More than 20 years ago, while I was working on call in my residency program, a young father was badly injured in an explosion at work.
The explosion caused significant injury to his hands and face and, in particular, his eyes.
He was first treated in a tiny, remote hospital in Oregon, where he was stabilized and underwent a few emergency procedures.
In the world of ophthalmology, when an eye is so severely injured that it has no hope for useful vision, the standard of care is to surgically remove the eye.
This helps prevent the possibility of sympathetic ophthalmia, where the fellow eye has an inflammatory reaction that can cause it to lose vision, as well.
One of the patient’s eyes was completely ruptured with no hope for useful vision. The fellow eye was damaged, too, with little hope of being saved.
Typically, in this type of injury, an eye doctor will immediately remove the most severely damaged eye.
But that night, for some unknown reason, the eye doctor in that small Oregon hospital chose to sew the eye back together as best he could, even though it was clear that no vision was possible.
After that procedure, the patient was transported to our large big city hospital in the middle of the night.
My attending and I began our four-hour case with heavy hearts.
When we saw the significant damage to both eyes, we were a bit overwhelmed with the young man’s sad prognosis.
I can still remember feeling helpless and grief stricken for this patient that I had just met.
My attending slowly and methodically addressed the less damaged eye, which also had significant trauma. It was almost unrecognizable.
I assisted as best as I could, and was grateful my attending was there to lend calm, clarity, and expertise to the surgery.
About half way through the procedure, my attending had an idea. He decided to take tissue from the eye we knew couldn’t be saved and transfer it to the eye that still had an ounce of hope.
Don’t ask me (or him) why he thought of this. This took place well before stem-cell transplants and such. It was just a thought that came to him in an instant, and he followed it.
My attending’s flash of intuition changed the patient’s life. He saved the less damaged eye and the patient had useful vision from it.
He sees from his eye to this day.
However, my attending did not take a lick of credit for helping this young man. Instead, he wrote a beautiful letter to the doctor at the tiny hospital who had decided not to remove the badly damaged eye before transferring him to us.
My attending told that doctor that his decision to try to mend the eye saved the young man’s sight.
What an incredible blessing.
That day, my attending taught me that trusting your instincts is part of being a skilled doctor.
He also taught me that being human is, too. . .