How do ophthalmologists save lives? (part 1)

Interview with Dr Benjamin

Have you ever saved anyone’s life?

To begin with, my father worked as a resuscitator during the Soviet period of our lives. He often took me with him to the hospital, and I saw how he really saved people. I dreamed of doing the same thing. As a teenager, already in the States, I watched fictional physicians on television series like ER heroically saving the lives of patients after car accidents, heart attacks, wounds, and injuries, understanding that these scenes were all-too-close to reality. These shows stoked the fire for my future profession. I remember around that time someone asking me, “Why do you want to become a doctor?”, and my answer was, “Because I want to save lives.” They told me, “If you want to save lives, become a firefighter.” Then, while studying in medical school, I leaned toward ophthalmology, telling myself that although I won’t be saving lives, I could improve them.

But it turned out to be better than that, right?

Yes – I found out that on top of all that, ophthalmologists sometimes do save lives. It happens that a person comes to the reception desk, not suspecting anything, and we discover something during a routine survey. They say, “Doctor, I wake up with red eyes and they constantly itch.” We look and see that they have the so-called Floppy Eyelid Syndrome. Carefully examining him or her, I ask, “Do you occasionally snore at night? Does your wife or husband complain about it? Often feel tired, fall asleep at work, or fall asleep behind the wheel?” It turns out, just as I thought, they have sleep apnea, where a person will periodically quit breathing for several minutes. Such patients usually have high blood pressure and are at risk of heart attack and stroke. If discovered in time, the person is sent to a pulmonologist and given a special machine. This simple and non-invasive intervention rejuvenates them, gaining energy, vivacity, and in short restores your taste for life.

It turns out you can spot these hidden problems by means of this easily reversible condition?

Yes, we diagnose systemic illnesses that can not only cripple, but kill a person if it is ignored too long. As a result of this diagnosis, though, these people can improve their lives, and become more productive and happy.

Oxygen starts flowing normally to the brain…

Also, ophthalmologists are often the first doctors to detect diabetes. People are unaware, because diabetic retinopathy can develop asymptomatically. But if caught in time, treatment again leads to an improvement in the general condition of the patient. Otherwise, they could find out about it in a later stage of the disease, with complications. The same can be said about high blood pressure, which can be seen during a retinal examination.

Do you come across patients who are unaware they have blood pressure problems?

There are patients in their forties who come in just to change their glasses, least of all thinking about blood pressure, but our smart machines carefully examine the condition of the blood vessels. They get a practically live picture of the patients’ arteries, and this allows us to identify the problem.

And that’s great, but we began this conversation talking about saving lives. Are there more dramatic examples of this, or in other words more immediate, instead of long-term deteriorating health?

Were there cases where we had to almost literally save lives? I’ll give you an example and you judge for yourself. A patient about 42 years old came to us and I noticed a black speck on his arm, just above the wrist. Seems like an ophthalmologist should only be looking at the eyes, but I was curious. I asked him, “What’s that?” He said, “It’s nothing, just a new mole. I showed my family doctor and he said it’s nothing at all.” Then I carefully looked at it and replied, “No, dear friend, it’s not nothing.” After examining his eyes, of course, I took him by the hand and led him to the dermatologist in our building. A few months later, that patient came back to the office and said, “Doctor, you saved my life. The next day, I had a biopsy and it turned out to be a malignant melanoma, which was only millimeters away from metastasizing into cancer. Another week, and it would have been too late.” The severity of melanoma is measured by the depth of its penetration, and if it is neglected at a certain level more than 90% of patients won’t live more than five years.

(To be continued)