Remembering Patient X

black-and-white-marina-bayI was recently asked to see a patient in the ICU. This patient was admitted for lymphoma and had developed a reaction to a drug she was taking. The reaction can also affect the Eye, and hence I was asked to review her.

She reminded me of a patient I operated on a few years ago. Mr X was an elderly gentleman who had end stage multiple myeloma and had been given 6 months to live. His Oncologist referred him to me because he had poor vision.

I examined him and found that he had significant cataracts in both eyes, causing his vision to be quite poor. I was hesistant to offer him cataract surgery because he did not have long to live, and didn’t have much time to reap the full benefits of cataract surgery. I did not want him to spend his time and his money on surgery if he had more fulfilling ways to spend the limited resources he had left on earth.

He assured me that surgery was what he really wanted. He told me, “Doctor Chan, I do not have much time left. I just want to see my loved ones clearly in my last days. Will you help me?”

We scheduled surgery a few days later. Cataract surgery is always done one eye at a time, and I arranged for the worse eye to be done first. I also thought that if I restored vision in the worse eye, perhaps he would be satisfied and may not want to proceed with the second eye.

Surgery went well and was uncomplicated. On the first postoperative day, he could see 6/6- perfect normal vision. He was elated. The first question he asked me was, “Doctor Chan, when can we do the second eye?”

I could not refuse him. We scheduled surgery 2 days later.

Mr X had a good outcome for the other eye as well, and achieved 6/6 vision in both eyes for distance. As I had implanted monofocal intraocular lens implants for both eyes, he required reading glasses to read, but was happy with the outcome.

His gratitude was palpable. He said, “Thank you Doctor Chan, you have made a dying man very happy”.

I reviewed him again a week after surgery, and again a month later. He was subsequently discharged to a hospice that cared for him in his final days. He did not show up for the appointment I made for him 6 months after surgery.

Every patient is special to me, I cherish each and every one of them, and I am always humbled by the privilege to help them. Mr X, however, reminded me what I studied Medicine for, why I worked so hard as a trainee to become an Ophthalmologist, and what debt I owe society for the privilege of being a doctor.

Mr X, I will always remember you. Thank you for the privilege of being your cataract surgeon. I am grateful for the trust you had in me. It was my great honourย to have helped make your last days brighter and more comfortable. May you rest in peace.sakura

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