Why wasn't Geordi able to regrow eyes?

[The Rock]

I forgot if he ever said he was able to regrow new eyes in TNG but chose not to for whatever reason.

If being able to regrow bodily organs was not possible even in the 24th century, why not? They had eradicated all 21st century earthly diseases by the 24th century (including cancer), so why haven't they've been able to regrow bodily organs with advances in medical science by that time?

 

[Timo]

We heard two medical opinions on LaForge's eyes, from Doctors Crusher ("Encounter at Farpoint") and Pulaski ("Loud As a Whisper").

1) Cursher:

CRUSHER: "Naturally I've heard of your case. The visor implants you wear-"
LAFORGE: "...Is a remarkable piece of bio-electronic engineering by which I quote see much of the EM spectrum ranging from simple heat and infrared through radio waves et cetera, et cetera, and forgive me if I've said and listened to this a thousand times before."
CRUSHER: "You've been blind all your life?"
LAFORGE: "I was born this way."
CRUSHER: "And you've felt pain all the years that you've used this?"
LAFORGE: "They say it's because I use my natural sensors in different ways."
CRUSHER: "Well, I see two choices. The first is painkillers."
LAFORGE: "Which would affect how this works. No. Choice number two?"
CRUSHER: "Exploratory surgery. Desensitise the brain areas troubling you."
LAFORGE: "Same difference. No, thank you, Doctor."
CRUSHER: "I understand."

2) Pulaski:

PULASKI: "It's possible to install optical devices which look like normal eyes, and would still give you about the same visual range as the visor."
LAFORGE: "Done? You say almost. How much reduction?"
PULASKI: "Twenty percent. There is another option. I can attempt to regenerate your optic nerve, and, with the help of the replicator, fashion normal eyes. You would see like everyone else."
LAFORGE: "Wait a minute. I was told that was impossible."
PULASKI: "I've done it twice, in situations somewhat similar to yours. Geordi, it would eliminate the constant pain you are under. Why are you hesitating?"
LAFORGE: "Well, when I came to see you, it was to talk about modifying this. And now you're saying it could be possible for me to have normal vision?"
PULASKI: "Yes."
LAFORGE: "I don't know. I'd be giving up a lot."
PULASKI: "There's something else you must know. This is a one shot. If you decide to change your mind, there's no going back. And there are risks. I can offer choices, not guarantees."
LAFORGE: "Well, this is a lot to think about. I'll get back to you, Doctor. Thank you."

So, it seems Crusher is a bit of a hack, not being aware of all the possibilities, while Pulaski does this stuff as a matter of routine and is surprised that not all doctors are well read on her work. Both tackle this pain issue, as is their duty as healers, but only Pulaski offers alternative ways for LaForge to see, with two types of cosmetic improvements on how he would look (i.e. no VISOR).

Both times, LaForge shoots it down on the basis of "No thanks, I won't take mere normal human vision, as I'd cease to be Superman and would become a cripple like the rest of you". So there is no incentive for the doctors to proceed.

But making new eyes, real or artificial, seems utterly trivial (which should come as no surprise, because eyes are simple things, mere lenses connected to a bit of preprocessing neural tissue - we could do those in a heartbeat with today's technology, and indeed have done already). The real fault appears to lie in the optical nerve, the regenerating of which is the thing Pulaski only promises to "attempt".

It's a bit weird. If eyes are just adaptive lenses with a primitive chip attached, the optical nerve ought to be a mere cable. The EMH replicates new nerves for a dead patient in "Emanations", bringing her back to life just as nonchalantly as Pulaski offers to give LaForge new real eyes via replication. Why is the optical nerve a problem here? Meddling with the brain can be done: a fourth doctor, Bashir, makes prosthetics for massive percentages of the brain in "Life Support". But even he admits defeat in removing a macroscopic implant from the middle of Garak's brain in "The Wire". Possibly the surgery to repair LaForge's nerves would be too risky in a variety of ways, even when the eyes are not a problem.

Add to this ST:Insurrection, where LaForge gets real, seeing eyes as a matter of a biological process (and not as an act of magic, as when Q gave him some). These seem to be his original eyes, which have always been there, even if there have been techno-contacts on them ever since ST:First Contact. Perhaps the eyes never were broken much to begin with, despite appearing oddly whitish-opaque? Nevertheless, Pulaski offered to replace rather than repair them, again emphasizing the triviality of the orbs, and the issue of the real fault lying elsewhere.

Timo Saloniemi

 

[The Rock]

We heard two medical opinions on LaForge's eyes, from Doctors Crusher ("Encounter at Farpoint") and Pulaski ("Loud As a Whisper").

1) Cursher:



2) Pulaski:



So, it seems Crusher is a bit of a hack, not being aware of all the possibilities, while Pulaski does this stuff as a matter of routine and is surprised that not all doctors are well read on her work. Both tackle this pain issue, as is their duty as healers, but only Pulaski offers alternative ways for LaForge to see, with two types of cosmetic improvements on how he would look (i.e. no VISOR).

Both times, LaForge shoots it down on the basis of "No thanks, I won't take mere normal human vision, as I'd cease to be Superman and would become a cripple like the rest of you". So there is no incentive for the doctors to proceed.

But making new eyes, real or artificial, seems utterly trivial (which should come as no surprise, because eyes are simple things, mere lenses connected to a bit of preprocessing neural tissue - we could do those in a heartbeat with today's technology, and indeed have done already). The real fault appears to lie in the optical nerve, the regenerating of which is the thing Pulaski only promises to "attempt".

Timo Saloniemi

Ah yes, thank you Timo! I sort of remembered both of those conversations but I had completely forgotten about the part where Pulaski saying she could try to actually regrow his eyes (for some reason all I remembered was the part about optical implants).

I guess Geordi changed his tune during the time of Insurrection since he was able to gain normal vision near that planet and he really liked it. I think being able to see a sunrise the way everyone else could see them is what changed his mind.

 

[Timo]

He liked normal vision in moderation, it seems: he took delight in looking at Tasha Yar like us mere inferior normal humans would, as early as "Hide and Q", but immediately turned down the supernatural being's gift as if it were of little consequence and the ethics of the issue easily superseded the practicalities.

A glimpse of Yar, a glimpse of a sunrise: possibly analogous to how one of us might enjoy being blindfolded for a tender moment. But after Insurrection, LaForge is back to having apparently boosted, decidedly inhuman-looking eyes in Nemesis. And in "Timeless".

Although not in the future of "All Good Things..", where he either wears more aesthetically conformist technology, or then has finally decided to get replicated real eyes. We might argue either way, seeing that "AGT" is a couple of years farther in the future than "Timeless" and might represent improvements in VISOR implant tech.

Timo Saloniemi

 

[F. King Daniel]

Maybe after Qiker gave him real eyes for a cup of coffee in season 1, he decided he preferred it better with his visor.

 

[Mr. Laser Beam]

In that ep where Worf got a new spine, it was considered a big deal - an untested, risky procedure - to grow organs from scratch. So they may not have been able to give Geordi new (biological, as opposed to synthetic) eyes.

 

[dupersuper]

Although not in the future of "All Good Things..", where he either wears more aesthetically conformist technology, or then has finally decided to get replicated real eyes. We might argue either way, seeing that "AGT" is a couple of years farther in the future than "Timeless" and might represent improvements in VISOR implant tech.

Timo Saloniemi

Though as both are aborted alternate futures, I wouldn't be concerned.

 

[Sgt_G]

So, it seems Crusher is a bit of a hack, not being aware of all the possibilities, while Pulaski does this stuff as a matter of routine and is surprised that not all doctors are well read on her work.

Just because Crusher hadn't read one particular report out of tens of thousands written every year does not make her "a hack". Also, I don't see where Pulaski was "surprised" that not all doctors had read her work, and it would be highly arrogant of any doctor to think that.

 

[Timo]

Well, if LaForge were a random patient walking in, Crusher's ignorance might be excusable. But she's gonna inspect the VISOR here specifically, and to discuss LaForge's medical issues - which she does, up to suggesting lobotomy. Reading up on "that particular report" would be a must, and not a major chore, since it wouldn't be gathering dust on a shelf somewhere: it would be searchable with proper keywords.

So, definitely a hack. Or then just a conservative: Pulaski suggests replicating some of the tissue involved, and when Dr Russell suggests the same in "Ethics", Crusher goes into conniptions. Perhaps she represents a school of thought that sees risks where there are none, or fewer than said school thinks? Pulaski's treatments supposedly worked just fine. And while Russell was a bit of a villain when it came to other stuff she did with her patients, her technique here did not appear to be inherently at fault, only more extensive than what had been done before. Interestingly, Crusher had read up on that one...

I could see doctors today doing it either way. Offering hope in the form of new and marginal treatments might not be a good idea in general. But Crusher here is indeed going speculative, on the painkiller techniques. Why not on actual cures?

Timo Saloniemi

 

[dupersuper]

Easily handwaved by saying the two cases Pulaski participated in happened within the past year.

 

[Mister Spock]

I misread the title as 'Why wasn't Geordi able to regrow eyebrows'.

I've always been curious, but with his new eyes in First Contact, had he had his blind eyes removed from his head and new eyeballs put in, or were they worn over his blind eyes like contact lenses?

 

[Timo]

The latter would allow the Fountain of Youth to more easily achieve the restoration we witness.

Then again, it isn't really restoration: LaForge never had working eyesight, not even in his youth. But perhaps he always had working eyes, and only his optical nerve was born wrong and never worked, as quoted? The weird milky opaqueness of the orbs might have been a protective contact over working eyes all along, to safekeep them in hopes of future restoration of sight.

Yet Pulaski did specifically speak of replicating new orbs once she got going with that optical nerve cure of hers...

Contacts mean less gore offscreen in ST:INS. Apart from that, no telling.

Timo Saloniemi

 

[STEPhon IT]

Add to this ST:Insurrection, where LaForge gets real, seeing eyes as a matter of a biological process (and not as an act of magic, as when Q gave him some). These seem to be his original eyes, which have always been there, even if there have been techno-contacts on them ever since ST:First Contact. Perhaps the eyes never were broken much to begin with, despite appearing oddly whitish-opaque? Nevertheless, Pulaski offered to replace rather than repair them, again emphasizing the triviality of the orbs, and the issue of the real fault lying elsewhere.

Timo Saloniemi

I didn't get how that could be since Geordi was biologically impaired? The planet should just restore him to how blind he was at a younger stage of his life. Does the optical nerve create cornea, conjunctiva, iris, and humor aquosus??? No, as seen his entire eyes were full sclera (White). Surgically giving Geordi normal human eyesight appeared very difficult even for 24th Century standards.

 

[Timo]

Well, not really - Pulaski could do it in a heartbeat, or at least claimed so.

The problem was that LaForge would never settle for having normal human eyesight, or other such debilitating handicap. So all the medical effort was directed at making his supersight less painful for him. Perhaps at some point, LaForge began to think that looking freakish (an issue first raised by Soran, nobody else in the 24th century caring, or admitting to caring) was one aspect of that pain, and thus accepted less conspicuous supervision aids. Or perhaps the tech just evolved - but this doesn't sound all that plausible, since surely it should have advanced to the point of creating perfectly human-looking super-eyes centuries before LaForge was born.

Timo Saloniemi

 

[Deks]

Well, not really - Pulaski could do it in a heartbeat, or at least claimed so.

The problem was that LaForge would never settle for having normal human eyesight, or other such debilitating handicap. So all the medical effort was directed at making his supersight less painful for him. Perhaps at some point, LaForge began to think that looking freakish (an issue first raised by Soran, nobody else in the 24th century caring, or admitting to caring) was one aspect of that pain, and thus accepted less conspicuous supervision aids. Or perhaps the tech just evolved - but this doesn't sound all that plausible, since surely it should have advanced to the point of creating perfectly human-looking super-eyes centuries before LaForge was born.

Timo Saloniemi

We can already grow new organs or repair damage to existing ones using say stem-cells.
So, for Starfleet, it would have been routine by then to detect the problem in utero and repair it either with gene editing (not for the purpose of creating a superhuman, but obviously just to repair a problem) or immediately after birth.

But one thing with genetic modification not being available was because it was not allowed. It's possible that some relaxation on the gene editing to repair some issues like blindness or lack of hearing wasn't allowed until the late 24th century.
And as we saw in Lower Decks, some people also wore visors. So it could have been down to the parents decision to not have the genetic treatment to allow the kid to see as anyone else.

But I have to agree with you that Crusher has had several instances in which she was against replication as means of repair. This is one of the reasons I liked Pulaski better than Crusher... because it seemed like Pulaski was just BETTER at medicine than Crusher.

 

[Timo]

We also had VISOR-style tech in the DIS 2250s (war wounds?), and Miranda Jones wore similar gear, only with different aesthetics (motivated to secrecy?). Might be there's a choice to be made between aesthetics and performance, and choosing the former means giving up any edge with the latter in the 24th century still - but meant such immense handicaps back in the 2250s that only psychologically unique individuals would choose style over functionality.

Why wasn't LaForge fixed in utero? Might be the prognosis was that a vision aid would solve all his problems without breaking taboos or medical no-harm guidelines - but the prognosis was wrong as regarded the pain issue. But the weirder thing here is that sight tech is so ubiquitous elsewhere in Trek (including making its by far most advanced and futuristic appearance in TOS!) yet LaForge is treated as a special case, known to Crusher as a famous patient ("Naturally I have heard of your case" really sounds like it's natural for every doctor in the Federation to know, rather than it being natural for LaForge's designated doctor to know).

Why is either LaForge or his VISOR so very special? We can speculate the tech does more than most vision aids. But we can also speculate that something went spectacularly and irreversibly wrong with the treatment of LaForge, which is why everybody is told about that so it would never happen to a patient again. Perhaps Silva and Edward went to jail for what they did (or failed to do) to their son, but are now back and suffering no permanent consequences we'd be able to spot?

Timo Saloniemi