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The Blind Physician January 9, 2007

Posted by Benji in Journal.
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          It was clear from her tears that she was scared. The white tissue veil she pressed against her face did not mask her pain.
          “He said the cornea needs to be amputated,” she said finally, rubbing both eyes with the palm of her hand.
          I stood there stupidly, quietly trying to piece together the story. I had no chart to guide me. I thought the reflexive response of “oh, it’s okay” was cliché and of little comfort – besides, it really might not be okay.
          One of her friends spoke up, embracing her from the side. “Wait until you go to Boston. See what they say there.”
          “Yes, I know,” the woman sobbed, “but the more I think about it, the more it makes sense. It was on my mind the whole holiday break. I just want some resolution to it now.”
          I still had no idea what was going on. I knew this was a stressful and serious life-event for the woman, but the vagueness of the pronouns left me with little to interject. She had been debating whether or not to have lasik eye surgery a few months ago, I remembered – the surgery must actually have worsened her vision, rather than helped it.
          I wondered what, in this moment, my role was: to play medical voyeur until I could make an evidence-based, scientific remark or to just become a confidant and offer trite phrases of solace? In deciding what my professional response should be, I simply froze up, following neither path, and thinking that that was worse than picking one extreme.
          “On top of this, he’s just such a jerk.” She was talking about her ophthalmologist. “My husband and I had to call him every day over the holiday to get an earlier appointment in Boston. He just sits on things.”
I hope it’s something sharp,” I thought to myself, simultaneously hating her eye doctor for being so blind (or, worse, apathetic) to her fears, but also wishing I could offer a sitcom punchline that would lighten the mood long enough for me to go back to the other patient I had left waiting during all this. Like the woman, I was as frustrated that there was nothing I could do now; only a second opinion from an eye surgeon in Boston would make the next step clearer.
          Breathing out slowly in an attempt to regain her composure, the woman picked up a manila folder from the desk and wrapped her stethoscope around her neck. Her eyes still red from crying, she stood up to see the patient I had started presenting to her 10 minutes ago. I followed behind her silently, somewhat confused that I had seen my physician-mentor in the role of patient, but also impressed that she was literally (trying to) leave her personal life at the door.
          She paused before knocking. “If it weren’t such a physical thing, maybe it wouldn’t affect me so much,” she said to the friend-colleague who had also followed us. “But every time I look in an ear, I have to think how I’m going to do it so I can see around my blind spot.”
          It’s an interesting dichotomy that we as physicians must look past our own shortcomings or biases yet pinpoint them in others. Failing to do this, or worse yet, failing to support the patient after problems have been discovered, is a particularly frustrating form of blindness. Though the myopic physician, overly focused on detail and not context, may be accurate, he is ignorant of what he fails to see, and his blindness instead presents a challenge to his patients. I knew that regardless of what happened to my physician-mentor’s eyesight, she would never be as blind as her ophthalmologist. Her dark eyes glistened from dying tears as she opened the exam room door and asked, “It’s nice to see you, Iris. How can I help you today?”

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