Posted on 08/12/2002 9:27:53 AM PDT by BADJOE
In 1977 I saw a lady who was a friend and a patient of eighteen years. Let's call her Dorothy.
Dorothy was in her early 40's, she had five kids, four of whom still at home, and she was a very pleasant person.
I noticed her left eye seemed to be lower in its socket than in previous observatioins. Now this is a very unusual stituation. I referred her to my friendly ophthalmolgist with the reason for the referral. He concluded there was nothing wrong.
Two months later she came back in to my office complaining of diplopia (double vision). I again referred to to my friendly ophthalmolgist and another ophthalomolgist, who specialized in retina surgury/deep socket eye surgury, her internist, a neurosurgon, her Gynecologist and her GP. Again all MDs gave her a clean bill of health.
Thirty days later she came back in. The left eye was now a full quarter of an inch below the right eye and she was looking through a one millimeter slit between her lids. I called the first ophthalomigist again and spoke with him. He said " Goddammit Joe, I told you there was nothing wrong with her, and he refused to see her again. I called the retina man and he said let's get the neurosurgeon to take another look. All said they could not find the cause. X-Rays were negative. They took no action.
Two weeks later she could no longer see out of her left eye without holding her lid up with her fingers. I called and then personally went to see all of the physicians involved and threatened to blow the whistle on all of them if they did not get in there and solve Dorothy's problem.
They called a conference, then called Dorothy and her husband in. They decided to do exploratory surgury with five different surgeons present in the operating room, and scheduled it for the next day. I cancelled my patients for the day and went to the hospital waiting room with to be with my friend, her husband.
Eight hours later we learned the results. Dorothy would be alright and live a perfectly normal life. She died 15 years later from other causes.
The problem of all things was benign but dangerous mucoseal (Pouch of mucous) that had formed in her superior left orbit. It had eaten through the bone above her eye and if it had ruptured , she would have died suddenly. They had to saw the top of her skull off, lift her brain, drain the mucoseal, remove it and cauterize the area of its formation.
The neurosurgeon told me that if they hadn't gone in when they did, she had less than a week to live at the time of the surgury.
Well I don't normally take pictures of my surprises .. The ONLY reason why I took that one is cause no one believed me ... LOL
I love my family doctor because he listens and is not afraid to say "I don't know." I loathe my cardiologist because he has an ego the size of the visible universe and is a jerk--but is said to be the best there is--by other doctors.
In any event, "never give up" is (usually) a good rule. On the other hand, "Fanaticism consists of redoubling your efforts when you have forgotten your aim."
The opposite is fatalism, and that would have killed your patient.
So I say "good on ya," and keep it up.
--Boris
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