Ophthalmology (I’ve Got My Eyes on You?)
February 7, 1999
Sunday
Dear On-Line Journal of Internship Subscribers,
Hi! This is the entry for Ophthalmology, which I don’t particularly like. Eyesight is important for most activities of daily living, and it is amazing how super-specialized eye doctors are, but it’s so… small. All that attention to a small part of the body. Besides, I don’t like the fact that while operating on an eye, it stares back at you. How uncomfortable – for both me and the patient. The patient sees all the operating instruments coming right at his eye and is unable to close it (reflex) as the muscles are paralyzed. Talk about how to feel helpless.
Ophthalmology is basically an out-patient rotation. We spend most of our time in the outpatient department (OPD), where we’re supposed to see general ophthalmology cases (ranging from the simple, like sore eyes/pink eye, to more complex stuff like cataracts). Sometimes you can’t believe how long people’ wait until they consult – like, their eyelids have been swelling for the past 2 weeks and it is only then they seek consult. The swelling could have been controlled by oral antibiotics (if it were due to infection) if a doctor had seen it early enough, but no… they have to wait till it’s big and bloated and they can’t see anymore nor move their eye. Patients like this are sent to the emergency room for intravenous antibiotics (they work faster). In, addition to this, an incision has to be made in order to drain the pus inside – yucky!
I guess it’s because most patients consider the eye such a minor part of the body, (and they can still see out of the remaining well eye) and maybe for financial/economic reasons too, that they consult so late. It’s just so depressing to see yucky eye stuff like that. Normally I can’t cake the sight of a bare eyeball, what more swollen or tumorous eyes? Yucky again.
If not at the OPD, an intern would be on duty at the emergency room, where cases like eye trauma are seen. The nice thing about ophthalmology is that they have a standardized “trauma form” which takes the place of the formal history (interview) which you have to write. The trauma form has blanks and little boxes with phrases to check, e.g. “work-related”, “accident”, “self-inflicted” and so forth. It’s so easy to interview in ophthalmology since all the information is already on the trauma form.
Schedule-wise, ophthalmology is a good news-bad news thing. The good news is it’s a light rotation, since it’s mostly out-patient work (eye surgery is left to residency/specialty training, so interns don’t really have a part in that). The bad news is that Pediatrics (an 8-week terribly toxic* rotation) comes after Ophthalmology.
As of this writing, 83 days to go (56 with Pediatrics)!
Notes:
* “Toxic” at the Philippine General Hospital can mean many things, but all of them have the sense of being “not easy”. Toxic can be an adjective describing you having a hard time during a rotation/clinic day/duty day, and the opposite of “benign” (easy). Alternatively, it can be used in the sense of “you’re so toxic” (colloquially in Filipino: “ang toxic mo naman”) – you are making extra efforts to do something that you really didn’t need to go overboard for. It can also be transformed into a verb, “tinoxic” (i.e., to make toxic) – someone giving you a hard time. The state of being toxic – in all of its different forms – is “toxicity”.
JOINT is the Journal of INTernship, a series of email messages to family and friends (“journal subscribers”) written during my yearlong medical internship from May 1, 1998 to April 30, 1999. Internship is one of the requirements before taking the Philippine Physician Licensure Examination (also known as the Medical Boards). Journal entries were edited for clarity in January, 2020. Read more about it in the first blog post, Introducing JOINT.
