We’ve spent a lot time calling patients the past few weeks, and we finally finished on Thursday. It’s been an interesting experience, to say the least. A lot of the phones are switched off, we get a lot of wrong numbers, and a good amount of the time there’s just no response. Sometimes people hang up halfway through because they’re offended by a question we asked or neglected to ask. When someone does answer, most people have a wonderful story — the surgery returned their eyesight, and they have nothing but nice things to say about the doctors and sisters. Some people say that Aravind is like a temple or that the sisters are like family. They thank the doctors profusely and say they are very satisfied. But every once in while, our translator, Suriya, talks to patient who had an operation that went poorly. I can always tell when she’s talking to someone who had a surgery go wrong. There will be silence on our side for a long time and then Suriya will make a sympathetic noise or spend a long time writing something down or start apologizing. One patient complained that the doctors were chatting during the surgery and discussing personal matters, causing the surgery to take more than two hours instead of half an hour, and the surgery ended poorly. Sometimes there are crying grandmothers on the line that will never get their eyesight back.

It’s hard to rectify these stories of failures with the calm, cool efficiency I saw in the operating theater. Dr. Usha spends five minutes on a cataract patient, and even the blind can discern the care and professionalism with which she operates. Her nurse stands by and unfailing passes her whatever instruments she needs, and they work in perfect tandem. I watched a few retina surgeries, bloody and more complex, but just as professional with everyone knowing exactly what to do in the operating room. We speak mostly with retina patients, though patients have undergone other surgeries as well, and retina surgery is not a guarantee like cataract surgery usually is, but it’s one thing to know that mistakes must happen as a statistic and another to hear about these patient experiences. Some of the worst phone calls are when our translator, Suriya, says the patient has “expired.” The first time, I was somewhat in shock, and I didn’t know how to respond because really, how do you respond to that news? Another time Suriya called a patient and a few seconds later immediately started apologizing. Clearly something was wrong, and when she hung up, she told us that the patient had expired, and he was a fourteen-year-old boy.

We don’t know the circumstances of any of the deaths, and we don’t ask. I’m sure some of the patients are simply very old, but the idea of these people dying, and maybe as a result of eye surgery, is hard for me to take in. Aravind does not have a perfect system. It is still a hospital and complications arise. We’ve heard lots of statistics about the low complication rate, but they exist, and these patients tell us about it. I do take comfort in the fact that we call hundreds and hundreds of patients, and we receive far more good news than bad. It still amazes me how open the patients are. Some answer our questions reluctantly, but some tell us all the problems, all the good and bad, and it’s been important to hear everything.

On another note, we visited Bangalore a little bit ago, and we managed to meet up with this kid to get some (really, really good) pizza and fries before he left India.

Peace and love from Madurai,

Doreen