HOW DO OPHTHALMOLOGISTS SAVE LIVES? (PART 2)
I asked him, “What’s that?” He said, “It’s nothing, just a new mole. I showed my family doctor and he said it’s nothing at all.” Then I carefully looked at it and replied, “No, dear friend, it’s not nothing.” After examining his eyes, of course, I took him by the hand and led him to the dermatologist in our building. A few months later, that patient came back to the office and said, “Doctor, you saved my life. The next day, I had a biopsy and it turned out to be a malignant melanoma, which was only millimeters away from metastasizing into cancer. Another week, and it would have been too late.” The severity of melanoma is measured by the depth of its penetration, and if it is neglected at a certain level more than 90% of patients won’t live more than five years.
It’s interesting that the general practitioner was so optimistic, but the ophthalmologist saw it for what it was. Why is that?
Because ophthalmologists should often look for spots on the fundus, the surface of the eye, eyelids, and on the face, so their eyes are trained for the task. Furthermore, I look not only at the eyes, but at the general condition of the patient, as well. How do they look? Healthy, ruddy, extremely thin, turning yellow, or even turning green.
Talk about a story! I would have right then and there erected a monument to the doctor.
That isn’t the whole story. Within a few years, he came back to me for another reason. We took a picture of his fundus – we have a special machine called Optos that without excessive pupil enlargement takes extensive and phenomenally accurate images. Thanks to that, we saw certain areas of the retina that can’t be seen through any other method, and this time we saw a very small, but not-good spot on his retina. Spots of this kind were doubly suspicious, as well, since he already had melanoma. I quickly sent him to a melanoma specialist at UCLA, even though I must say that this phenomenon is extremely rare – only 50 recorded cases in the entire country. They ran some tests that confirmed the diagnosis and he was treated immediately for an eye melanoma, using a radioactive shield that stays in place for five days and irradiates the eye. As a result, he was cured again.
You managed to save his life twice.
There was also an element of happy coincidence. If he had not come in for another reason, or if he had come and we didn’t have that expensive machine, which few ophthalmology offices have (God forbid even 10% have them), then things would have turned out much worse.
It’s as if lightning struck one person twice. What reaction did he have after the second life-saving incident?
Normal human reaction. We were both happy!
Were there any other amazing cases?
A guy came in with not-too-bad myopia and he says what many people say, “Let’s not waste time; I just need glasses.” I go to him and ask what’s the matter. He says, “I’m not sure that my insurance will pay for a normal exam, I don’t want to pay out-of-pocket, and I’m a poor resident…” I ask him in what specialty is his residency, and he says ophthalmology – that is, within a year, he’ll be an ophthalmologist. “Just dilate my pupils and take a look. That’s it. Tomorrow I’m leaving.” I respond with, “No, dear friend, that will not work for us. We have to take images. If your insurance won’t pay, then we’ll call it even, as colleagues.” We took pictures, and it turns out that this future ophthalmologist, in a place that could not be detected by other means, had a ruptured retina. What’s more is that it could have detached at any moment. Fortunately, we have a retinal specialist in our office that was able to save his eye, “welding” the retina with a laser.
This, as far as I understand, wasn’t the saving of a life, but rather the saving of a life-story.
If he had a detachment, then the enormous amount of time and money that he had spent on training would have gone to waste, and he would have never become an ophthalmologist. Even future specialists that think they know everything have to be forced by us, like small children, to be thoroughly examined. Afterward, they thank us. Therefore, I ask everyone over the age of 40 to trust your doctor and get checked out. Don’t just stick your head in the sand – this doesn’t only apply to the eyes, either.