits and hats with perfectly shined black leather shoes despite the red mud. The women wear many layered garments with vibrant patterns. Flowering bushes and trees are everywhere, with brilliant yellows, oranges, reds, and purples. It is a rich and sensual world here, abundant in every sense. And yet sometimes the colors can seem muted, dull, or deficient in some way. When that happens, it is time to take a deep breath and look around.

Haircut, Shampoo…

Yesterday, while walking around Eldoret I decided to get a haircut. I have been a little bit hesitant to do this in Kenya because my hair is different than pretty much everyone else around me. I just wasn’t sure what the result might be. There was that fact, along with the sensational reports in the local press about people contracting HIV through a haircut. This could be possible under extremely unhygienic circumstances I suppose, but would be highly unlikely. I selected a place called Executive Cuts in a shopping mall near a Tuskys department store. As I expected, when I walked in all eyes turned towards me. “How much for a haircut?” I asked. “300 shillings ($3).” the barber replied. He was a tall young guy, with a friendly smile. “Sawa,” I said and sat down to wait. A few minutes later he called me up and I sat down. There was the usual, “How do you want it?” “Just shorter. Do your best,” I said. As expected, he brought out the electric razor and selected the longest comb attachment. He looked at me as if to ask, “Is this okay?” and I nodded. He carefully sprayed everything down with a blue liquid that I assumed was some kind of disinfectant. Very soon I was like a sheep being shorn, with white locks falling all around me. It was shorter than I would normally wear it, but he did a good job and even kept it a bit longer with a touch of style in the front. I was then sent to another section where a nice young lady expertly shampooed my hair, then applied faintly eucalyptus-smelling waxy substance and rubbed the heck out of my scalp and neck, finishing with a blow dry and light combing. I thanked both of them and paid my 300 shillings, then left a 100 shilling tip which is a lot here.

When I got back to the hotel I took a nap. When I woke up I had a text message from an optometry student at the university. Many students check in with me every now and then. I wrote that I had gotten a haircut. She wanted to see it. “Take a picture and send it,” she wrote. “You want to see a picture of my bald head?” I replied. It was about dinnertime so I headed to the hotel bar where they served food. I told the bartender that a student wanted to see a picture of me with my new haircut. “Do you have an egg?” I asked. He laughed and thought it would be funny. We both decided that surely they would have an egg in the kitchen. So I headed over to the kitchen and told the chef my plan. He was enthusiastic to help. He brought out an egg, a brown egg. “Um, do you have a lighter one?” I asked. “I am mzungu, after all,” I said. We both laughed. He found a lighter one and I took a picture of it and sent it to the student. I headed back to the bar and soon I got the “Hahaha!!!” I was hoping to receive.

I am having fun in Kenya, and fortunately the people here love to have fun too.

Spectacle Fabrication at the KCMC School of Optometry

lens4

Image 1:  A welcoming sign at the Kilimanjaro Christian School of Optometry

Today we met at the Kilimanjaro Christian Medical Center (KCMC) School of Optometry and discussed the challenges facing optometry programs in Eastern Africa. Once again I mentioned the issue of spectacle fabrication, one challenge we have been facing at the Masinde Muliro University of Science and Technology. One of the faculty members said, “It’s easy. Let me show you how to do it. We use simple and inexpensive technology available all around the world.” We went next door to the optical shop.

lens1

Image 2:  Laying out the spectacle lenses. Here one lens, in the optometrists hands, has already been roughly completed, while the other lens on the cloth is awaiting preparation.

The first step is to find and mark the optical center of the of the lens using a lensometer. Lensometers are not too expensive and are usually readily available. The lens blanks are usually 60 to 70 millimeters (mm) in diameter, and can be made of plastic (CR-39) or glass. It is important to know the interpupillary distance (IPD) of the patient which is the distance between the centers of the pupils. This distance is easily measured using a ruler with the patient present and is usually between 50 and 70 mm, depending mostly on the width of the nose and age of the patient. The optometrist then measures the frame to be used, taking note of the bridge width (B). Using the formula of (IPD – B)/2, and an outline of the shape of the frame, the optometrist can calculate the distance from the inner nasal edge of the spectacle aperture to the optical center of the lens. The optometrist then uses a marking pen to outline size and shape of the frame aperture in relation to the optical center of the lens. It is important to place the optical center of the lens in front of the pupil center. The higher the prescription, the more crucial the optical center placement.

lens2

Image 3:  The optometrist uses a glass cutter tool to etch the glass. The purpose is to remove the excess glass on the periphery of the lens.

lens3

Image 4:  The optometrist uses pliers to grab the periphery of the lens and carefully remove the excess glass. He puts on safety glasses for this step to avoid eye injury.

lens7

Image 5:  The optometrist uses a manual grinding wheel to remove the excess glass and smooth the periphery of the lens. He is careful to grind the lens to the correct shape, making a beveled smooth lens edge. This process is called lens edging.

lens5

Image 6:  Once both lenses have been edged, the plastic frame is heated, and the lenses are carefully inserted into the frame, usually from the front. The whole process takes about a half hour. Metal frames require more precision because metal is less forgiving than plastic. Rimless frames using nylon line require a special indented lens edge that is more difficult to fabricate by hand. The optometrist proudly shows his handiwork. It is in this way that high quality spectacles can be created at very low cost. All that is needed is a bank of lens blanks of varying power, plastic frames of varying sizes and shapes, and the tools and instruments mentioned here. Of course, knowledge of the process and experience is very important. Novice lens edgers tend to break a lot of lenses.

When I was an optometry student from 1989 through 1992, we learned how to complete this process although we did not spend much time on it. Now the spectacle fabrication process is rarely completed by optometrists in the United States, and is usually done by opticians using automated equipment. The KCMC School of Optometry has the more advanced equipment normally used in the United States, but they wanted to show me how to get started fabricating spectacles when the more expensive equipment is not available. This process could be very helpful at the Masinde Muliro University of Science and Technology School of Optometry, given that we currently do not have a spectacle fabrication laboratory.

lens6

Image 7:  After showing me how to fabricate spectacles using inexpensive and readily available materials, we sat down and spent two hours discussing slit lamp biomicroscopy techniques.

The exchange of ideas and information at the KCMC School of Optometry has been very stimulating and rewarding.