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    Hollow victory: Why our glaucoma victory felt meaningless


    An intense tutorial on mortality

    But when Paul entered the clinic that afternoon, I wasn’t aware of that. My lead technician is superb and normally the first to audible a time-out in the middle of a busy clinic if he spots something out of the ordinary. But we were cruising at full speed and altitude that day, and my tech was on autopilot. He proceeded with the IOP check and visual field, and it wasn’t until afterward that I found out that Paul had mere days to live.

    More from Dr. Brown: Why you can't separate refraction from pathology

    “I felt really bad making him do the visual field,” my tech said, his head hanging in regret as he brought the printout into my office. “He’s in a lot of pain.”

    My first thought was: I wish I had known that before we did the visual field. My second was: Why did he even come? Then I remembered how conscientious he was, how he’d never missed a follow-up visit, following all my instructions and guidance to a tee. We spend our careers riding herd on compliance, but in a few cases, perhaps we do our jobs too well.

    I gently reminded my tech to “go with his gut” and ask me first if he thinks there is a situation that might call for aborting the plan for a visit. I then looked at Paul’s IOP and visual field. His pressure was in the low teens and his visual field was stable with good reliability indices all around.

    My life has been punctuated with episodes of attending the dying and the dead (I held my mother’s hand and whispered “Love, love, love” in her ear as she passed), and I know how I should, in the words of the biblical Book of Psalms, “number my days aright.” Even so, here I was in line for yet another intense tutorial on mortality.

    Next: Goodbye and Godspeed

    Michael Brown, OD, MHS-CL, FAAO
    Dr. Brown has practiced medical optometry in a comanagement center and with the U.S. Department of Veterans Affairs Outpatient Clinic in ...

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    • Thank you Dr Brown for your article. It was filled with compassion for those experiencing the end of their life. I have also dealt with similar situations and have found them to be so meaningful. Your article allowed me the opportunity to reflect on them, and here I sit with tears in my eyes.

    Optometry Times A/V