In the early 1980s, during the Cold War, a Soviet submarine ran aground on the coast of Sweden, in close proximity to a Swedish naval base. The Soviets claimed that they were forced into the territory by severe distress and navigation errors. Sweden, however, saw the maneuver as evidence that the Soviet Union was invading its waters and considered it an act of military aggression.
Spooked, the Swedish government went on high alert. The incident was aggravated by military reports of acoustic signals in the water and small bubbles on the surface. For an entire month, naval ships, submarines, and helicopters hunted for intruding submarines. Every search was fruitless, but the efforts continued for more than a decade.
Finally, in 1996, the Swedish government enlisted outside help from a team of bioacoustics experts led by Magnus Wahlberg, PhD, of the University of Southern Denmark. Dr. Wahlberg quickly observed that the sounds were “not at all” what he would have expected from a submarine. Upon further investigation, the specialists discovered the source of the distressing signals: fish flatulence.
As the bioacoustics experts explained, herrings have swim bladders that are connected to their anal ducts and can be squeezed to expel bubbles. They also swim in massive schools—likely explaining the magnitude of the signals the Swedes had been hearing. Turns out, Sweden wasn’t under enemy threat, but it did spend 10 years deploying its military in pursuit of gassy fish.
As this stranger-than-fiction anecdote illustrates, sometimes human beings get so close to a problem and the perceived solution that they lose sight of all other possibilities. Medicine is no stranger to such dogmatic thinking. But, the history of ophthalmology is filled with examples of figures and technologies that challenged the status quo for the better. On a smaller scale, we have all likely witnessed the importance of questioning our own beliefs and practices. Doing so may not always prompt a dramatic overhaul, but it is a useful exercise to confirm we aren’t operating according to expired principles in a field that is constantly evolving.
In this issue of GT, contributors share their perspectives on refractive solutions in patients with glaucoma. Although the current dogma may be that certain technologies and treatments should never be utilized in glaucomatous eyes, these articles show that sometimes expanding our views—particularly to include the perspective of the individual patient before us—can open us up to a new reality and help us to differentiate the heresy from the herrings.
