Thursday #88 – this Thursday was The Thinks-He’s-So-Smooth
Dispenser’s 23rd birthday so just before midday we all got together
out the back to sing happy birthday to our youngest team member and eat
cake. I had brought my lunch to work
this Thursday (a rare but needs to be less rare occurrence) but with free cake
on the menu I decided to leave my pasta in the fridge for Friday and get by
with a less filling lunch. This way I was
not only prepared for the next day’s meal but I also had more room for cake. Genius.
After lunch (and cake) I saw a rather memorable 4 year old
patient. He arrived 10 minutes late and
The Girl With The Tiger Tattoo asked if I would have time to see him or if he
was too late and she should tell him he missed his appointment. In hindsight, if I had any idea what the next
half an hour would be like, I would have sent that kid home for making me
wait. Instead I welcomed the 3 of them
into my room – The Stocking Destroyer, The Crying Toddler and The Idiot Mother.
The Idiot Mother explained that The Stocking Destroyer had
recently had an eyetest at daycare and “gotten 6 out of 9” so it was
recommended he have his eyes checked by an optometrist. I let her description of his visual acuity
slide as I was just grateful that she was able to provide some useful
information, even if it was incorrectly worded.
I understood that her explanation of her son getting “6 out of 9” meant
that somewhere she had seen “6/9” written down to symbolise his visual acuity.
**A quick lesson in visual acuity: We use the metric
notation of 6/6 to describe nominal performance; this is more commonly known as
“twenty twenty vision”. The first 6 (or
20) refers to the test distance in metres (or feet) and the second number
refers to the distance at which you should be able to see the chart. That is, for 6/6 vision you can see the 6
metre line at 6 metres and for 6/9 vision you can only see the 9 metre line at
6 metres – you need to be 3 metres closer than someone with 6/6 vision. **
She also explained that the GP had found a similar result at
his 4 year old check-up and recommended a 2nd opinion from an
optom. I wasn’t too worried as
technically 6/9 still falls under the norms for 4 years old so he can’t have
been doing too badly. The testing was
not off to a good start when I sat across the table from The Stocking Destroyer
and he wildly swung his legs, kicking me in the leg and making a massive hole
in my stockings. I was less than
impressed and not remotely sympathetic when he later complained that his shoe
had fallen off. I tried my best to get
his visual acuity but with letters and numbers out of the question I was left
with our picture chart and its questionable illustrations of a cake, horse,
car, bird, hand and plane. He did not
appreciate the eyepatch and was clearly messing with me as sometimes he claimed
to not see any of the big pictures but then quickly rattled off a smaller line
of the same pictures.
Aware that the pictures were a tad dubious, I had taken a
photo of the chart, printed it out and cut out each individual image so that he
could match them to the ones on the chart if he couldn’t articulate exactly
what they were. The kid did not seem to
appreciate this and I was getting nowhere fast, the noisy presence of The Crying
Toddler and The Idiot Mother were not helping matters. Since my subjective tests were proving
useless, I did my best at getting some objective results. Retinoscopy proved a waste of time when The Stocking
Destroyer refused to focus in the distance and look at the plane, opting
instead to look directly at the light in my hand. When I asked him to look at the plane not at
my light he simply covered the eye I was looking in with the light. Très helpful.
The autorefractor was equally useless as he refused to look at the
target in that as well.
“Are you looking at the hot air balloon?”
“Yes”
“I don’t think you are, can you tell me what colour it is?
(because I can see your eye and it’s not remotely looking straight ahead, it’s
looking at The Crying Toddler)”
“I am”
This went on for a little while before I gave up. The Crying Toddler was screaming his head off
and The Kiwi Early Leaver had come out of her consulting room to give him a toy
to play with, making me feel particularly under-prepared. The Idiot Mother insisted we keep trying and
that she would help. It was a nice
thought but hard to explain that it didn’t matter how long I sat there, if her
son refused to follow my instructions and look at the balloon I wasn’t able to
do anything about it. Eventually I called
it quits; I was running late for my next patient and was sick of this kid and
his whole family. I explained to The
Idiot Mother that I wasn’t getting any useful results but I wasn’t too worried
as 6/9 is still considered normal at his age so I would just re-check next year
when he’s a bit older and can deal with the tests a bit better. I used my best optometry talk to express the
view that I could not do my job because unfortunately it relies on the patient
being moderately cooperative.
This was when The Idiot Mother decided that she knew best
and seemed to question my expertise.
Earlier in the day I had seen a gastroenterologist as a patient and was
super intimidated by his use of big words and ability to read music and whatnot
but even he, with his much more impressive medical degree and real doctor
title, seemed to trust that I was the expert in the room when it came to
optometry. Not The Idiot Mother, she
said she was worried because two people (daycare and the GP) had said it wasn’t
normal and to see an optometrist and now I was saying it was normal. I do understand where she was coming from but
also wanted to point out that what had really happened was she had had two
people (daycare and the GP) admit that they weren’t sure and to see someone who
would be sure and now she doubted that person’s opinion. I also wanted to point out that her kid
seemed like an annoying brat and I was quite confident he probably could see
the smaller pictures he just didn’t want to try.
Instead I offered a few more solutions – he could return for
a test where we put drops in his eyes to paralyse his focussing system so that
when I shine lights at him he has no choice but to be focussed at the chart in
the distance and not at my light, he could see a paediatric optometrist who
would have different charts and be better equipped for testing kids (I once
again found myself writing down the name of The Forestville Optometrist) or he
could see a different optometrist here (since The Idiot Mother seemed to think
she had to see an HCF optometrist for it to be free despite both me and The
Girl With The Tiger Tattoo explaining that it is covered by Medicare and not
private health insurance). I don’t know
what she decided in the end but I think I did a good job of talking her out of
the drops so I’m pretty sure I won’t have to see him again.
When I finally saw my last patient of the day I was a little
frazzled and conscious of my now ugly stockings but the appointment was all
fairly straight forward and she had been running late herself so wasn’t left
waiting for too long anyway. The Manager
turned the lights off on me and I had to run out, almost forgetting to take my
phone with me. Ordinarily I love that my
work doesn’t involve overtime and I am usually out of there by 4:50pm but
sometimes I find it a little stressful if I am still there at 5:05 and being
frantically rushed out the door.
I wanted nothing more than to go home and vent but I knew
that DTM was in Chatswood at the library waiting to meet up with some guy about
a business. I stopped in at The BH&G
Fan’s house on my way home but the absence of any lights told me there was no
point even ringing the doorbell. Instead
I went home, got changed and headed off to the shops for some retail
therapy. I quickly met up with DTM while
he ate some dinner before his meeting and got to have my vent. I then wandered around aimlessly, uninspired
by any of the clothing in the shops before finally grabbing a burger from Grill’d
and heading home to eat and watch TV.
DTM phoned to say The Armenian Grandmother had been taken to hospital
and we weren’t too sure what was wrong but it was too late to visit that night. He decided to stay in Chatswood after his
meeting and watch a movie to take his mind off things and I went to bed.
For a Thursday which started so promisingly with cake, it
ended quite poorly with annoying patients, a sick DTM relative and a lack of
much-needed therapy from the retail world.
One dress I had had my eye on for a month or so was finally on sale and
when I showed DTM in the brief time I was with him he told me it looked like a
quilt so I went home empty-handed. Here’s
to a better Thursday next week after my long weekend.
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