The Ophthalmologist

I’ve come to dislike articles by blind people that expose the insensitivity that sighted people can display. They tend to be one-sided, with the sighted offender looking stupid while the blind character is all innocence. But once in a while such a story is worth telling.

Last month, Laura (my partner, for want of a better word) and I went together for my appointment with an ophthalmologist I’d never met before. She usually joins me for my first appointment at a doctor’s office so we can compare notes. My eye condition is such that none of today’s medical advances is likely to restore my vision, but I still have eye issues that need to be checked. When the doctor finally saw me, he said a perfunctory “Hi” to Laura, not me, and told me to put my chin on his examining platform. I said, “and hi to you, too.” He said, “Hi,” with a grin in his voice. I said, “I wasn’t trying to be funny,” which he ignored.

He turned to Laura to tell her what he observed. When I asked a question, he began by answering me, but once again turned to Laura as he continued speaking. I started asking another question, but Laura told me he’d left.

The easy explanation for the doctor’s rudeness is that he’s an over-worked, unpleasant man who sees his job as fixing a set of problems involving eye care, and not as mollycoddling patients. The question of doctors’ bedside manners is old and long, but such physician authors as Atul Gawande encourage me to think that doctors today are being trained to think in terms of people, not merely conditions. In fact, the ophthalmologist did show some courtesy to Laura, and his staff was friendly and professional, hardly a sign of a hated boss. It is possible, of course, that he walked into the room and took an immediate dislike to me. Who am I to rule it out?

But I felt certain he’d distanced himself even before seeing me. Perhaps he did so because nothing he could do would restore my vision. I represented the limits of his expertise. Also, the more time and energy he put into my case, the less he had for other patients in his over-subscribed practice.

Before leaving, he told Laura an odd anecdote that revealed something more disturbing. His previous “low vision” patient (remarkably, he indicated I was only his second) had stopped taking a certain medication because he was supposed to take it at a certain time of day and couldn’t be sure he’d know when that time arrived. The doctor seemed to think blind people have no means of telling the time. Between talking clocks, braille watches, smart phones, the radio and other information sources, the story made no sense. It made sense only if in the doctor’s mind, a blind person can’t function in any usual sense of the word.

His attitude felt like a repudiation, and I left his office feeling dejected. He seemed to have been saying that if one’s eyesight is beyond restoration, something essentially human is also lost.

For a counterexample, I think about a situation that doesn’t directly involve me. During World War II, Laura’s mother volunteered to help rehabilitate soldiers who had lost their hands. As the October 11, 1942 issue of the Kalamazoo Gazette reported, Jane, an art school graduate who would go on to design specialty shop and airplane interiors, taught “amputee cases… engineering and drawing and home planning.” She told her family that before starting that position, she was warned that showing distress would upset her students. If she thought she might find it too difficult, she should volunteer for something else. She insisted she could cope and went on to prove it. Such work must require a combination of nerve and generosity. Many among us would project loss of a hand as if it could one day happen to us, and we run from it. Running from it means running from those who have experienced the loss.

It seems to me that the ophthalmologist was doing the equivalent of running from me. It’s a reaction that all disabled people must manage from time to time. We hope our personalities, words and actions put the people we encounter at ease. Ultimately, we hope they put us on an equal footing.

I suspect most people who casually say “basket case” don’t know that the phrase was a term for servicemen who had lost not just their hands, but both arms and both legs. Their existence was emphatically denied during World War II, presumably because such a consequence of war would be bad for the nation’s morale. I’m sorry to admit that I myself find the condition terrifying to contemplate, as many people undeniably find blindness. I’ve never met anyone who is a quadruple amputee, although America’s recent involvements in Iraq and Afghanistan have led to at least five soldiers losing all four limbs. (Today they can be given functional prosthetic limbs, and they are no longer kept hidden.)

The increasing number of blind people in city streets, the classroom and work settings seems to have helped people in general to think of blindness as a condition rather than a person’s entire identity. The ophthalmologist’s perception of me as nothing but a disability was a throwback to an attitude that I rarely find today. Reason enough to find the ophthalmologist’s reaction offensive.