reflections THE HUMAN SIDE OF OPTOMETRY
"It's Not About You!"
This O.D. never expected so much company in the exam room.
MICHAEL C. BERNER, O.D., SAN DIEGO

I never realized that complete strangers would watch me so carefully. Scrutinizing my every action. Beady eyes piercing the back of my hairless head. I signed up to examine people's vision. I didn't know that the spouses, friends and relatives of patients would launch a barrage of questions at me throughout the exam. And not about the person I'm examining, either. No, their questions revolve around their own eye problems -- which they lob at me as soon as the lights dim.

ILLUSTRATION BY JO TRONC

Submitting to my fate

The line "Doctor, is it okay if I come along and mind my own business during the exam?" falls on deaf ears because it rarely pans out. If the spectator is a teenage boy, then there aren't many questions because they communicate with pubertal grunts. Husbands are the worst offenders. As I'm beginning to take a close look at Mrs. O'Leary's cataracts, Mr. O'Leary comes alive. "Doc, I don't want to distract you, but sometimes my eyes get crusty and that crustiness falls into my food . . . ."

Actually, it's not just the sidebar questions that drive me crazy, it's the running commentary throughout my exam. "Nice equipment, Doc. Bet that cost a bundle. No wonder your fees have gone up! Hey, what's legally blind mean, anyhow?"

Have you noticed that spectator accompaniment follows an inverse bell curve? The younger or older a patient is, the larger the entourage that follows him into the exam room. When little Ricky gets his eyes checked, it's a family reunion complete with video cameras. Parents, brothers and sisters all gather, sometimes bringing a grandparent just to add a wheelchair to the mix. No matter how often parents reassure me that their children will watch quietly, they rarely do. And siblings come to each other's rescue when one of them struggles with the chart. Rule No. 1 is to whisper the letter loud enough so that it's easily heard in the exam chair. Rule No. 2 is to shout it out. Rule No. 3 is incessant giggling and snorting.

Elderly patients take a different approach. They accompany each other under the guise of support but their mission is to get their own questions answered. Shrewd, practiced and prepared, they brazenly pull out their lists, leaving nothing to chance. Fortunately, many can no longer read their own handwriting.

Meet the worst offender

There's one uninvited guest who wears out his welcome instantly: the cell phone. It's now a daily occurrence that either the patient or the spectator receives a call during the exam. Most patients cut the conversation short, but for some reason, the observer feels free to talk at length about the results of Uncle Bill's prostate exam. I have some fairly effective facial expressions and spastic hand motions to communicate my displeasure with these situations. But if the spectator is in real estate, it's a lost cause. Trying to get them off the phone is like trying to take my dog's food bowl away in the middle of a meal!

Bloody but unbowed

Well, I've got to go -- did I mention I'm examining an elderly patient accompanied by her children, cousins and a few neighbors? But today I'm implementing my new strategy. I'll be handing out complimentary T-shirts to everyone accompanying the patient. They read, "This exam's not about you!"

DO YOU HAVE A MEMORABLE EXPERIENCE YOU'D LIKE TO SHARE? DISCUSS YOUR STORY WITH RENÉ LUTHE, SENIOR ASSOCIATE EDITOR OF OPTOMETRIC MANAGEMENT, AT (215) 643-8132 OR LUTHER@BOUCHER1.COM.