Having qualified with a postgraduate degree in ophthalmology and after a spell as senior registrar in northern India, I moved back home to Bangalore in southern India. I decided to spend eight months with my parents while preparing for the exams to come in Britain. Needing funds for the voyage, I put up a sign at home offering my specialist services to “private” patients in the evenings. Few patients trickled in, allowing me sufficient time to catch up on my reading.
The year was 1985, and the town was under a scare of violent burglaries and dacoities targeting remote houses. One winter night, we were suddenly woken up by the door bell at 2 am. Peering through the mosquito mesh in the window, I could just perceive a group of men hovering at the door. One of them had a towel draped over his face and seemed to be supported by another. The leader requested a consultation with me as his “brother” had woken up in agony unable to open his eyes and, hence, practically blind.
My anxious parents warned me against opening the door, so I elicited a quick history through the closed door. The patient had been welding the previous afternoon, at the local motor garage, without using a protective shield. Suppressing my fears, I decided to let them in, while my worried parents stood (an ineffective) guard in the next room. The man had severe photophobia and was unable to open his eyes. A drop of local anaesthetic and cycloplegic made him comfortable, and I found the eyes were otherwise healthy. I explained the diagnosis of a welder's flash (arc eye) and sent him home wearing eye patches and with antibiotic ointment. I reassured his friends that he would recover over the next few hours and declined their offer of payment until review. The group left sceptically. My parents heaved a sigh of relief, and none of us slept well for the rest of that night.
The next evening I was greeted by an even larger group of men headed by a beaming patient delighted that he could “see” again. The fee I now accepted seemed trivial compared with the patient's and his family's immense gratitude. I did not dare mention our suspicions of the previous night. The incident was followed by a considerable surge in the popularity and practice of the new “eye” doctor.
This incident is regularly recounted in my teaching of juniors, not merely for its academic and dramatic content, but to show the satisfaction and thrill of a doctor's ability to relieve suffering even under trying circumstances.
Footnotes
We welcome articles of up to 600 words on topics such as A memorable patient, A paper that changed my practice, My most unfortunate mistake, or any other piece conveying instruction, pathos, or humour. If possible the article should be supplied on a disk. Permission is needed from the patient or a relative if an identifiable patient is referred to. We also welcome contributions for “Endpieces,” consisting of quotations of up to 80 words (but most are considerably shorter) from any source, ancient or modern, which have appealed to the reader.