023 Personal Perspectives on Vision Loss with Nik Kirkpatrick

Today's guest is Nik Kirkpatrick — a forty-year-old living with Stargardt's disease, a condition he was diagnosed with at seventeen. Nik found inSight Out through the Stargardt's subreddit, where he regularly supports others who are newly diagnosed. In this conversation, he offers a raw, honest, and at times darkly funny account of what it has taken to build a life he genuinely wouldn't change. This one is for anyone who has ever felt like they were falling behind — and needed to hear that the detours sometimes lead somewhere worth going.

Letting the Universe Come to You

There is a particular kind of conversation I find myself returning to in my work as a psychotherapist — the kind where a person says something they've clearly been carrying for a long time, something they've almost stopped noticing because it's become so much a part of how they move through the world. And then they say it out loud, and for a moment, the room gets quiet.

Nik Kirkpatrick gave me several of those moments in Episode 023 of inSight Out.

Nick is forty years old and has lived with Stargardt's disease since he was diagnosed at seventeen. He found the podcast the way many in our community find each other — through the Stargardt's subreddit, where he regularly shows up for people who are newly diagnosed and terrified. He came on the show not as an expert in vision rehabilitation or technology or medicine, but as someone who has simply lived it. Longer than most. More honestly than most.

What He Was Told — And What Was Left Out

Nick's diagnosis didn't come with a roadmap. His neuro-ophthalmologist told him that his vision would deteriorate over five to ten years. He was around 20/70 at the time. What the doctor didn't say — or what Nik didn't hear, or what simply wasn't fully understood — was that the timeline and endpoint were far less certain than that framing suggested.

I know this particular experience well. I have Stargardt's disease too. And the way our prognoses are communicated, or miscommunicated, shapes years of decision-making. For Nik, it shaped his relationship to planning, to school, to work, to hope.

He told me he spent most of college and his twenties essentially pretending the diagnosis wasn't real — avoiding accommodations, dropping classes he couldn't follow, staying in work environments that were familiar even when they weren't safe. Not because he was in denial, exactly. But because the information he'd been given hadn't given him a coherent picture to respond to. When you don't know what you're adapting to, it's very hard to adapt.

This is something I see often in the adjustment process: people aren't failing to cope. They're coping with the wrong information. Grief requires an accurate object.

The Long Road Into Therapy

Nick's history with therapy is, to put it charitably, a series of near-misses. His first experience ended after a few sessions when the billing fell through and his therapist sent a passive-aggressive email. His second was with someone who ended the relationship after a single session for unrelated reasons. His third was with a newer therapist who, though well-intentioned, wasn't quite the right fit — and who eventually stopped reaching out.

He found his current therapist about three years ago. And by that point, he told me, most of the work wasn't directly about his vision. He'd done a lot of that processing on his own, over time. What remained was the other stuff — the relational patterns, the financial stress, the accumulated weight of years spent navigating a world that wasn't designed with him in mind.

I want to be careful here not to overstate the lesson, because Nik told his story with characteristic plainness and I don't want to impose more meaning than he intended. But I did notice something. The years of not-quite-right therapy weren't wasted time. They were part of a longer process of discernment — Nik learning, slowly, what he actually needed, and what kind of support felt real versus what felt performative. That's not nothing.

The Invisible Grief in Ordinary Moments

One of the most precise descriptions of vision-related psychological pain that I've heard in a long time came in the form of a story about a music festival.

Nik was out with his wife and a friend. They went to a restaurant. The bill came. Nik didn't reach for his debit card — not because he was avoiding it, but because that's just not how he navigates restaurant situations. And somewhere in that moment, their friend internalized something: that Nik wasn't a full participant in the financial and logistical life of the outing.

Earlier in the day, she had remarked that dividing by three was hard. Nick, who is by his own accounting good at math, was quietly mortified.

He brought the whole weekend to a therapy session. And he told me something that I found clinically precise: he wasn't spending that session talking about how he can't see. He was spending it talking about how, because he can't see, he was having a negative interaction with someone about a totally unrelated issue.

That is how vision loss actually works in a life. It doesn't stay in its lane. It bleeds into the restaurant check, the job interview, the sidewalk, the dinner conversation — not because vision loss is the problem in all those contexts, but because it changes the margins. It removes options. And when options are removed, even small social moments can carry weight they weren't designed to carry.

The Foundation That Predated the Diagnosis

Here is the thing about Nik that I kept coming back to throughout our conversation: he has always known who he is.

He described it as being "cool" — meaning not swagger, but groundedness. A sense of his own worth that didn't depend on external validation. He traced it back to his upbringing, to watching his parents make decisions he didn't want to replicate, to deciding early that emotional reactivity and avoidance led somewhere he didn't want to go.

That foundation — that preexisting sense of self — has been his most durable resource. It's why, when people treat him as though his vision loss makes him less capable or less relevant, he doesn't internalize it. It says more about them, he told me. And he doesn't have time for those people.

In my clinical work, this is one of the most important threads I try to locate with clients who are adjusting to vision loss: what do you know about yourself that this diagnosis cannot touch? Because there is always something. And the work, in part, is about reconnecting with it — not denying the loss, but refusing to let the loss be the whole story.

Nik came in already holding that. Not everyone does. And his candor about the economic consequences — the Social Security income, the hourly work, the very direct message to young people newly diagnosed to get educated — reflects the other side of that groundedness. Knowing who you are doesn't insulate you from structural disadvantage. But it does give you a place to stand.

What He Said at the End

As we wrapped up, I asked Nik if he could summarize what he'd learned. He said everything happens for a reason — and then immediately complicated that cliché in the best way. If he had done everything right when he was young, he never would have met his wife. He wouldn't live where he lives. He wouldn't have the dog.

He said: if you make the mistake, own it. If you do the right thing, be grateful — and give back. Because someone is behind you dealing with the same fear you had, and they need the support.

Then he said something I've been thinking about since:

Let the universe come to you.

And when I repeated it back and added: and accept it when it does — he said yes. And we left it there.

I don't know that I have a cleaner ending than that. Nik Kirkpatrick is not a polished public speaker. He's not a motivational voice. He's someone who has lived something hard, paid attention to it, and found a way to make it mean something. That's the whole job, really. For all of us.

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022 The World of Descriptive Audio with Darla Biccum