Ring of Fire III

An Eye Opener

Spring 1635, Magdeburg

“I hear business is slow.”

Ursula Sprug finished securing the door of her optometry practice before turning around to face Cathy McNally. “What makes you say that?”

“Your receptionist told me. He’s worried you’ll have to close your practice.” Cathy grinned. “I think he likes you.”

“Thomas is just happy with his new glasses.”

“But business is slow?”

Ursula sighed. Slow didn’t describe the near total lack of customers. “Yes.”

“Well then, why don’t you take advantage of your friends?”

“I don’t know many people in Magdeburg, and those I know don’t need glasses.”

“I don’t mean you should try to fit your friends with glasses. I mean you should ask them to help you. For instance, I bet there are dozens of girls at school who need glasses. Talk to Casey and Staci. See if they’ll let you examine their students.”

“They’d never let me take the girls out of school to bring them to my office,” Ursula protested.

“They might, if they felt the girls might benefit, but what about just using an eye chart and doing a simple screening test at the school? If you find any girls need glasses you can let Casey or Staci know and they can contact the parents recommending a proper examination and the purchase of prescription glasses.

“You could also offer to give the students a little talk about the different problems people can have with their eyes and how important properly fitted glasses are. Dad and Dr. Shipley would certainly approve of that.”

Ursula thought about Cathy’s suggestions. Dr. Shipley and Mr. McNally, the Grantville optometrist and optician who trained her, would definitely approve of her educating people about eye health. And Casey and Staci were, well, more than just teachers at the new Duchess Elisabeth Sofie Secondary School for Girls. They were part owners and could talk to Lady Beth Haygood, the principal. “How much can I charge though?”

“Well, just to get them interested, I’d suggest doing a screening test of the current pupils for free,” Cathy suggested.

“Free? Dr. Shipley said I should charge for examinations.”

“Hey, it’s not as if you have a lot of paying customers. And you might want to prepare a handout for those little talks. Those girls all have families, you know. The more people know, the more likely they are to want to do something. Think of it as preparing the ground for seed. Anyway, it’s a way to get your foot in the door. I know of at least a dozen girls who wear those funny down-time glasses, and I bet they would benefit from a decent pair.”

Cathy certainly had that bit right. Her father was pretty scathing of the quality of the glasses the local spectacle sellers peddled. At best they had lenses of equal power, when very few people who needed glasses needed the same prescription in each eye. At the worst, well, Jim McNally considered them more damaging than going without.

“Okay, I’ll talk to Casey or Staci.”

“Tonight! After class.”

Ursula glared down at Cathy. “Yes, tonight.”

“Don’t forget.”

Ursula had a feeling that if she did forget, Cathy wouldn’t. “I won’t forget.”

Karickhoff’s Gym

The dancers were pulling on their outdoor clothes after a hard session under the eyes of Bitty Matowski. Ursula was pulling a brush through her hair when she felt Cathy’s eyes boring into her. In the mirror she could see Cathy nodding suggestively toward Casey Stevenson who was just about to leave the changing room. She glared back at Cathy before thrusting her hairbrush into her bag and scrambling to her feet.

“Casey, could I have a word?”

Casey turned from the door and smiled. “Sure. Can you talk while we walk? I’m supposed to be going to the American Kitchen with Carl.”

“Thanks.” Ursula took a deep breath. “I was wondering if I could do screening eye tests on the pupils at your school?”

“What does that entail? We can’t afford the time to take them to your office.”

“I was just thinking of using a room at the school and doing a simple test using an eye chart. For most of the children it wouldn’t take more than five minutes.”

Casey nodded. “And how much were you planning on charging?”

“Cathy suggested doing the tests for free.”

“Can you afford to do them for free? I hear you haven’t had many customers since you opened your office.”

“What? Where did you hear…Oh. Cathy’s been talking?”

“Yes, Cathy’s been talking. You really should have spoken up earlier. Come on, there’s Carl. I bet Kelly Construction would be interested in having their work force screened for vision problems.”

Ursula skipped home with a new spring to her step, and after an hour and a half of barre and center work under Miz Bitty’s eye, that was saying something. She might not have any guaranteed customers, but Carl had promised to talk to the guy who doubled, or tripled, as health officer at Kelly Construction about scheduling screening tests, and Casey had promised to bring up the idea of screening tests and talks on eye health with Lady Beth. Surely some of the tests would result in customers.

She used her key to open the door of the boarding house where she had a room and made for the kitchen. Everyone knew she went to dance class after work, so there was usually something left simmering on the range for her.

She bounced into the kitchen, and froze. Sitting back at the kitchen table working her way through a bowl of stew was the landlady. “Hi, Elisabetha. It’s been a fantastic day, hasn’t it?”

Elisabetha Schmelzer smiled. “Did you get a customer?”

Ursula flushed. Did everyone know that she’d barely had any customers? “Not yet, but I’ve arranged to do screening tests at Kelly Construction and the new girls’ school.”

“What are screening tests?”

“It’s just a quick and dirty way of determining whether or not someone needs a proper examination. I can give you one now if you like. I just need to get a chart and tape measure from my room.”

Elisabeth shook her head. “No need to rush. Get something to eat, and then have a soak. There’s still plenty of hot water. How much are you charging for these screening tests?”

Ursula found a clean bowl and, after filling it with stew, collected some bread and joined Elisabeth at the table. “I was planning on doing them free.”

“Have you thought about offering free tests at your office?”

“No.”

“You might want to try it. A lot of people see the fancy office and think they can’t afford to see you. If you put out a sign offering free examinations…well, it’ll be a foot in the door.”

Ursula blinked. There was that phrase again. “Have you been talking to Cathy McNally?”

“No. Should I have been?”

“It’s just she used that exact same phrase when she suggested I talk to Casey about screening the girls at Duchess Elisabeth Sofie.”

“Ah, well, it’s probably a common up-timer phrase. My Tommy uses it a lot.”

Ursula grinned. “And which door is your Tommy talking about putting his foot in?”

Elisabeth waved her finger at Ursula. “That’s enough of that, young lady. Just you finish your dinner and I’ll run you a bath.”

Glowing inside, Ursula set to cleaning her plate. She’d do what Elisabeth suggested and advertise free examinations. It would, as everyone seemed to be saying, get her foot in the door.

Two weeks later

It was after noon before Ursula returned from the latest series of screening tests at Duchess Elisabeth Sofie. She walked up to the reception desk to check if any mail or messages had arrived while she was out.

“Two parents called about you seeing their daughters. They were on the list you provided me and I’ve scheduled their appointments.” Thomas smiled. “At this rate you’ll be able to afford to pay your receptionist this week.”

Ursula poked her tongue out at him before copying the appointments into her appointment book. Thomas’ services as receptionist were provided to the tenants as part of their rent. “Thank you. I’ll be in for the rest of the day.”

“Do you want me to put your ‘Free Examinations’ sign out?”

Ursula checked her schedule for the rest of the day. There were just three appointments over the next five hours. “Yes, please.”

The sign caught Juliane Lortz’s eye. The enormous glasses showed the shop sold glasses, but it was the word “free” that held her attention. She wasn’t sure exactly what was being offered, but it wouldn’t cost her anything to ask. She tugged at the hand of her daughter. “Come on, Anna. Let’s see what they are giving away.”

The man manning the front desk was wearing glasses just like the ones on the sign. She approached him. “What are the ‘free examinations,’ please?”

“The optician does a few simple tests to determine if you need glasses or if there is some other problem with your eyes that needs to be addressed.”

Juliane glanced down at her daughter. Surely her eyes shouldn’t be turning in like that. “Could I have one for my daughter, please.”

“Of course. The optician is in. I’ll give her a ring.”

Behind one of the doors was the gentle tinkle of a bell in response to the cord the receptionist pulled. The door opened and…a very young female came out. Juliane swung round to question the receptionist, but didn’t get the chance before he spoke.

“Fraulein Sprug, this lady would like you to examine her daughter.”

“Of course. Would you please come this way?”

Ursula studied the woman and child as they approached. Their dress suggested “poor but proud.” The daughter’s clothes looked like they’d been made out of material from her mother’s old clothes. The mother’s clothes had few obvious repairs, but they were heavy wear for the current weather. If she had to guess, Ursula didn’t think she’d be able to afford the full cost for glasses.

“What’s the patient’s name?” she asked the mother.

“Anna.”

Ursula wrote that down. “And how old is Anna?”

“She’ll be four in August.”

Ursula added the age to her notes, then pulled out the booster seat that would raise the child to a comfortable working height and placed it on the examination chair. “If you’ll just seat Anna, I’ll be right with you.”

While Juliane lifted Anna onto the booster seat Ursula took her first really good look at the little girl. She had to bite her tongue to stop herself crying out. Both eyes were turning in. She’d seen this condition in patients during her apprenticeship back in Grantville, but not this bad. She took a small paddle from her work table and did a simple cover-uncover test. She knew young Anna had a definite problem when her eyes swung back and forth. Fortunately, the condition had been caught early enough that it should still be treatable…if the family could afford it.

Ursula selected the special child’s eye chart and proceeded to do the best she could to determine whether there was more wrong than just the eyes turning in. She started by pointing to the largest picture on the chart. “Can you tell me what that is, Anna?”

“A horsie?”

“Very good.” It was actually a man on a horse, but at least Anna could make out the horse. Ursula pointed to an image on the next line down, a hand. “Now, how about this one?” Anna shook her head. Ursula pointed to the next picture on the same line. “What about this?” Anna shook her head again.

Ursula repeated the procedure with Anna’s left eye, regularly glancing at Anna’s eyes. They didn’t turn in as much when Anna was looking at the chart. Ursula added that snippet of information to Anna’s notes. Finally she turned to the mother.

“Anna has a definite problem, but it is treatable. Unfortunately, the condition that is causing her eyes to turn in is beyond my current ability to assess. She really needs to see Dr. Shipley in Grantville.”

“Grantville! We can’t afford to go there. And a Grantville doctor? We can’t afford the kind of fees they charge.”

Ursula nodded in silent sympathy. She knew all about the fees Dr. Shipley charged. “I believe Dr. Shipley intends coming to Magdeburg for Fourth of July Arts Week. I can probably get him to examine Anna free of charge then.”

“Why would you do that?” Juliane demanded.

“So I can learn how to do the examination myself.” Ursula was proud of that statement. It even contained a grain of truth. It would be a useful learning experience, but she’d probably have to pay Dr. Shipley’s fee herself.

Ursula watched the woman wrap her arms protectively around Anna, and tried to reassure her. “The examination won’t cost you anything, I promise. However, Anna does need prescription glasses, and they could be expensive.”

“How expensive?”

Ursula mentally compared what she could afford to subsidize with how much a new pair of glasses cost. “About three hundred dollars.”

“Three hundred dollars? For glasses for a child? You can buy a pair from a peddler for a fraction of that.”

“Yes, you can buy a cheap pair of glasses from a peddler, but Anna’s problem won’t be helped by them. And if you don’t do something soon, her vision could be permanently damaged.”

“Permanently? You mean Anna could go blind?”

Ursula hastily shook her head. “Not blind, just beyond our ability to correct. Come on, let’s get Thomas to take down some contact details and I’ll be in touch as soon as I hear back from Dr. Shipley.”

July 1635, Magdeburg

It usually took about half an hour for the atropine eye drops to stabilize a child’s eyes enough for him to examine, so Dr. Ezra Shipley spent the time explaining the importance of good eye health to the mother. Eventually he was happy with the dilation of Anna’s eyes and turned his attention to his patient.

“Anna, I’m not going to do anything that will hurt you. I’m just going to shine a light in your eye and put some lenses in front of it, like this.” He knew that a demonstration helped calm any apprehension a child might have. It even worked on some of his more highly-strung adult patients.

He selected a lens and held it in front of Anna’s eye and shone the light from the hand held retinoscope through it. The reflection of the retina still showed movement, so he tried another lens.

“Ursula, come try this. I want you to see how when I move the beam from the retinoscope across the pupil the reflex moves the same way as the light and how it moves faster at the forty-five degree angle than the hundred thirty-five degree angle. It’s really easy to see here, because the difference is so great.”

He gently coached Ursula through the steps to neutralize the refractive error in the right eye, and after checking for himself, fitted the selected lens into the trial frame before repeating the process on the left eye. With two lenses selected, he passed the loaded trial frame to Ursula and crouched down so he was at Anna’s level.

“Now Fraulein Sprug is going to hold this funny-looking thing in front of your eyes. It’s called a trial frame. And we’re going to try some more lenses.”

With Ursula holding the trial frame, which was too big to fit Anna comfortably, Ezra used cylindrical lenses to correct both eyes for the other meridian with the same method.

“There. Now that wasn’t so bad, was it? Let’s see what you can see on the chart.”

In a few minutes Ezra finished measuring Anna’s vision through the trial lenses. She was now seeing 20/30. Or more correctly, she was reporting 20/30. Young children had an unfortunate tendency not to want to reply when the pictures got very small. Not great, but probably the best they could do with purely objective measurement. In a couple of years’ time, when Anna was old enough to give reliable subjective feedback, Ursula could refine the prescription closer to 20/20. However, there was still the matter of convincing the mother to purchase glasses she might not really be able to afford. He glanced over at Anna. She was a sweet little girl. She didn’t deserve to be condemned to a world permanently out of focus just because of a few dollars.

“Frau Lortz, your daughter needs a high prescription. As Miss Sprug has already told you, if we don’t correct her vision now she will have blurred vision later in her life that we will be unable to treat. It is imperative that we fit her with glasses as soon as possible. Now, you’re probably worried about how much they’ll cost. Because they’re for a child we can make them up for…” He glanced at Juliane’s worried face. Ursula had warned him about the price she’d quoted and why. He might have gone lower, but Ursula had also commented on the poor but proud appearance. “Three hundred dollars.”

The mother reached out a hand to run it gently over her daughter’s head. She looked at the eye chart and back to Ezra. Then she reached under her jacket and pulled out a crumbled piece of paper, which she handed him.

Ezra flattened out the paper and read it. It wasn’t cash, but it the next best thing, a note from the local branch of Boot’s Bank saying that Juliane Lortz had the ability to pay Ursula Sprug up to three hundred dollars for glasses for her daughter Anna. He passed it over to Ursula. “I’ll get onto Anna’s new glasses as soon as I get back to Grantville. Ursula should have them inside a week.”

“Thank you, Doctor.”

“You’re supposed to be running a business, not a charity.”

“I know, but well…” Ursula sighed.

“Yes, I know. You can’t condemn a child to an out of focus world just for the sake of a few dollars. But you have to earn a living. Can you afford to subsidize Anna’s glasses?”

Ursula nodded. It would be hard, but not as hard as knowing that Anna would continue to live in her out of focus world.

“It’s good to see you’re not in the business just for the money, but just this once, I’ll carry the cost.”

“Thank you, Dr. Shipley.”

“Now, about that sign outside your shop…you’re not going to tell me you’re performing free examinations, are you?”

Ursula shuffled her feet and bowed her head to break eye contact. “I had to, Dr. Shipley. Hardly anybody came in for an eye examination when I was charging for them. Now I have half a dozen or more examinations every day, with most of them leading to orders for glasses.”

“You’re making up for the examinations on the glasses?” Dr. Shipley shook his head in disgust. “You’re putting the profession back decades, Ursula.”

“What? Back decades? I thought what I can do was supposed to be years ahead of the general standard of optometry.”

Dr. Shipley grinned. “Back up-time it took the profession decades to make the practice of hiding the cost of examinations in the price of glasses illegal.”

“Why make it illegal? Why would people pay for an examination if they didn’t know they needed an examination? Quite a few of my customers didn’t think they needed glasses, but they wanted to take advantage of something that was free.”

Dr. Shipley opened his mouth as if to reply, then slammed it shut. He glared down at Ursula and gently shook his head. “It’s not professional.”

A week later

Anna stared at Ursula from her position high on the examination chair. “The man hurt me. You’re not going to hurt me, are you?”

“No, Anna. I’m sorry the eye drops hurt, but Dr. Shipley had to use them so we could check your eyes. Now, I just want you to look at the eye chart.” Ursula covered Anna’s right eye and pointed to the man on the horse on the on the top line. “What am I pointing to?”

“Horsie.”

“Very good. Now let’s try going down a line.” She pointed to the hand.

Anna shook her head.

Ursula repeated the steps with the left eye covered with similar results.

“Right. Now I’m going to put on your new glasses and we’ll try again.” Ursula removed the spectacles from their case, checked them for dust and finger prints, and then gently placed them on Anna’s face. She had to make a slight adjustment to the nose piece to position them properly, but soon she was happy.

She pointed to the hand on the second line. “What is this shape?”

“It’s a hand, and below it is a duck, and a fish, and a hand, and a man on a horsie.”

“Very good, Anna. What about this?” Ursula pointed to the cat on the fourth line.

“A cat.”

“ Very good.” Ursula took Anna down the chart as far as she could go and then checked the other eye. It looked like Anna was now seeing at 20/30, just like Dr. Shipley had said she would. “That’s very good. Now, I want you to take very good care of your glasses. I’ll give your mother instructions on how to care for them.” She walked over to Juliane, leaving Anna to look around the room.

“Look at all the birdies.”

Juliane turned to see where Anna was pointing. There were sparrows pecking at something on the ground nearly thirty feet away. Anna had never noticed anything smaller than a horse that far away before.

“There are people riding on that wagon, Mommy.”

Juliane felt a lump in her throat. Anna was looking around and pointing at things as if she was seeing them for the first time. She looked around the street and tried to imagine what it must have looked like to Anna before she got her new glasses. And to think she and her husband had almost decided they couldn’t afford glasses for Anna.

She crouched down and hugged Anna. “Yes, darling. There are people in the wagon. What else can you see?”

Anna’s tiny hand reached out and brushed the eyebrows above Juliane’s eyes. “What are these?”

“They’re eyebrows. Feel above your eyes; you have them as well.”

Anna brushed a hand against her own eyebrows. “I do too.”

Juliane rose to her feet. The change in Anna already was astonishing. It was reward enough for the economies they would have to exercise to pay off the debt to the bank. Surely Joachim would be pleased for Anna.

Anna let her mother take her hand again. She didn’t really notice where they were going; she was too busy examining the new world that her glasses had opened for her.

They walked up to their home. Anna was able to recognize some things, but there was so much that she had missed in the past.

There was a man standing at the door. Anna walked up to her father, studying every detail. “Your eyebrows are bigger than Mommy’s.”