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He is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of Ophthalmology Times.
It was about 1990 when Thomas (not his real name) came to see me. I was a young assistant professor and we were in the very early days of excimer laser keratorefractive surgery.
Thomas wanted to serve in the military and specifically in the special forces, but his fairly low amount of myopia was enough to exclude him.
In those days the military did not perform refractive surgery. Thomas had learned that if he had a great result from surgery and could then pass all the vision testing they would give him then he would no longer be ineligible.
At this time in my life, I spent time working out and particularly liked to do push-ups. I would travel a fair amount for work and wherever I was it was simple to just do push-ups and sit-ups on the hotel room floor.
In the movies about the military the sergeants were always disciplining young recruits by making them do push-ups, and I felt pretty good that I could do about 120 push-ups before my arms got tired and I had to stop.
So, I felt a bit of a kinship with Thomas. Perhaps if corneal surgery became boring, one day I would become a Navy Seal, I joked to myself.
After we discussed the risks and expected outcomes, Thomas decided to have the procedure.
He was young and healthy and within a few days his corneas were crystal clear, his uncorrected vision exceeded 20/20 in both eyes, and contrast sensitivity and glare testing demonstrated outstanding visual functioning.
Frankly, I doubted anyone examining his eyes would have guessed that he’d had surgery.
His result was completely stable. He was happy, and I was happy, and he was about to begin his military service. While he was clearly in good shape, it occurred to me that I was bigger and heavier than Thomas and I wondered if I might not have “the right stuff” for the special forces.
So, I decided to quiz Thomas.
A ‘few hundred’ pushups
“Say, Thomas,” I asked.
“How many push-ups can you do?”
“What do you mean?” he replied.
“I mean how many push-ups can you do before you have to stop?” I answered.
“Why would I have to stop?” he replied, a quizzical look on his face.
“I mean how many push-ups can you do before your arms get so tired that you can’t do any more?” I clarified.
“I don’t know,” he replied. “It’s never happened. After doing a few hundred I usually get bored and switch to doing sit-ups or something else. Why do you ask?”
“Oh, just curious,” I said.
“Well, thanks for doing such a good job with my vision, doc,” he said.
We shook hands and he left my office and headed off to serve his country.
“Better stick with your measly 120 push-ups and some weekend basketball games, Mr. Tough Guy,” I said to myself.
“That’s Dr. Tough Guy to you!” my brain replied to itself. I walked into the adjacent room to see my next patient.