The New Year.

I’m not big on resolutions but I do want to buckle down this January. The six months between my residency at Yaddo, where I accomplished so much, and the end of the year, were so full of things besides writing. I keep thinking I’m close to the end of this book and then I’m not.

I admit that my biggest obstacle here is a lack of personal discipline. It’s a lifelong challenge, one that I’m more or less friends with at this late age. But the more acute problem lately is that I’ve been struggling mightily with my vision.

I’ve had strabismus since I was a little kid, maybe it’s congenital?, a weak eye muscle. (They used to call this “lazy eye.”) I don’t remember it bothering me until I was a teenager and started getting bad headaches and seeing double and my optometrist prescribed lenses with a prism, which corrected the problem. Sometime in my twenties, though, it started to get worse. I didn’t have health insurance, and I couldn’t really afford much for my eyes beyond cheap glasses, so I lived with the headaches for years.

The first time I had health insurance as an adult was in 1990 when, after temping as a legal proofreader for a couple years, I took a full-time position at Mayer Brown & Platt. My insurance was an HMO called HIP. I don’t think it exists anymore. At that point, I was seeing double and feeling nauseous pretty much all the time, worse at night. My doctor referred me to an eye muscle surgeon at Beth Israel. As I remember, it all went pretty smoothly and the surgery completely corrected the double vision. The nausea and headaches disappeared overnight.

About 20 years later I started seeing double again, especially in the later part of the day if I was tired or had had a drink or if I was watching TV. With some effort I could bring the images together. Most people don’t consider how much of their vision is handled by their brain. Your eyes capture a certain amount of data but your brain synthesizes and completes the picture so you see one coherent image (or series of images). Giving my eye muscles and my brain both a serious workout, I could manage to see pretty well for a while, but eventually, with each eye delivering increasingly different images, it becomes too difficult for your eyes and brain to pull them together.

I had lost my insurance when I left the law firm job and New York for Nashville and then life on the road, so I was uninsured through my 40s. But in 2011, Chan and I registered as domestic partners in New York, and I got insurance through his firm. My ophthalmologist connected me with another eye muscle surgeon (incidentally, my primary care doctor, my ophthalmologist, and my eye muscle surgeon were all named Dr. Cohen).

This time the process felt more protracted, maybe because I was older, maybe I’d forgotten the first one, but the preparation, all the tests and measurements, seemed much more strenuous and intense, and recovery from the surgery took longer. The surgeon this time attached the muscle with an adjustable suture that, several days after the operation, had to be tugged back and forth to get my eye aligned. What’s weird though is that none of that process was based on an objective “right” or “wrong” position because the whole time the doctor was moving my eye around, my brain was compensating for the misalignment. Beyond the nausea it causes, it’s just kind of a nightmare to have your eye pulled all over the place.

Anyway, it worked again. The surgery, in short, involves cutting a small piece out of the muscle at the side of one eye and then sewing the two ends together to shorten the muscle, which pulls the eye in the direction of the shorter muscle. So, though you can see better within most of the field of vision in front of you that you use for most purposes, your eye no longer has full mobility, making it difficult or impossible to focus on those quadrants of your field of vision that one eye can’t get to because the short muscle prevents it from moving far enough. (For me, that quadrant is the left, especially below left. I’m constantly misjudging distances there, running into counters or dropping things, or setting them down too hard.)

Here we are now, only 14 years later this time, and the problem is back. I get nauseous headaches and just plain exhausted after reading (or writing) for more than a few minutes at a time. TV, or anything that takes sustained focus, is also fatiguing. (For some reason, big screen movies are not quite as difficult; maybe it’s because I can move my head around to see different parts of the screen?)

I’m not sure if I can have the surgery again. There’s only so much flesh they can cut out of that muscle. But medicine tends to advance, so maybe there’s something new now? A pig muscle?

I’m dreading finding out what my options are, if I have any. When I was 29, and even when I was 49, things like surgery didn’t phase me, but now it’s of a piece with my encroaching (and, to be honest, unexpected) anxiety about aging and decrepitude. It’s not just a problem that needs to be addressed, it’s my body falling apart and turning into worm food. (My back and hips and knees. I always said and believed that living in the city, walking everywhere, I was getting enough exercise, keeping fit, staying youthful. But I didn’t consider the wear and tear on my knees and hips from walking on pavement every day.)

And then. I’ve decided to scrap most of the work I’ve done on the autobiographical musical I was writing. I want to go back to the songs and write a solo show with monologue and songs, which was how the thing was conceived to begin with. I’d like to record the songs first and make an album, keeping in mind that the main lesson of making an album is that more than likely nobody wants an album of my songs. But at least now it’s all streaming and no physical object to manufacture, so I won’t have to take boxes of 500 unwrapped CDs and toss them in a dumpster five years later.