Mind Over Miller: It's not perfect, but it's the best we can do - Veterinary Medicine
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Mind Over Miller: It's not perfect, but it's the best we can do


The next day my wife complained of photophobia. Her eyes looked normal, but they became so sensitive to light that even the candles on the dinner table caused her discomfort. Fears of glaucoma flashed through my mind, and we would not be home for another two weeks.

Because it would be impossible to see an ophthalmologist on such short notice, we went to a local emergency room instead. A nice, young physician checked my wife's eyes with a flashlight and an ophthalmoscope, but as he fumbled with the latter, I could tell eye treatment was beyond his expertise.

"Well," he said, "I can't see anything wrong, but I must be honest and tell you I am a general practitioner, and, frankly, I don't know much about eyes." I asked if it were possible to do tonometry to rule out glaucoma. He said he'd write a referral for us to see a specialist at Leeds where they had a teaching hospital.

The next day, I drove my wife to Leeds, a half hour away. We registered and sat in a waiting room jammed with patients. In front of us, a comatose 6-year-old boy lay on the bench, his head on his mother's lap. In the hall, several hospital staff members sipped tea, talked, and laughed. On the walls, posted in several places, was an unforgettable message: "Profanity and displays of temper will not be tolerated, and offenders will be expelled from the hospital." I confess that I cannot remember the exact wording on the signs, but this conveys the message.

Hours went by. The comatose boy had not yet been seen when we were called. A nurse asked to see our referral slip. When we showed it to her, she said, "This is from Harrogate. You must have a referral from a general practitioner in Leeds." A G.P. was duly found, and the flashlight-and-ophthalmoscope routine was repeated. Always pleasant and gracious, the doctor explained that a specialist must see all eye problems, and we were given an appointment for the next day. So we again drove to Leeds. This time a friendly and personable young resident examined Debby's eyes for half an hour. Finally he explained, "I'm a resident. I see a growth in your wife's eye that I am concerned about, so a senior ophthalmologist will look at her."

Filled with concern that my wife had an intraocular tumor—the tonometry examination results were normal, so my worry about glaucoma was relieved—we waited another two hours. Finally, an ophthalmologist did a careful examination. Not realizing that I understood the entire conversation, the ophthalmologist explained to the resident that the abnormality was an insignificant anomaly on the choroid, and a minor meibomian gland inflammation was causing the photophobia. They then explained to me, in layman's terms, what was wrong. I never did tell them my profession, but I asked what we should do. I swear to this: We were advised to buy some baby shampoo, the "nonburning" kind, and put one drop, full strength, in each eye every eight hours. Although filled with doubt, we bought the shampoo and followed orders. My wife stopped screaming after I irrigated her eyes with water and told me she would prefer blindness.

When we returned to our hotel in Harrogate, I telephoned our ophthalmologist in the United States and told him all I had done. After a long silence, he asked if I had any ophthalmic ointment. "Yes," I said, "I have some gentamicin ointment."

"Good," he said. "Use it b.i.d. When do you get home?"

"Two weeks from today," I answered, "on Sunday."

"I'll see your wife at 8:30 Monday morning," he said. "Enjoy England."

Now it is unfair to make a judgment based on two or three incidents, as I have related, and I didn't. What convinced me to forever oppose socialized medicine was those signs in the waiting room. In a society in which civility, politeness, and good manners are unmatched, the signs are evidence of an inadequate medical system.


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