LOOK AND LISTEN TO INTERPRET PATIENTS’ ISSUES

WE, AS Homo sapiens, are mammals who exist on this spinning blue globe with all the other species. As animals, we all emit certain vibes, messages, odors, signals that can — and should — be interpreted by other mammals. Licking my lips, for example, means I want a Starbucks.

The more obvious message could be the odor emitted after a strenuous workout, stressful situation or — for the truly unfortunate — just from breathing. The message may be “I just had a situation,” yet, we read that as, “Shower, with soap.” Even less subtle is, “I am going to have a mint. Would you like one?” I could elaborate on the messages that odors create but that would be really immature, and this column is for a mature appetite.

OBSERVE TRUE MEANING

Some messages can be a wink, a head nod, a smile or just a single finger. (If I had a dollar for every time I gave or received the latter, I could use the funds to pay my kids’ ways through a private school undergraduate education.) In nature, we can see bees creating an elaborate dance to give directions. How many times have you been tongue tied or had food in your mouth, thus you just gesticulate and grunt, like a bad game of charades, to get your point across. Sadly, I get annoyed and frustrated when my lack of word retrieval is met with nothing more than silly gibberish and dumb guesses. (Don’t you know me?!)

What about the not-so-subtle messages we convey? The subliminal signals? Isn’t it apparent, sometimes, that the patient may be saying something with his or her words and, yet, the patient’s body language is conveying the opposite? “No, I am fine. No, no problems,” the patient says while she cannot keep her eye open, or he says, while he winces as you come near him. You are showing your patient a new frame, and she deftly prances around with alacrity only to tell you that it really does not look right on her. True meaning: “I am going to find these frames that I love cheaper, girl. Bye.”

INTERPRET THE SIGNALS

These messages are the crux of the doctor-patient relationship. In fact, I have said this a million times: Our patients make an appointment because they have a problem. Most of my colleague’s only see the signs if they are oozing out of the eye or are verbalized by the patient. Yet, the underlying message is there: You need to “look” and listen to interpret.

“I’m fine, I just need to update my prescription.”

Translation: “I am not seeing as well as I used to and I need you, the doctor, to find out why. Please help me! Look at my eye, the lids, express my meibomian glands, stain my conjunctiva — and my cornea if you need to. Prove to me it is not my tears that are the culprit. Yeah, look at the anterior chamber and posterior chamber. Tell me what I don’t know. I may not have problems now, but I don’t want to get worse. Dude, you are the eye doctor, talk to me!”

Look for all those subliminal messages, and be a proactive doctor. And. . . take the offered mint, please. OM

DR. BLOOMENSTEIN practices at Schwartz Laser Eye Center in Scottsdale, Ariz. He is a founding member of the Optometric Council on Refractive Technology. He is a speaker and advisory board member for: Allergan, Bausch + Lomb, Shire, Akorn, TearLab, OcuSoft, Lunovus and AMO. Email him at mbloomenstein@gmail.com, or visit tinyurl.com/OMComment to comment.