Article Date: 11/1/2006

reflections - THE HUMAN SIDE OF OPTOMETRY
Perception is Everything

This patient taught one O.D. the meaning of looking on the bright side.

BY MICHAEL B. SILVERMAN, O.D.

I've owned my current practice for 10 years now. While we have many nice patients, one of them stands out above the rest. Liz (not her real name) always has a smile on her face. If I had a dollar for every thank you she threw at me, I could have retired by now. Liz is blind, with hand motion vision in the right eye and light perception in the left. Most people wouldn't think she has a lot to be thankful for, yet she lights up the room with her smile when she visits.

I couldn't say no

I met Liz several years ago. She was in her late 30s and had no money. She complained of poor vision. Her eye exam revealed diabetic and hypertensive retinopathy; I instructed her to see a primary care physician for immediate treatment. She tried to get State Medicaid but had trouble. I made some calls to the Florida Medicaid office to help her get medical care but was unsuccessful. I called local doctors to see if someone would treat her, not necessarily for free, but even at a reduced rate — no one would. She appreciated my help so much. Finally a member of Liz's family said she would help her financially.

Liz returned a year later. She said she had no money, no Medicaid, but promised she would repay me if I examined her. She told me she was seeing "red" and blurry for a month. I told her I would examine her and not to worry about paying me back. Dilated exam revealed proliferative diabetic retinopathy with vitreous hemorrhages. I phoned a local retinal specialist and told him Liz's situation. He agreed to treat her for free for at least some of the visits she would require. Subsequently he phoned to let me know he performed pan retinal photocoagulation but that without systemic treatment, it probably would only be a temporary fix and that she would die without medical care. Some months later, Liz finally did get Florida Medicaid and went on insulin.

Life lessons

She stopped in a few months later with her husband to say hello — smiling like crazy, using a walking stick and looking at me through her side vision. Once again, a million thanks poured from her. Proliferative diabetic retinopathy had taken over her eyes. Her vision was 20/400 in each eye; further retinal treatment was of no use. But she happily informed me she was pregnant.

Last holiday season, Liz stopped in with gifts for my little daughters and a box of chocolates for my office. She told me she lost her baby at six months gestation due to toxemia of pregnancy. She said that she was given the dead fetus and took a picture before the funeral. She told me the baby's name and asked if I liked it. I told her it was beautiful — trying not to cry. She then asked how my two daughters were and said she hoped they would like the presents she brought. She offered to get them different presents if they didn't.

Liz and her husband are both mentally challenged. Although Liz is now blind, she sees the bright side — always. Though I've never made any money from her, she's the most welcome person in my practice. If I ever feel down about trivial stuff, I remind myself how lucky I am and what a bright outlook I should have. We could all take a lesson from Liz.

DO YOU HAVE A MEMORABLE EXPERIENCE YOU'D LIKE TO SHARE? DISCUSS YOUR STORY WITH RENé LUTHE, SENIOR ASSOCIATE EDITOR OF OPTOMETRIC MANAGEMENT, AT (215) 643-8132 OR LUTHER@LWWVISIONCARE.COM. OM OFFERS AN HONORARIUM FOR PUBLISHED SUBMISSIONS.



Optometric Management, Issue: November 2006