Category: Health Care

Redlining: A Tale From the Trenches of Primary Care in America

If you could walk in my shoes, and look through my eyes, as I daily fight the good fight in the trenches of primary care in America, you might see something like this:

It would begin with a fight between two homeless men, probably over some spare change or a scrap of food, under the I-565 bridge. One of them, a 61-year-old black male, would get the worst end of the exchange–a fist fit neatly into the orbit of his right eye, his assailant’s bare knuckles impacting like rocks from a slingshot.

The concussive force of the blow would send a shock wave through the eye and crystalline lens, which is about the size and shape of a plain M&M candy.… Read the rest

Red Fog Rising

When an eye doctor goes blind, there are no special dispensations or exemptions. He does it just like everybody else–one eye at a time.

My recent self-diagnosis of a retinal tear in my right eye took a colorful, and ominous, turn on July 4th. I was driving around Huntsville when a blood vessel which crossed the area of the retina that was treated with laser burst open like a uncapped oil well. No black gold or Texas Tea, Jed, just blood.

It started with a single red ribbon which began to flow upward from my inferior visual field. Other scarlet streaks soon joined it, each dividing into tributaries and tendrils which filled my clear field of view with smoky-red smudge.… Read the rest

Physician, diagnose thyself

I consider myself a better than average ocular diagnostician. Whenever my technician or an intern comes into my office and tells me a patient’s history and describes the patient’s signs and symptoms, I usually know what is wrong without even looking. I am like Carnac the Magnificent, only with a white coat and head-mounted ophthalmoscope instead of a cape and feathered turban.

In my head, I generate a list of three to four possible diagnoses and rank them according to their probability. If it is my technician, I tell him what I think is most likely going on and perhaps ask him to perform another test or two and then dilate the patient’s pupils.… Read the rest

A Major Breach in the Britches, Leap Year 1972

Today is February 29, Leap Year 2012. This is also the week that pro football wannabes are showing off their physical skills in the NFL Combine. Put the two together, and you come up with a traumatic, cringe-inducing, early childhood memory.

It was the spring of 1972, another Leap Year, and I was in Ms. Traylor’s 4th grade class at Burnt Chimney Elementary School in Wirtz, Virginia. We were on the playground finishing up the last event of our biannual physical fitness tests–the broad jump. I was on the line, waiting my turn.

“Go ahead, jump!” Ms. Traylor called out. I swung my arms in rhythm–one, two, three–and then crouched low, like a panther set to pounce…

The previous fall, I had failed every one of my physical fitness tests.… Read the rest

Ten Thousand Words

Ain’t it like most people? I’m no different
We love to talk on things we don’t know about

“Ten Thousand Words” –The Avett Brothers

In a perfect world, each of us would have both a personal trainer and a personal editor; the former for our obesity, the latter for our verbosity.

I’ve seen America fatten right before my very eyes. As a grunt on the front lines of primary health care over the past 25 years, I know first hand the effects of increased sedentary lifestyles and the “cornucopia” of processed and fast foods available at nearly every turn with just the swipe of a credit card.… Read the rest

Homeless Hank’s Christmas Miracle Turkey

I smelled it long before I saw it. You’ve seen those cartoons where the character catches a whiff of a powerful, pleasant odor and suddenly rises off the ground, borne along by the fumes like a slave in chains. That was me, right before lunchtime a couple of days ago in my clinic.

I sprang from my chair to see what was the matter. I’m used to the pungent odor of burned popcorn coming from the break room microwave, but this was different; more like Sunday brunch at the Ritz. It was deep brown, slightly crispy on the outside, moist and tender on the inside, seasoned with just the right amount of rosemary, garlic and basil.… Read the rest

I May Have “Pink Eye,” But I’m No Commie

In the aftermath of the tornadoes in Alabama, armies of Good Samaritans have rushed to our aid with a million good deeds. Taking up their various instruments of mercy, they have come to attention as the Master Conductor has waved his wand, and the resultant symphony of compassion has been sweet, soothing music to our ears.

But they say “no good deed goes unpunished.” “They” are right.

When cell phone service returned to near normal two days after the storm struck, I downloaded my email and saw that a local church was offering an 8:00 AM communion service followed by an opportunity to go into the tornado-stricken areas around Harvest north of town and help out.… Read the rest

Is There a Doctor in Da House?

The answer is: Yes. In fact, he’s been “in da house” since Monday. Sick. Out of commission. Down for the count.

It didn’t used to be that way. In my younger doctor days, I would often work through “the crud” because I was convinced that I was indispensable and that my patients would go blind if I wasn’t in the office. So I would trudge in, snot dripping, coughing, wheezing and croaking from the inevitable laryngitis that would set in after a few days. I was careful and often wore a mask, but still, put yourself in my patients’ shoes. I had no trouble getting my patients to open their eyes on days like that.… Read the rest

A Case of Mistaken Identity

It was another morning at Clinica Ezell in Montellano, Guatemala, and another case of mistaken identity.

There had been a lot of that going around that week. Since I was doing all the preoperative exams, I had spent the most time with the patients. Many of them thought I was the Big Tamale, the Chief Gringo–The Top Gun. Once they were sedated and lying under the operating microscope waiting for their cataracts to be removed, Dr. C was merely the Upside-Down Man behind the mask.

In reality I was Goose to Dr. C’s Maverick, monitoring a million different things and make sure young Mav was constantly exposed to a “target-rich environment.”… Read the rest

Supercentenarians of the World–Live Long!

On January 31, 2011, Eunice Sanborn, widely believed to be the world’s oldest person, died in Jacksonville, Texas at the age of 115–bless her heart. She handed off the baton to Besse Cooper, 114, who was born in Sullivan County, Tennessee on August 26, 1896. Bless her heart too.

And let’s not forget to bless Frank Buckles while we’re at it. A veritable pup in comparison–he turned 110 on February 1st–Frank is the sole remaining US veteran of World War I, the Last American Doughboy (what cohort of uber-humans, pray tell, comes before The Greatest Generation?).

When the three of them, squirming, grunting, caterwauling little bundles of joy and raw, “FEED ME!”… Read the rest

Entoptic Phenomena

entoptic phenomena: Events taking place totally within the eye

The way my patients squint and squirm in the chair, you’d think I was coming at them with a dentist’s drill. Or worse yet, a serpentine colonoscope, which, aside from a sword, is perhaps the coldest and most impersonal use of steel man has ever devised.

But I’m not that kind of doctor. I’m an optometrist, and the only instruments of torture I’m wielding—at the moment, anyway—are a large, table-mounted flashlight which, when turned all the way to “11,” rivals the glory of the sun, and a tiny, hand-held Coke-bottle thick magnifying glass, the kind you used to fry ants when you were a kid.… Read the rest

Good Geezer, Bad Geezer

I’ve been thinking a lot this week about my impending geezerhood.

Actually, I think a lot about it every week since the majority of my patients are on the far side of fifty and serve as a “sneak preview” of the doctor visits, pills, surgeries and saggy body parts which are waiting for me just up the road around the next bend–if I’m lucky. Each day I stare mortality in the face, and it stares right back at me, sticks out its tongue, and proceeds to regal me with stories of blurry vision, “itchy-burny” eyes and prostrate problems.

Yes, apparently spending inordinate amounts of time stretched out with one’s face to the ground in the universal posture of adoration or submission is something that all of us guys have to look forward to.… Read the rest

Remembering Optometrist Dr. Tom Little

Many people talk–a lot–about their personal faith and how “things ought to be.”

Dr. Tom Little was one of those rare breeds who actually lived what he believed, putting flesh and bones–and blood–to all those words. Rather than yammering on and on until eyes glaze over in “here we go again” ennui, he looked around at the things that were askew and out of balance in the world and then went forth and actually did something about it.

Dr. Little was an optometrist and the leader of a group of medical relief workers in Afghanistan that was mercilessly ambushed and executed in a remote valley north of Kabul recently.… Read the rest

Optometrist Quits Job, Goes Optical

Huntsville police and SWAT teams are currently at the scene of a hostage situation in the Medical District.

An optometrist (OD) employed at an ObamaCare-affiliated medical clinic (the one with the new Death Panel drive-thru window) is apparently fed-up to his eyeballs with all the incessant yik-yak from his patients, the constant sniping and backstabbing from co-workers and the drowning deluge of mind-numbing emails, bureaucratic buzzwords and meaningless acronyms (MNEMBBMA) raining down from his overlords on Mt. Olympus.

The OD–OMe! OMy!–has apparently quit his job and gone optical.

Police will identify him only as “Mike the Eyeguy.” According to a department spokesperson, Dr.… Read the rest