Gifts of Sight

For most surgeons, the operating room is a sanctuary.  It is an escape from the frenetic demands of a busy office practice – a waiting room filled with patients, who are becoming increasingly disgruntled as the minutes since their appointment time continue to tick away – hurrying between exam rooms and trying to be efficient but also trying to give each patient the time and attention they need and deserve – telephone calls from patients with concerns or other doctors who want to discuss a problem case – emergencies coming in unscheduled, and patients with postoperative complications, all of which set the day’s schedule further and further behind.  And amid the demands that seem to come from all directions at once, the doctor must remain calm and focused, remembering that any error in judgment could spell harm for a patient.

           
But then the surgeon enters the operating room, as though passing through a hallowed portal into an atmosphere of tranquility.  The cacophony of the busy office is suddenly replaced with a symphony.  It is not so much that the tempo slows, but that everything now flows in unison with only one focus – the patient on the operating table.  And each person in the room, rather than pulling the doctor in every direction at once, is helping to achieve a single goal – the best outcome for the patient.  On most days, it is truly a well orchestrated symphony and a source of great satisfaction for the surgeon and all the operating room staff.  But when something goes wrong – really wrong – there is no greater crisis or agony that a doctor can face.  For me, one of those moments came the day I was scheduled to perform surgery on Pearl Overbee.

I had only known her for a short time prior to the surgery.  She had a long history of glaucoma that had been well controlled with medication, but progressive cataracts had now severely impaired her vision.  Because of the combined cataracts and glaucoma, her family ophthalmologist had elected to send her to Duke for her surgery.  Mrs. Overbee was an attractive, white haired octogenarian with a charmingly sweet and serene demeanor. She was brought to the office by her daughter, who was about my age.  The two women were obviously very close, and the daughter took pride in telling stories about her family, especially her mother and father.  She must have sensed my genuine interest in the stories, because she not only continued to tell me more on subsequent visits, but also brought in copies of old newspaper articles from over the years. By the time of the surgery, I felt that I had come to know the family quite well.  As it turned out, I had come to know them too well.

Mrs. Overbee’s surgery went smoothly, and I felt good when we sent her back to the hospital room, where all her family was waiting for her. I sent word by the nurse that I would come to their room as soon as I finished the last case.  That case was just getting started when a nurse rushed in to the operating room in obvious distress.  A hush suddenly fell over the room amid whispers and gasps. Something was very wrong, and I could tell they were debating whether to disturb me with it during the surgery. I paused for a moment and looked up from the operating microscope at the nurse, who came over and whispered in my ear.  My blood ran cold and my whole body trembled as I digested the news.  I wanted desperately to leave the operating room, but that wasn’t possible.  My only responsibility at that moment was the patient in front of me, and we were far enough into the surgery that I had to complete it.  I momentarily closed my eyes, took a slow, deep breath, forced myself to relax and then began to move robotically through each step of the operation.  But I could not keep my mind from being flooded with the stories I had heard during the past few weeks – stories that spanned more than half a century.