CHALLENGING THE OBSTACLES OF OLD AGE
In my mid eighties, I decided in 2007 to leave England to live in Kathmandu, Nepal. This might seem a drastic step to take at that age but , although fairly active, I was concerned about the future: too many of my friends had disappeared into Nursing Homes. No danger of that in Nepal where the people revere their old relations and honour their responsibilities to care for them to the end.
Over the past twenty years I had visited Nepal regularly and loved the country and the people, and shared dangers with them in their role as Gurkhas in World War II..
But most important, I had a ready made Nepali family: my godson Karna Tamang, you could really call him my son, his wife Santi and the two children, Santosh James and Ngima Dolma who looked upon me as their grandfather and had grown up with me since birth.
Sadly, my trekking days in the wonderful valleys and mountains of Nepal were over, but there were many new places to see, picnics to enjoy. Still, after a year or so I found that time seemed to be passing rather slowly. Then I came across the draft of the novel I had started some thirty years earlier but, for some forgotten reason, abandoned. Several of my non-fiction books had been published , but I had always wanted to write a novel, so I decided to resurrect it.
The book was beginning to take shape when an unexpected disaster struck. My eyesight began to deteriorate rapidly. A fluorescein angiography showed that I had Macular Degeneration (AMD) in the right eye, very advanced. I had left it too late to seek advice and so the eye could not be treated. Unfortunately, the angiography also revealed that the disease had started in the left eye, albeit at an early stage.
With so many people living longer, Macular Degeneration is rapidly becoming widespread, affecting millions of people in many parts of the world. What happens is that new blood vessels grow in an area like the macula, and leak blood and fluid which causes permanent damage in central vision. You don’t go completely blind, it is just the centre which is blocked so you can’t read or drive. The periphery stays clear, but in reality it is not far from blindness.
I was told there was no cure, but there were two drugs on the market which had a reasonable chance of preventing any further deterioration. These were Lucentis and Avastin. The treatment consisted of three injections, one every month for three months. If I was to save my left eye an injection was imperative. But at that time as it was not available in Kathmandu. I should have to go to England or India.
I flew to England with Karna—it would have been most difficult to travel alone– and had the first Lucentis injection in a London hospital. However, I realized it was going to be impossible for me to stay two months in England for the other two injections , and too expensive to fly back and forth. At the eye consultant’s suggestion, we went to an excellent hospital in Bombay which was closer to Kathmandu.
According to OCT tests, the injections had held back the advance of the liquid in my left eye, but there was no appreciable improvement in my eyesight. A couple of months later I began to suffer severe distortion: the balcony of the house opposite was a wavy line, the telephone poles were twisted, and when I looked at trees in the distance, and even paintings on the wall, they would suddenly fill with beautiful red flowers.
Fortunately, Karna discovered that the Avastin injection was now available at the Tilganga Institute of Ophthalmology–a non profit organization. under its Medical Director, Dr Sanduk Ruit–a few minutes drive from our house. Every day hundreds of Nepalis attend the hospital. There is no National Health, but the fees are not excessive, and poorer patents do receive assistance. The doctors and nurses are extremely efficient and very caring, and it is amazing how the staff cope with so large a crowd, many of whom are uneducated, and come from remote villages, and find everything confusing and frightening. I have learned a great deal about Nepalis by joining them for treatment. But you need a lot of patience as you wait your turn. Not so bad now that Nepalis are learning how to queue—or get in line as they call it. And sometimes, fellow patients, concerned at my age, quietly nudge me up the queue.
When I first met Doctor Govinda Paudyal at the hospital, he recommended an Avastin injection. This not only checked the degeneration, but also, within a few weeks, my sight had miraculously returned. I could read and use the computer. All the distortions and the flowers had vanished. Over the next few months I had two more injections, and during the last two years the degeneration has not advanced any further. Dr Paudyal and his colleague Dr Thapa test my eyes every three months or so to keep a careful check.
Now that my left eye was working again, I was able to return to my novel The Scorpion Trap. The background of the book was Burma’s Dunkirk, the 1000 mile retreat from the Japanese invasion in 1942 ; the main plot a love and war story about a British Officer in the Gurkhas, and an English girl and her family fleeing from the Japanese.
Well, the book was written, but was I really too old to start the suspenseful progress of a novel? I approached my previous publisher, Jeannie Leung of Janus, who accepted the MS. Mind you I had no visions of grandeur, but I hoped that by the time the book was published my eyesight would still be all right. A few days after my 87th birthday, at the beginning of September 2010 , a copy of the book arrived, and I was thankful that I could savor the moment , and know that I had challenged and defeated at least one obstacle of old age.
WORDS: 1,039 HAROLD JAMES