View from the High Street: Love at first sight
Judy Lea talks about the massive difference we can make to patients just by listening and taking them seriously
Author: Judy Lea
Last year’s NHS 70th anniversary quite rightly sparked a flood of declarations of ‘I love the NHS’. And as someone who is both a patient and a provider of NHS services, I’m all for that.
My family had reason to experience the positives of the NHS last year, when my orthoptist son was involved in a serious car accident, resulting in a life-threatening bowel injury. We have so many people to thank for saving his life, from the paramedic who recognised early signs of internal bleeding at my comment of ‘gosh, you look grey’, to the anaesthetist who came on shift early so that surgery could start as my son’s blood pressure was dropping into his boots and his life was quickly hanging in the balance. Fortunately, the outcome was a good one. While it’s been a long recovery, 12 months on and we are now on the other side.
As eye care practitioners, our encounters with our patients are rarely quite that dramatic – but I’m ever aware that it is within our gift to detect symptoms of life-threatening conditions and refer people for treatment. And I’m grateful to have such a fantastic team of clinical optometrists, who regularly put themselves out and run into their breaks to see a concerned patient when an appointment doesn’t really exist, putting the patient’s needs ahead of their own, just as that anaesthetist did for our family.
Often patients will tell me what I sometimes consider to be some of the most ridiculous concerns that they have, but I have learned to listen and trust what they are describing to us – and sometimes I am surprised by what I find. We all know, for example, that the signs and redness associated with acanthamoeba are minimal compared with the patient’s description of their symptoms in the early days. If we don’t respond to these, then we run the risk of not diagnosing in time.
I always remember the patient who telephoned the practice to say she could see bleeding inside her eyes. I don’t know what she was seeing, and we were very booked up that day, but an emergency appointment was found and yes, she did have multiple retinal haemorrhages, found later to be caused by leukemia. To this day, I don’t know how she came up with her self-diagnosis, but she was correct!
I also try to remind myself, when I see a patient with something like a ‘simple’ cortical cataract, that while for me it is relatively insignificant and easily treated, for them it can be life-changing. I learned this lesson many years ago as a newly-qualified optometrist on seeing an elderly gentleman who attended with poor vision and wanted an improvement in his spectacles. When I explained that we couldn’t do that as his reduction in vision was due to cataracts for which I could refer him, he sobbed. He was petrified of leaving his wife alone who needed care and was even more scared of things going wrong and losing his sight. I can still remember sitting with him for ages and drawing lots of diagrams, showing him what would happen and why that made the risks minimal. That day, my clinic ran very late, but this was outweighed by the job satisfaction when he returned following successful surgery.
Similarly, the lady who walked into my consulting room, removed her coat and stood there saying ‘Look!’ It took me a while to realise that her jumper was handknitted. As a result of my referral for ensuing cataract surgery, despite her having advanced macular degeneration and only a minimal improvement in acuity, and with the help of a friend with a computer to enlarge the print of the knitting patterns – she had knitted a complex cable type jumper, something she said she hadn’t been able to do for years. She sat in the chair and exclaimed how she loved the NHS, how they had ‘given her her sight and her life back’ and a large sum of her inheritance was now going to be left to them as a thank you.
Patients expect expertise. But maybe the way to being loved by them is simply to treat them as individuals, give them our time, listen to their concerns and try to explain and help them in the best way we know how, which is what all those NHS staff did for my family and for which I will be forever grateful.
Judy Lea is optometrist director of Specsavers, Longton, Staffordshire.