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Tuesday, July 6, 2010

Bedside Manner

I had a "visual field" test this morning with the optometrist whom I had sought originally when my eyesight was dimming last September. Long story short, the test was fairly normal but there are a few darker blotches, possibly of some concern. I can't compare the results to anything the neuro-ophthalmologist has been tracking, but the tests were faxed over to the neuro in case he wants me to come in to double-check something on his equipment.

More interestingly, not only did my optometrist remember me but she was visibly pleased to see me again.

"I was so excited when I saw you were coming in," she said. Then she pointed, "I keep your file on my desk every day!"

"Really?" I asked. (In Internet lingo, I might have typed, 'wtf?').

"Sure," she continued. "I'm going to make you my 'case' for a presentation. It's next November."

"Great," I said. "Then you have a lot of time to prepare."

"Well, applications are due at the end of the month, so maybe it won't be until the next November."

I thought about that and said, "Maybe if you wait I'll have some more interesting things happen to me. Craniopharyngioma patients are like an open-ended storyline."

"You bet," she said. "And I don't think I'll see another visual field like THIS for a while." She dangled my original scan in front of me which looked like map of a lake with various depths shaded grey and black.

Now that I know what regular visual field tests tend to look like on paper, I honestly can't believe how doctors can keep a straight face when they have a talk with patients about terrible test results.

"Let me ask you something," I said while pointing to my original test scan from last September. "When you saw this last year, you had to know it was a tumor. But we talked about how I should probably see someone to get a few more tests, get an MRI, to be certain before we jumped to any conclusions."

"Right," she said.

"Didn't you just want to shake me and say, 'Oh I'm soooo sorry! I think you have a . . . a BRAIN TUMOR! I think you are now in for a world of pain and constant monitoring and surgeries for the REST OF YOUR LIFE . . . [sob]."

We both laughed, because in retrospect (for me, at least, with my very weird sense of humor) it was quite funny.

"Yes," she said. "It's hard for us too, you know. But it is critical to do things a certain way, very carefully with sensitive situations like this."

Of course, she was right. I wouldn't have wanted it to have transpired any differently last fall. And that is probably the reason she is a doctor and I am a composer. One follows the rule book and the other burns it.

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