I rarely drive home riding on a wave of pride that I might have made a tiny difference in one of the patients I saw that day. Sometimes, our patients give us much more than we can give them. Even ones who have so little to start with.
Pulling my sweater neck hole over my nose, I stared at the visual evoked potential machine. “Poor connection, test failed”. Again? This was the seventh time I had run the same test. I clenched my teeth in frustration. My patient could sense my irritation. “I’m sorry, I’m sorry…” he stuttered. “What am I doing wrong?” I took a deep breath, and my nostrils filled with the sharp, foul smell that permeated the small exam room. I looked up and saw him holding the eye occluder with one hand and his tattered baseball cap in the other. His expression was perplexed, mouth open showing his few blackened teeth, so narrow they looked more like dominos lined up for play. My face softened. “Nothing, Mr. H, you’re doing just fine. I just want you to keep focusing on the red cross at the center of the screen for me.” Today was my sixth day training to be a technician, but I have been working as a scribe at this ophthalmic practice, South Bay Retina, since June. For the past few months, I have been spoiled by the “private practice life”. Between gourmet lunches from drug reps and old ladies who come in for dry eye and call me “sweetie”, I really don’t have much at all to complain about my new job. Recently, I wanted to further connect with patients and asked to be trained as a technician. Along with a host of new responsibilities, my new role requires me to get up close and personal with each patient I see. I learned to check pressure by holding a patient’s eye open while tapping their pupil with a pen-like instrument. I also clean patients’ foreheads and scalps to stick electrodes to measure their optic nerve potential. This usually isn’t a problem, given most of my patients are grandmas who smell like pumpkin spice and balding men. But today, the technician who is training me wanted to give me a challenge. On top of the crazy blinkers this morning, he asked me to run all tests on Mr. H, a “special” patient, he told me. No worries, I thought. I had worked with difficult patients as a volunteer at the county hospital. I had even helped give blood pressure screenings to homeless women at Baltimore City health fairs. But I had barely got through checking Mr. H’s vision before I wanted someone else to take over. It wasn’t that Mr. H was rude, or that he wasn’t good at following instructions. It was the smell from his clothes and bag of belongings that I just could not stand. The whole visit, I cycled between feelings of frustration and guilt. When I had to redo multiple tests, I cursed under my breath because I wanted nothing more than to get some fresh air. At the same time, I thought about my medical school personal statement, how I promised to understand all my future patients, regardless of race, gender or socioeconomic status. All my interest in serving the underserved, working in homeless clinics… was it all a lie? After all, if I couldn’t even run simple eye tests on this man, how would I one day be able to do rectal exams or check the rotting feet of my diabetic patients? I tried my best to push these thoughts aside and focused on the man in front of me. Mr. H’s right eye was losing vision from glaucoma, and the tests I was doing would help the doctor determine the best treatment for him. I started to ask Mr. H about his life. He told me that his insurance was improving and that after he fixed his eyes, he would fix his teeth, too. I told him to start by snacking on the sugar free candy we hand out instead of the usual peppermints he picks up at the front desk. We both laughed. I asked how his week was going, and he replied, “Every morning when I wake up, I tell myself how thankful I am to be alive in this world. That is how I am so happy, even with all my misfortunes.” I stopped cleaning his forehead, caught his eyes, and shared a moment of mutual understanding. When I finished with Mr. H’s testing an hour later, I hardly noticed the smell. I thanked him for being so patient with me; I was learning how to conduct these new exams. “You are saving my eyesight,” he replied. “Why are you thanking me?” Still, when he opened his arms for a bear hug, I hesitated before meeting his arms. There’s still a long way for me to living up to that promise I made, but I can only hope that more patients like Mr. H will help me along this journey. I rarely drive home riding on a wave of pride that I might have made a tiny difference in one of the patients I saw that day. Today, Mr. H made me remember why it’s been my dream to be a doctor for as long as I can remember. Sometimes, our patients give us much more than we can give them. Even ones who have so little to start with.
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