Ow, my eye! Part I

Retinal detachment is both weird and depressing. For me, it was a spontaneous failure of a part of my body I normally did not worry about. One day my retina was in place, sending signals to my brain, the next it had peeled off, and all I saw was a green, translucent blot. No impact, no external cause.

As soon as my optometrist saw it, she sent me to an ophthalmologist. A charming young guy from his office came and picked me up and drove me up to Andover, about a forty five minute drive from where I live. After a couple of hours of sitting around, the ophthalmologist popped in and injected gas into my eyeball to try to float the retina up in preparation for surgery, to take place two days later. This was less fun than it sounds.

Then the doctor disappeared. I had to sign a long series of sheets detailing the possible procedures he would perform on me in a couple of days.  I had never heard of any of them: scleral buckle, vitrectomy, etc. They might remove my lens, my iris, inject oil into my eye. It all depended on how things looked when he got in there. The sheets I was signing said the doctor had carefully explained things to me, and I was aware of all the risks and possible negative consequences.

Of course, he had done no such thing. To the doc, I was a bunch of supporting tissue dangling from a surgical site. I might have feelings about what was going to be done to me, but I certainly wasn't supposed to have opinions. It was just like clicking Accept on a software contract. What other choice did I have? To give him a little credit, I was an emergency addition to what was clearly a busy schedule, some of it presumably with other people who had serious conditions.

This was a surgery that shouldn't wait. The retina is an impossibly thin and delicate piece of tissue, thinner than plastic wrap. Waiting around could damage it beyond repair. Given a lot of advance planning, I might have reviewed a series of eye surgeons in the Boston area, considered the options for treatment, and chosen someone. But, again, time was tight, and a quick search showed that this guy had the characteristic of most use in cases like this: he does a huge number of these operations, on a daily basis. With any delicate surgery, you want a specialist, who does only that type of surgery, and has done it a lot, so that by the time he gets to you, every kink has been ironed out, every oddball condition seen, and every movement deeply ingrained into his nervous system.

And, of course, I wouldn't trade that amount of experience for a better bedside manner. I presume it's possible to get both.

This is where physician ratings by "consumers" become kind of meaningless. I could rate how well he explained things to me, but how was I to rate how well he did at the thing that mattered, the operation itself? I know how I am recovering (slowly, but steadily). If something goes wrong, was it because of something he did, or because things go wrong no matter how well he did? Could I be recovering faster? When my vision settles, will it be as good as it could have been? Really no way for me to tell. He can be rated only statistically, and I have no way of doing that.

So they sent me home, to sit up and bed and fret. The bubble floated the retina up a bit--there was a bit of translucency in the green, and it got a bit smaller. But not enough to be worth anything. A day later, early in the morning, Mary drove me up to a surgical center in New Hampshire