Doctor Rand

by Katrina Trinko
Senator Paul performs pro bono eye surgery.

Paducah, Ky.

‘Oh my God. Oh my God.”

Those are Cynthia Burke’s first words after Senator Rand Paul, an ophthalmologist, completes her eye surgery, removing the cataract in her right eye. Lying down in the operation room, Burke, a 55-year-old woman from the Ozarks town of Fredericktown, Mo., looks up. Standing above her are Paul and another ophthalmologist, Barbara Bowers, both dressed in blue scrubs.

Because of her cataracts, Burke hadn’t been able to perceive much color, and couldn’t see at all in her right eye when there wasn’t natural light. But now, with the surgery just completed, Burke’s sight is already hugely improved. “You have on blue clothes,” Burke marvels.

Paul, who just moments ago was bent over Burke, looking through a microscope at her eye as he methodically and precisely moved needles and tools to remove the cataract, laughs happily. “You’re seeing colors again,” he warmly observes.

“Now you’ll recognize him on TV,” Bowers jokes to Burke about Paul.

“Oh my God,” Burke repeats. “It’s awesome. Oh my goodness.”

Burke is one of four patients that Paul performs pro bono eye surgery on today. In recent years, Paul has done between 10 and 15 eye surgeries a year for free. “I’ve always done some since I’ve been in practice,” he recounts. In 1995, Paul founded the Southern Kentucky Lions Eye Clinic, which provided free eye care for low-income people, “because I wanted to be able to give back to the community.” He did free operations for locals and also for children who had come all the way from Guatemala.

Paul estimates he has done over a hundred pro bono surgeries over the years. In the health-care debate, he remarks, it was overlooked how many doctors already perform free surgeries for those in need. Performing surgery pro bono, Paul insists, “is not unusual for physicians.”

Burke, a health-care worker who helps elderly men and women with home care, says she heard about the pro bono cataract surgeries from a friend. For about five years, she had suffered from cataracts. “Here’s the thing: When the sun goes down, or if the sun’s not up yet, this girl can’t drive. I have no vision at all in my right eye,” Burke told me before the surgery. She was tired of all the limitations the cataracts imposed on her: “I’m only 55 years old, come on, it’s not time to give up on this life.”

Today, she is all smiles. “I’ve been so excited I can’t hardly wait,” says Burke, who has a blonde-brown bob hairstyle and wears a plaid shirt. She jokes that she should ask Paul to inscribe a small tattoo under her eyelid that shows he did her surgery so people will know she’s telling the truth. “Nobody else will ever believe that Rand Paul, the senator of Kentucky, did my cataract surgery,” Burke predicts. “The girls at work are going to say ‘No, no, no,’ and I’m going to say ‘Oh, yes.’”

In a nearby room at Bowers’s clinic waits Judy Prince, who will also be having cataract-removal surgery today. “I’m totally blind in my left eye,” says Prince, a 61-year-old woman with short, gray hair and a calm demeanor. Prince, who lives in Bardwell, Ky., and who voted for Paul in 2010, notes that her vision regularly makes her feel disoriented: “I feel like I’m walking sideways,” she remarks.

Five weeks ago, Prince had broken her arm because of a sight-related accident. “I was outside and a car came around the corner, and the light shone in my right eye, and so that made me totally blind,” Prince recalls.

“I fell and I dislocated my elbow and I broke my arm because I thought I was going to reach out — I knew I was going to fall,” she explains, “and I thought I was close enough to our truck, I was going reach out — [but] I wasn’t anywhere near close to our truck. So I fell right on my arm, I couldn’t see, I couldn’t get up.”

A few months prior, Prince had stopped driving, concerned about the safety risk of relying solely on one eye. Told by her optometrist she needed to see an ophthalmologist to take care of her cataracts, Prince opted to consult Bowers, who was also her mother’s ophthalmologist. Prince planned to ask about a monthly payment plan to finance the surgery.

“I would have to pay for it out of my pocket, because I don’t have any health insurance,” Prince explains. Her husband, who is nine years older, is on Medicare, but Prince is too young to qualify and can’t afford the $690 a month she says health insurance would cost her. She was thrilled when Bowers told her that she and Paul did pro bono surgeries. “Finding out that he would do it for nothing is like he just gave me $2,800,” Prince says.

Paul doesn’t mention Prince by name the next day when he gives a speech and does a Q&A with medical students at the University of Louisville. But she might well have been on his mind when he was asked whether health care is a commodity or not.

“There’s a philosophic debate which often gets me in trouble, you know, on whether health care’s a right or not,” Paul, in a red tie, white button-down shirt, and khakis, tells the students from the stage. “I think we as physicians have an obligation. As Christians, we have an obligation. . . . I really believe that, and it’s a deep-held belief,” he says of helping others.

“But I don’t think you have a right to my labor,” he continues. “You don’t have a right to anyone else’s labor. Food’s pretty important, do you have a right to the labor of the farmer?”

Paul then asks, rhetorically, if students have a right to food and water. “As humans, yeah, we do have an obligation to give people water, to give people food, to give people health care,” Paul muses. “But it’s not a right because once you conscript people and say, ‘Oh, it’s a right,’ then really you’re in charge, it’s servitude, you’re in charge of me and I’m supposed to do whatever you tell me to do. . . . It really shouldn’t be seen that way.”

On the day he does the surgeries, Paul also goes to the Paducah Rotary Club to deliver a speech. On the ride over in a tan Prius, which belongs to one of Paul’s staffers (“We’re just trying to save the planet,” Paul says wryly, and then talks about the jobs created by Toyota’s Kentucky plant), Paul says his only eye problem is that he needs reading glasses — a common condition for someone his age.

Paul first became interested in ophthalmology as a child. His grandmother on his mother’s side, Carol Wells, had significant eye problems: Over the years, she suffered from cataracts, glaucoma, and macular degeneration, and even had a corneal transplant. “As a kid growing up, I went to the doctor with her several times,” Paul remembers. She remains in his thoughts: In his foyer now hangs a 1930s photograph of Wells participating in the rifle team at Ohio University.

Paul’s mother, Carol Wells Paul, had cataracts at 48. “She had trouble seeing, telling the difference” between colors, Paul recalls. “My little sister used to ride around with her, saying, ‘Mom, it’s green, it’s red’” when they came to traffic lights.

At medical school, Paul became involved in research related to corneal transplants, and he decided to pursue ophthalmology. (His father, former congressman and ob-gyn Ron Paul, observed that his son had picked a medical field more conducive to getting sleep.) Paul kept his ophthalmology practice active until he became a senator, right on through the heated primary and general-election Senate campaigns in 2010.

He didn’t care what his patients’ politics were, but as Paul became a statewide figure during the campaigns, patients started bringing it up. “As I was running for office, I got slower and slower seeing patients because everybody wanted to talk about politics,” he recalls wryly. “I don’t bring it up typically. . . . It doesn’t matter to me whether you’re Republican or Democrat or whether you agree with me or not” when you’re one of his patients.

And while politics didn’t influence his work as a doctor, his experience in health care has affected how he views health-care policy. “Having been a physician, I see people from all walks of life and I see how it works and how it doesn’t work,” he remarks. In particular, his experience has made him an advocate of increasing price competition in health care.

“Insurance doesn’t cover Lasik surgery, the surgery to get rid of glasses,” Paul remarks. “So it started at about $2,000 an eye, maybe even $2,500 an eye, and it’s down in some communities to under $500 an eye because competition works and people call on average four doctors to get the price and see how much it’s going to cost.”

Paul also cites the cost of contact lenses, which don’t tend to be covered by insurance either. “When I sold them,” he recounts, “I was within pennies of Walmart, because you gotta compete.”

After his election, Paul received unpleasant news: Senators aren’t allowed to hold second jobs except, in some cases, teaching. Since his father had been able to continue practicing as an ob-gyn while in the House, Paul had assumed he could do the same. But Senate and House rules are different, and the Senate Ethics Committee denied Paul’s request to continue his work without receiving a salary (he wanted to continue charging enough to pay his staff and keep up his malpractice insurance).

Paul misses practicing medicine. “This is a good day for me,” he says. “This is exciting for me to come back and do it.” He also misses the technical aspects of the work. Describing a new laser machine, Paul explains how it helps with certain cataract surgeries: “It makes the opening for you and then it partially dissolves the lens,” instead of requiring the doctor to make the cut directly. When he gets a chance to use the new equipment later that afternoon, Paul is clearly wowed. “That is so cool,” he comments. “That is wild.”

After the speech, Paul heads to the clinic where he’ll do the operations. He changes from brown embroidered cowboy boots and a suit to blue scrubs, and chats with Bowers as the two of them thoroughly wash their arms and hands in a huge sink. Cynthia Burke, resting on a stretcher, is wheeled into one of the large operating rooms, and Paul, Bowers, three reporters, and several assistants file in. The green-painted room is packed with medical equipment, and overhead, disconcertingly, top-40 music is playing: During the operation, it includes songs with lyrics such as “We just wanna make the world dance / Forget about the price tag” and “But you’re an animal, baby, it’s in your nature / Just let me liberate you.”

Paul pulls on big yellow rubber gloves and holds out his arms as a blue smock is put over his scrubs. He sits down on a chair right behind Burke’s head and positions a large microscope over her eyes. “Hold really still,” Paul tells Burke as he begins. “You’re doing great.”

During the operation, he deftly inserts needles and other tools into her eye, watching his work through the microscope. Overhead, a large TV monitor allows everyone else in the room to see in excruciatingly vivid detail exactly what Paul is doing: The monitor shows Burke’s eyeball, forcibly held open with clamps, pulsing and oozing and sliding as Paul punctures and scrapes and removes the cataract. “We’re making really good progress,” Paul assures Burke. “Not too much longer to go.” Later, Burke says all she felt during the procedure was a sensation akin to water entering her eye.

Earlier, Paul had shrugged off the squeamishness factor of operating directly on the eye. “It’s a little bit like giving a public speech,” he says. “The first time you do it, you’re a bit nervous and you’re concerned about doing it and it becomes easier. I’ve probably done 10,000 now, so I’m fairly accustomed to doing it.”

After the surgery, Burke is dazed — and elated at her new ability to perceive color. “You got on a blue hat,” she tells me, referring to the scrubs I had to wear to enter the operating room. Before, Burke says, “it was like a lot of the colors were either black or white, not much in between.

Later that afternoon, Paul removes Judy Prince’s cataract. Like Burke, Prince is ecstatic, albeit in her own calm, no-nonsense style, when she looks around immediately after the surgery. “I can see Dr. Bowers over there,” she says, still lying on the stretcher in the operating room. “I can see.”

“God,” Prince then declares, “has given sight to the blind.” Her newfound range of sight amazes her: “I haven’t been able to look to that side and see anybody in forever,” she tells me.

Before the surgery, Prince had observed, “If he gets to be president, you know, I can say the president gave me back my sight.” But her thoughts quickly shifted past 2016. “I just think it’s a wonderful thing he’s doing,” she said of Paul. “He’s doing this strictly because he loves people, I guess. He cares about people.”

— Katrina Trinko is an NRO reporter.