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Monday, February 22, 2016

One Doctor Said I’d Go Blind Within 2 Weeks. But a Second Opinion Changed Everything.

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march 2016 aol health seeing my diagnosis differently

As I was finishing my freshman year at Vanderbilt University, I joined my parents in an Italian restaurant, celebrating the completion of my first year of premedical studies.

My father was blissfully breathing in the steam from his ravioli in lobster cream sauce as my mother prepared to dig in to a plate of basil penne pasta with spicy meatballs. I lifted a forkful of manicotti, about to describe how hard I’d studied for finals. Then I realized that something was very wrong.

My fork had twisted itself into a bizarre shape, like something out of a Salvador Dalí painting. The pasta on my plate, too, was distorted. I looked up at my parents, at the waiter pouring our wine. Everything was weirdly curved to one side, as though it were being sucked into an invisible vacuum cleaner somewhere off to my right.

We left in a hurry. My parents drove me to a local eye hospihospital, where I was assigned to see a retinal specialist. A middle-aged man, Dr. Essers [name has been changed] greeted us politely. Never had I felt such anxiety while hearing familiar words: “Put your chin right here, please … Press your forehead up against the bar … That’s right; now look at my ear.”

Five minutes later, Dr. Essers whistled under his breath. “There it is,” he said softly. “There’s a blood clot on the back of your retina. It behaves similarly to macular degeneration, but it can be caused by trauma.”

“Macular degeneration in a healthy 20-year-old girl, occurring while eating Italian food?” I said, bewildered.

“Or it may be related to your myopia,” he added, turning to order more testing. “I’m sorry,” he continued distractedly, tapping on the computer keys. “I’m afraid this means that you’ll go blind within two weeks …”

I felt my enthusiasm for medicine fading, replaced by doubt and suspicion.

I blinked a few times, making sure I hadn’t misunderstood. Using my minimal medical knowledge, I explained the diagnosis to my parents, still struggling to make sense of it.

The other test results were reassuring but puzzling. My retina was not actively bleeding, so what was causing this distortion? Dr. Essers offered no further explanation. “We’ll continue to monitor your condition,” he said. “Come back in one month.”

I felt my enthusiasm for medicine fading, replaced by doubt and suspicion about physicians, Dr. Essers in particular. I oscillated between worry and wild speculations.

The next day, I got a second opinion from Dr. Smith [name has been changed], a young ophthalmologist noted for his academic and surgical accomplishments. After examining my eyes, he rolled his chair back, looked at me, and said, “Tell me about yourself, Melissa. How is school? What do you study?”

“Well, I’m premed. We had finals the last two weeks. It was pretty stressful …” Dr. Smith listened attentively.

After about ten minutes, he said, “Well, from what I hear, I think you have central serous retinopathy. It’s induced by stress, and although it’s rare—it occurs in only one in 100,000 females—it’s more common in young people.” He found a handout. Grabbing a marker, he highlighted the prognosis: Most patients recover without intervention. “I think you’re going to be OK,” he said. “I’ll see you in a month. In the meantime, try to relax, because stress is the main cause of your condition.”

After minutes of listening, Dr. Smith had performed a medical miracle. I’d gone from imminent blindness to an almost certain recovery.

Seven years later, as a resident in anesthesiology, I’ve never forgotten my debt of gratitude to Dr. Smith.

He showed me the most important instruments in every doctor’s toolkit: an open mind, listening ears, and the right words, carefully chosen.

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