Melissa Zhu Murphy
On Mother's Day 2007, as I was finishing my freshman year at Vanderbilt University, I joined my parents for a warm, happy reunion in an Italian restaurant, celebrating both the day and the completion of my first year of premedical studies.
My father was blissfully breathing in the steam wafting up from his ravioli in lobster cream sauce as my mother prepared to dig into an enormous plate of basil penne pasta with spicy meatballs.
I took a bite of crusty Italian bread and lifted a forkful of manicotti to my mouth, getting ready to describe how hard I'd had to study for my biology and chemistry finals. Then I realized that something was wrong.
It was my fork. It had somehow twisted itself into a bizarre shape, like something out of a Salvador Dalí painting.
That's weird, I said to myself, staring at the twisted tines and handle. I took a look at the pasta on my plate. It too was distorted. I looked up at my parents, at the waiter pouring our wine and at the rest of the restaurant. Everything was distorted--weirdly curved to one side, as though it were being sucked into an invisible vacuum cleaner somewhere off to my right.
I took out my contact lenses. Nothing changed.
Wow, I thought. I know I'm nearsighted, but this is way worse than that.
We left in a hurry. My parents drove me to a local eye hospital, where I was assigned to see a retinal specialist.
A middle-aged man, Dr. Essers greeted us politely and asked me to sit in the examining chair. Never had I felt such anxiety while hearing the familiar words: "Put your chin right here, please....Press your forehead up against the bar....That's right; now look at my ear."
Five minutes later, Dr. Essers whistled under his breath. "There it is," he said softly, his face just inches from mine. "Just a minute...."
Afterward, with the lights back on, he said somberly, "There's a blood clot on the back of your retina. It behaves similarly to macular degeneration, but it can be caused by trauma."
"Macular degeneration in a healthy twenty-year-old girl, occurring while eating Italian food?" I said, bewildered.
"Or it may be related to your myopia," he added. "Let's get a florescent test right away." He turned to the computer screen and started to put in the order.
"I'm sorry," he continued distractedly, tapping on the computer keys, "I'm afraid this means that you'll go blind within two weeks...."
"Blind in two weeks?" I blinked a few times, trying to make sure I hadn't misunderstood. Then I turned to my parents. Using my minimal medical knowledge, I tried to explain Dr. Essers' diagnosis to them while also struggling to make sense of it myself.
Quietly, my parents walked with me to the fluorescent-test room. They seemed even more nervous than I was.
The test results were reassuring, but also puzzling: the florescent tags were all concentrated inside blood vessels, which meant that my retina was not actively bleeding. So what was causing this bizarre visual distortion? And why had it happened?
Dr. Essers offered no further explanation. "We'll continue to monitor your condition," he said. "Come back in one month."
As we left, I felt my enthusiasm for medicine fading away, to be replaced by doubt and suspicion about physicians in general, and about Dr. Essers in particular. Driving home with my parents, I oscillated between worry and wild speculations about my condition.
The next day my parents took me to see Dr. Smith, a pleasant young ophthalmologist noted for his academic and surgical accomplishments.
After examining my eyes, he rolled his chair back a bit, looked at me and said, "Tell me about yourself, Melissa. How is school? What do you study?"
"Well," I began, "I'm a premed student. I just finished my freshman year. We had final exams the last two weeks. It was pretty stressful, and I studied really hard...."
As I continued describing the college year just past, Dr. Smith listened attentively, offering nothing beyond an occasional nod or "Uh-huh."
After about ten minutes, he said, "Well, from what I hear, I think you have a mild condition called central serous retinopathy. It's induced by stress, and although it's rare--it occurs in only one in 100,000 females--it's more common in young people like yourself."
He gave me a moment to take this in, then went and found a handout describing the condition in more detail. Grabbing a marker, he highlighted the prognosis: most patients recover spontaneously without intervention. Then he handed me the paper, smiled and patted my shoulder.
"Melissa, I think you're going to be okay," he said. "I'll see you in a month to follow up. In the meantime, try to relax, because stress is the main cause of your condition."
Heading home, I felt almost giddy. Dr. Smith had performed a medical miracle: after just ten minutes of listening, he'd transformed my diagnosis--and my future. I'd gone from fearing imminent blindness to looking forward to an almost certain recovery.
My heart overflowed with hope--and with renewed admiration for medicine and physicians.
Dr. Smith was right. Over the next two months, my vision gradually improved until it was completely normal once more.
Now, seven years later, I'm a resident physician in anesthesiology, caring for my own patients. Like all residents, I have a hectic schedule--but no matter how busy I get, I never forget my debt of gratitude to Dr. Smith.
He taught me that careful history-taking and clear, compassionate communication can mean the difference between a faulty diagnosis and an accurate one.
And he showed me the most important instruments in every doctor's toolkit: not fancy equipment, but an open mind, a pair of listening ears and the right words, carefully chosen.
About the author:
Melissa Zhu Murphy is currently an anesthesiology resident at Vanderbilt University Medical Center, in Nashville. She completed her medical degree at Texas Tech Paul L. Foster School of Medicine. "I first became interested in medical humanities while taking a narrative medicine class as an undergraduate at Vanderbilt University." This is her first story for Pulse.