the way i see it
I Said What?
Not all patients can accurately recall what we tell them.
MARC R. BLOOMENSTEIN, O.D, F.A.A.O.
Some would say that I am unrefined, bordering on inappropriate, in my approach to patients. I like to play it close to the edge and instill a sense of colloquialism while still bathing my patients in professionalism, the way a 14 year-old bathes himself with his first bottle of Axe body spray.
All these fun and games are amusing until someone loses an eye. Although that can be profitable, it is not how I roll. My joviality stops at anything that can harm the patient, question surgical safety or if my patient’s neuronal capacity has reached its greatest level at almost zero (“Can you repeat that? One or what?”).
This being the case, I am still shocked at what patients think they remember hearing or how they perceive the information we give them.
A game I like to play is not looking at the chart and walking in cold. Like a comedian who practices his craft at an “improv club,” I want to sharpen the blades of my diagnostic tools. On one particular occasion, as I peered into the exam room much like pulling back the curtain to see my audience, I was surprised to see who was sitting there.
The occupant of my reclining chair was a hulking male I recognized immediately. “Hey, I know you! How is it going, bro?”
His response to my dimple-inducing facial expression: “You? What the hell?”
Now, I know what you are thinking: “Marc, what did you do? Why is Hulk angry?” Honestly, I was utterly in shock. I distinctly remembered this patient and his bilateral PSC, which were not induced by any steroid usage (“Never used the juice ever, and if you doubt me I will put my foot down your throat until there is poop on my shoe!”). The patient received one presbyopia-correcting lens at 34 years old (yep, no steroids) and did really well, or so I thought.
“What are you doing here?” he asked. “I remember you. You messed me up really bad. I was looking for you to show you how much I ‘appreciated’ what you did.”
Other patients have shown gratitude with homemade Rice Krispies treats in the shape of one of their 18 cats, but I did not think he wanted to show me love: This was his “non-steroid-induced” rage.
I noticed a slight pulsation to his neck as he said, “You told me to open my eyes in the shower and flick my finger at my eye. Dude, that messed me up real bad, for months.”
No simple solution
I thought about defending myself against an absurd statement when it hit me: If this guy was dull-witted enough to open his eyes in the shower and place a digit in this vital organ, what can I possibly say to assuage his angst?
I realized it was my responsibility to reassure my patient that he misunderstood my lid massage and warm compress treatment for his meibomian gland dysfunction — the shower is a great way to warm the lids and do a quick cleanse. However, I scampered away after quickly calculating the time I would waste attempting to reassure Kong that he misunderstood only to have to explain my explanation. No good deed goes unpunished. OM
DR. BLOOMENSTEIN CURRENTLY PRACTICES AT SCHWARTZ LASER EYE CENTER IN SCOTTSDALE, ARIZ. HE IS A FOUNDING MEMBER OF THE OPTOMETRIC COUNCIL ON REFRACTIVE TECHNOLOGY. E-MAIL HIM AT MBLOOMENSTEIN@GMAIL.COM, OR SEND COMMENTS TO OPTOMETRICMANAGEMENT@GMAIL.COM.