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This post was originally published on taylordenniswrites.com on November 17, 2020.
A couple years ago, I had an appointment at the ophthalmologist that I will never forget.
Like the other 15 patients who were there, I was led into an exam room and given eye drops soon after arriving, then sent back out to the lobby to wait while the drops kicked in. Once my pupils were dilated, I saw the doctor. He looked briefly at my eyes, gave me even more drops, and sent me back to the waiting room once more.
There I sat, unable to see anything well enough to really entertain myself. If you’ve ever had your eyes dilated before, you know the experience: Bright light is difficult to tolerate, as your pupils can’t contract as they usually would, and your eyes are also unable to focus on things close-up—think phone screens, books, etc. For people with perfect vision, like me, this experience provides some insight into what it must feel like to be far-sighted. If nothing else, this exam that I undergo every 18 months helps me empathize with older adults who find their arms are now too short to hold a book or newspaper in the right place.
As I waited for the doctor to call me back in, I noticed him leaving the exam room with another patient. It’s a small space, and I couldn’t help but overhear the conversation as the pair headed toward the receptionist’s window.
“All right, we need to book Mrs. White in for some laser,” the doctor said. “Yes, next week would be good.”
And then, to the patient: “Theresa will get you an appointment, and then she’ll tell you everything you need to know about laser. I’ll see you at the hospital.”
That was it—he was back to the exam room; back to the next set of (probably) diabetic eyes; back to the next patient he would spend approximately two minutes examining; and, perhaps, back to the next person to whom he would casually announce the need to shoot a laser beam into their retina.
Meanwhile, Mrs. White stood in the lobby, trembling.
I don’t know Mrs. White (not her real name), and I don’t know her story. I know only what I saw, which was this: A very thin woman, probably in her 50s or early 60s, went to the eye doctor alone. There, she learned that she required laser photocoagulation to repair leaking blood vessels in the retinas of both of her eyes. I can only guess that this woman has had diabetes for some time, and if that’s the case, I can say with much more certainty that this outcome is something she’s been fearing for equally as long.
To the doctor, this was just a normal Wednesday afternoon. I don’t mean to portray him as cold or insensitive. He’s a pleasant enough man, and I’m sure he wants what’s best for his patients—which, for Mrs. White, happened to be laser photocoagulation. Scary as it may sound, it is an effective treatment. As this informative post written by healthcare professionals explains, “For people who have diabetic retinopathy, laser photocoagulation will very likely help prevent more severe vision loss over time. Diabetes experts agree that early detection and treatment of retinopathy can prevent many, or even most, cases of severe vision loss and blindness in people who have diabetes.”
Still, after decades of performing surgical procedures to prevent blindness in patients with diabetic retinopathy and other serious conditions, it seems my ophthalmologist had become somewhat numb to the heavy weight his patients carry. After all, the prospect of imminent blindness is terrifying, no matter how effective the treatment may be.
During our brief time together, the doctor gave me what I know to be his usual spiel: “You understand why we read you the riot act about your blood sugars, right? You know, we didn’t used to know that keeping blood sugar under control prevents all the complications. I used to laser 15 diabetics a week.” (As you can tell, he has been practicing ophthalmology for quite some time.)
Medical professionals didn’t used to understand the link between blood glucose management and complications like blindness. The clearer this link has become, the more firmly patients have been told to vigilantly monitor and manage our blood sugar levels.
So, when Mrs. White was told she needed laser therapy, she may not have heard that she had developed a very common complication to a very difficult illness. Instead, she may have heard something completely different—something that the doctor didn’t say explicitly, but which he had implied during every other visit, and which her other nurses and physicians had also enforced as they continually stressed the importance of self-management. That is, she may have heard that she could go blind, and that it was entirely her fault.
That’s a lot to process, particularly when you’re alone in a room full of strangers.
The doctor’s day went on. The receptionist’s day went on. My day went on. And Mrs. White’s day went on, too. As I left the doctor’s office, temporarily half-blind from the eye drops and more grateful than usual for my as-yet undamaged retinas, I couldn’t help but reflect on how life somehow always manages to keep moving, even when we come up against things that feel impossible to face.
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I am a 72 year old type 1 diabetic (62 years of type 1) who recently had a stint in a nursing/ rehab facility. As I always figured, no one there knew anything about type 1 and wanted to treat me as a type 2 and nearly killed me. Type 1 education needs to happen in hospitals and all other medical facilities!