A Sudden Change in Vision

My first emotion was irritation. It was Friday afternoon around 5 o'clock, and it had been a particularly busy week. I still needed to make rounds at the hospital on a couple of inpatients, but I had finally finished the afternoon clinic. I was within an hour or so of finishing my work for the week. Then I would have a whole weekend off to relax, recover, and play with my kids. I finished reviewing all the lab reports and phone messages and was heading out the door. Then one of the nurses brought me one more patient message to deal with before I got out. Scrawled in the triage nurse's handwriting on a memo paper clipped to the front of a thick chart was the offending statement: “Mrs. Jones called to say that she has had blurred vision ever since she had that echo test this morning.” I smirked. Suddenly echocardiograms were mysteriously causing visual difficulties.

I was irritated and tired. This week it seemed that the patients had questioned every thing I had prescribed or ordered. The smoker with diabetes and a low-density lipoprotein cholesterol reading of 225 had balked at my statin prescription because he had heard on television that the medicine could hurt his liver. My hypertensive patient had stopped her diuretic on the advice of …