Today, I made a two-year-old cry because I wanted to look into his eyes to rule out vision-threatening disease. The light was too bright, the lens was too close, and the attention was too much.
After enlisting the patient’s mother and nurse to straightjacket the patient, and trying to pry his eyelids open with no success, I went for the lid speculum. Now, the lid speculum is a special torture device that unlocks a whole new world for the ophthalmologist, even if the child has swallowed the key.
It was this ace-in-the-hole that was nowhere to be found on this ordinary afternoon in the pediatrics ward. Looking around hastily, I said, “Alright, let’s give him a chance to cool down and I’ll be right back.” The nurse and mother relaxed as I bought myself some time. Checking my bag again with disdain, I quickly departed among bawling and hugs to begin the long walk to the opposite end of the hospital.
Turning the corner out of the pediatric ward, I almost walked into someone as I was caught up considering the other patients that needed to be seen and blaming whoever had left the bag without a lid speculum. It was probably me. While listening to the swish of my pant leg scrubs marking my progress down the corridor, I suddenly felt this cloud upon me. I slowed my gait and looked up. There in the hallway were parents, friends and family, both inside and outside the same day surgery waiting room, overflowing and just waiting. Standing, sitting, stretching, staring, and simply waiting. It was a strange experience to be walking on this side of the operating room as we are usually with the patients and call for family to join us in the post-care unit after surgery. But for this snapshot in time, I was in their world as they waited.
Waiting for surgery to be over, waiting to see their loved ones again, waiting to see how the patient will feel after the operation, waiting to hear the outcome of surgery. Lots and lots of waiting. Now, being a surgeon, I know this waiting can be from many things. Waiting for anesthesia to finish their consent and to bring the patient back to the actual operating room. Waiting because equipment or medication still needs to come from central sterile or pharmacy. Waiting because something totally unexpected happened during surgery and we are trying to decide what to do next. Or waiting for the operating room to be cleaned so all this orchestrated trauma can even begin. There truly is a universe’s worth of uncertainty for those standing outside in the world of same day surgery waiting.
And all this waiting, standing, and sitting must require a lot of anxious breathing because that waiting area air had a level of humidity that was probably conducive to multi-microorganism growth. Cultures would fair well out here. It was almost as if it had just rained on a cool autumn day inside the hospital and a thick fog had settled in comfortably, but just in that hallway. And through that fog, everyone was waiting to see what the world would be like when the heavy mist cleared. Would there be a smooth journey in and out of the operating room and a progressive lifting of the haze? Or would there be complications that would need to be fixed and more thunderstorms on the way? Only one way to find out — by waiting.
The words, “Everything went well. That’s it,” is everything to patients and family. In the mist of all their waiting, those words are like beams of sunlight slicing through the fog, making it easier to see and breathe. To those waiting for their loved ones, we are those surgeons and we are that source of light. Yet, very often as I walk through residency, I feel hurried and in a rush. I am running from one patient room to the next, or looking for my attending to staff a patient, or getting the laser ready, or hoping there is a clean speculum at my destination. Among all this training in a world filled with burnout, there certainly is a whole lot of doing.
Today I made a two-year-old cry. But from his tears, he brought to my eyes that within all this human doing, there is most definitely and more importantly, a whole lot of human being.
Image credit: Layers of Trees by Jonathan Chen is licensed under CC BY 2.0.
Peer Reviewer Emeritus
Geisinger Eye Institute
Jonathan Tsui is currently an ophthalmology resident at Geisinger Eye Institute in Danville, PA. He studied finance at Rutgers Business School as an undergraduate and then continued on at Rutgers to obtain his medical degree. Prior to starting ophthalmology residency, he completed his preliminary year in medicine at University of California, Irvine. His career interests include cataract surgery and global health. Today, when Jonathan is not operating or seeing patients he can be found at the gym, spending time with family, or backpacking abroad.