I am one of millions of Americans with wet age-related macular degeneration (AMD), a potentially blinding degenerative eye disease. I was diagnosed more than five years ago and, thanks to careful monitoring and treatment, still have 20/25 vision in both eyes. I receive my treatment at a huge Retina Clinic nestled within a vast academic medical center. The Retina Clinic is frequently disrupted by add-ons and emergencies. Delays are common. I don’t complain because I, myself, have caused disruptions and delays.
Once, shortly after a treatment, I woke up unable to see clearly out of the injected eye because of a drug reaction. Less than two hours later, I was an add-on patient in the Retina Clinic. It was December 20. They initiated treatment and saw me daily. December 23 was a Saturday. The clinic was closed. They had me come to the main entrance of the building at a designated time. I joined a small group of fellow patients, most with eye patches, and we were admitted to the closed facility by a security guard.
In the dark and shuttered clinic, the fellow and residents moved confidently, putting us in rooms and doing whatever needed to be done, case by case. We knew we were lucky to be cared for in the closed clinic, instead of being sent to the ER. Not only does the ER not have the specialized equipment the clinic does, who would want to go to a busy ER over a weekend if there was an alternative?
Sometimes people have said to me, “Well, of course they give you special treatment—you’re a doctor.” But it doesn’t work that way. You can’t fake this stuff and see a few emergency patients in an ad hoc fashion just to impress someone. Such procedures must be a routine.
Once, I asked one of the techs how often they come in and find the clinic disturbed because the residents or fellows have treated patients during the night. Her response? “Every morning.”
It’s become fashionable to talk about “personalized medicine.” The care I have received at the Retina Clinic goes beyond personalized medicine—it is incredibly personal medicine. It is taking responsibility for patients at the highest level—the patient you have seen who has an urgent problem, and the patient you have never seen before. It takes time, it disrupts schedules, it makes doctors run late.
But good doctors often run late.
Iowa City, Iowa