As optometry students, we look up to our attendings with their many years of experience and wealth of knowledge. They’ve taught us to make educated predictions about what might be causing a patient’s visual complaint just by listening to their chief complaint. We’ve learned what tests to order and what medications to prescribe for various conditions. We’re constantly being shown tips to be efficient and taught how to be smart with what tests should be performed. While all the lessons our attendings and professors have taught us have been invaluable, sometimes the greatest lessons can come from our patients.
A 30–year–old female came into our binocular vision clinic and reported symptoms that I had only heard about in textbooks but never expected to encounter. She reported words moving on the page when she read, grocery aisles towering above her as she shopped and legs that seemed to lag behind her as she walked. As the exam continued, she seemed worried that she was the only patient with such unique symptoms. I could sense that she needed reassurance and told her that while her symptoms were extraordinary, she was not alone and that we believed her. She was immediately relieved to know that we believed that what she was experiencing was real and that there are others who also have out-of-the-box symptoms.
From this experience I learned that while listening to our patients is incredibly important, it is just as important to make sure that our patients know that they are being heard and to provide reassurance to their insecurities.
When I was working in our eyewear clinic, an older lady walked in looking to buy a new pair of glasses. We had a great time trying on frames that matched her blue eyes and that best suited her face shape. During the process we shared stories about new hobbies that we picked up during quarantine, and I had made a joke about how I randomly decided to bleach my own hair because no one was going to see. We laughed about it until she suddenly started tearing up. She apologized and soon opened up to me that I was the first person in a long time that she’s had a conversation with as she had been quarantining alone in her home for so long.
Because we interact with so many patients each day, sometimes we forget that we may be the only interaction that our patients have had in a long time, especially during this pandemic. This encounter was a good reminder to slow down, be personable and remember how important it is to connect as human beings beyond just small talk.
During my primary care rotation, I decided to chart review and saw that I had a patient with corneal neuropathy. In her chart, it seemed like her chief complaint was extreme dry eye and that she also was being seen by our school’s dry eye clinic. I saw that she had spent thousands of dollars for various treatments such as multiple treatments of Lipiflow, autologous serum, various steroids, scleral lenses, punctual plugs and more. I immediately thought to myself that if she were already being seen at a dry eye clinic and other specialists that surely I, just an optometry student, couldn’t possibly help her relieve her dry eye complaints. But as I reviewed the list of treatments that she has undergone, I noticed that there was no mention of an amniotic membrane, which was a treatment plan I had just learned about a week prior. So during my exam, I presented the idea and she was surprised to hear about it, assuming she had already tried everything. Due to insurance purposes, we thought it would be best to get the amniotic membrane done with her specialist, but she was appreciative of the suggestion. So while I may never know if that amniotic membrane actually helped her dry eye complaints, I learned that just because you’re not an expert or specialist, it doesn’t hurt to try to be creative and suggest other solutions for your patients.
I had an older gentleman come in who had been battling colon cancer for four years and other various medical conditions. Given everything he had gone through, he still had such a positive outlook and shared his passion for cooking and Scrabble. While I was doing RET, he explained how his favorite dish was steak despite the high cholesterol intake. Continuing on with the exam, my attending and I unfortunately found signs of ARMD. My heart sunk because I knew he was battling so many other health conditions and I didn’t feel it was fair that he would be getting more bad news. When we explained our findings, he became a bit more silent. Once the exam was over, I walked him over to get checked out and he began to chuckle while mentioning, “I think I deserve a steak today! If I’ve learned anything in my life, a good steak always solves the problem! And I’ll be sure to add some leafy greens as a side.”
It’s often so easy to focus on bad news and get bogged down with life, such as the stress of studying for boards or worrying about grades. My patient’s positive outlook on life and genuine appreciation for all the small things that life has to offer reminded me to not completely lose myself in my studies and to make time for the activities that make me happy. It also reminded me to appreciate how far I’ve come and how fortunate I am to have my health and this unique opportunity to pursue a career that makes me happy and fulfilled.