Article

MEMORABLE PATIENT ENCOUNTER

Wrinkles in time

A few stories spring to mind whenever new coworkers or friends ask if I have ever had any “interesting patients.” One that has gotten its share of chuckles is the woman who told me, in all seriousness, that she was concerned that she “kept losing vision whenever I closed my eyes” (I told her, reassuringly, that she would be fine as long as she kept her eyes open). But my favorite involves an elderly cataract patient I saw in the late ‘90s.

NO GOOD DEED GOES UNPUNISHED

At the time, I was an ophthalmologist at St. Luke’s Cataract and Laser Institute, located in Tarpon Springs, Fla. The 75-year-old woman I was treating had very poor vision before her procedure, but her cataract surgery went smoothly and she ended up with uncorrected 20/20 vision.

The next day, I walked into her exam room for the day-one postop check. I was expecting an easy conversation due to the success of her procedure, but instead I saw a frown on her face. When I asked if there was a problem she said, “Well, just look at me.” I didn’t see anything unusual, and said as much. She angrily responded, “Well, just look at my face. Where did all these wrinkles come from? I did not have them before surgery — what did you do to cause all these wrinkles?”

THE TRUTH IS NO DEFENSE

At first, I thought she must be joking, but a look at her face told me she was serious. She really believed she didn’t have any wrinkles prior to surgery. I was flabbergasted, but finally managed to say something like, “I do not know what caused your wrinkles because I have never seen anyone get  wrinkles from cataract surgery or any medications used during the surgery.” You might think this a mild and reasonable response, but it did not sway her one bit: She left convinced that I had caused her wrinkles. I don’t recall seeing her again afterward.

I believe what must have happened is that her eyesight was previously so bad that she genuinely had not seen her wrinkles before her cataract surgery. I don’t know how long she had been living with them, but I do know it’s not uncommon for some patients to wait years before having them fixed due to fear of something going wrong during surgery.

I’ve had patients before and after her who have commented that, with their cataracts removed, they can now see colors better or see themselves more clearly, but I’ve never since had someone who was so certain my surgery had given them wrinkles.

The exchange was so stunning to me that after I left her room I immediately went out and told another doctor at my practice.

And I’ve been telling that story ever since. OM

Dennis L. Williams, MD, is retired from regular practice.