I first met “Mrs. L” in the early 1990’s when she brought her husband, “Mr. L,” to my office in Drexel Hill, Pa., for cataract surgery.

Mr. L was a retired Army general who had been suffering from Alzheimer’s disease for several years. He was a big man and could be difficult to handle, and his poor vision made his disorientation worse. If he was startled at night or when resting, he had a tendency to swing a fist at whoever was near him. Mrs. L was having trouble caring for him, and his in-home caretakers were also frustrated.

In my office, I found Mr. L to be jumpy but cooperative. No punches were thrown.

On the day of cataract surgery, Mr. L was more agitated than usual because of the unfamiliar surroundings. We took our time, explained what we were doing, and the surgery went well.

Once the cataracts were removed, Mr. L was a different person. Being able to see his surroundings, people’s faces and whether it was day or night made a remarkable transformation in his behavior. He was calmer and more cooperative. I still share his story with my patients whenever someone questions whether cataract surgery is of any value in an Alzheimer’s patient.

Mrs. L continued to care for her husband for several years. She was a tough, no-frills woman, and she soldiered on. Mr. L eventually went to a nursing home and passed away.

A SURPRISING TURN FOR MRS. L

Mrs. L continued to return to my office for her yearly evaluations. I have become used to seeing patients return year after year, a little older and a little frailer. Mrs. L was no exception.

She typically looked very dignified and pulled together. But, on this autumn visit four years after her husband’s passing, things were very different. I walked into the exam room and saw the polar opposite of her usual self. She had exaggerated rose-colored makeup on her cheeks, mismatched shoes and socks, and a baseball cap backwards on her head. I feared she was heading in the same direction as her late husband.

As I reviewed her medical history she answered appropriately — nothing new, all was well as usual. I was still perplexed. Finally, she said, “I hope I can get out of here quickly today. I’m on my way to the Halloween party at the senior center.”

Another “aha” moment in medicine.

Mrs. L had made her own transformation. I was glad to see she had a healthy social life after her husband’s passing. I still saw her for yearly check-ups afterwards, and all was well with her. OM

John P. Sammartino, MD, practices general ophthalmology at his private practice in Drexel Hill, Pa.