August 25, 2011

Lost, With My Eyes to Blame

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When I first arrived at Cornell, I hopped out of my parents’ car with the same intentions as every other doe-eyed neophyte around me. I was eager to claim a bed in the room, start befriending others in the dorm and most importantly, establish myself as an independent young adult on campus.

This sense of autonomy manifested itself in myriad ways among my peers, though one of the most ubiquitous was our blatant disregard for our own health. As freshmen, we sacrificed sleep (and grades) for a few more hours of FIFA. We ate mountains of fried food just to wash it all down with sugary energy drinks. We jumped off cliffs into Beebe Lake and went swimming in Fall Greek Gorge. I even saw friends so intoxicated they frequently needed assistance finding their way home. Yes, we were invincible.

This illusion ended the very day my first spring break began. Looking into the mirror after my shower, I noticed that my eyes were very red. They were like two ripened cherries with pupil-like pits poking through the middle. Alarmed and embarrassed, I hurried off to the doctor who prescribed antibiotic eye drops without hesitation. Even though my eyes didn’t itch, hurt or contain any noticeable discharge, both the doctor and I presumed this must be infectious conjunctivitis, or pink eye. I wish it had been.

One week later, my eyes were still red, so a second antibiotic was tried. My eyes grew redder still. My doctor was stumped, but remained resolute. I wasn’t surprised when the third antibiotic also proved ineffective.

Once back on campus, I went to Gannett for a second opinion. I was to soon realize that this frustrating affair was far from over.

“I’m going to put some yellow drops in your eyes, then take a look with this blue light.  This will tell us if it’s HSV.”

Wait. Herpes? In my eye? How does that even happen? My heart started racing and my clothes became damp with sweat. I panicked.

“Hm. Nope. Well, I have no clue then. I think you should see an ophthalmologist.”

At least it wasn’t herpes. But, what was it? This had been wreaking havoc on my social life for some time, though I now began to worry about something more important — my physical health.

I didn’t believe what the ophthalmologist told me, initially. “You have dry eyes,” he said once more. While I sat processing this information, he explained I would need to take eye drops regularly to prevent damage to the cornea, along with two medications to reduce inflammation. I was relieved to finally have a diagnosis, but I was still left looking for answers. I wanted to know why this happened, but the doctor seemed unconcerned. Unsatisfied and still curious, I continued my quest online.

The internet can be a powerful resource for a patient, but it is frequently confusing and potentially treacherous. After only ten minutes on Google, I discovered that “dry eyes” meant I was either an aging woman or had some terrible autoimmune disease, such as lupus or Sjogren’s syndrome. Predictably, every subsequent ache and sniffle fell under intense scrutiny as I searched for some hidden process intent on disrupting more than just my ability to make tears. I was in danger of becoming a hypochondriac.

It struck me that there was some cruel irony in this. I had originally gone away to college, excited to be on my own for the first time in my life. However, I was soon forced to realize that with independence comes responsibility. Obligated to make these health-related decisions myself, I felt like the weight of the world was on my shoulders.

Fortunately, after several anxiety-filled months, I discovered a potential reason for my dry eyes. The day before spring break, I had accidentally inhaled the vapors from some hydrochloric acid I was pouring in chemistry lab. I didn’t think much of it at the time, because the burning in my throat quickly subsided and the start of my vacation was near. For better or for worse, this forgotten event had given rise to months of apprehension but also a valuable lesson in growing up.

Navigating the health care system can be extremely difficult, especially when it is new and unfamiliar. Not only is the student population mostly healthy and therefore inexperienced, but any prior medical challenges were likely confronted with the help of our reassuring parents. How does one find a specialist? What does “co-pay” mean? Do I even need to go to the doctor? At some point, we all find ourselves adrift in this endless sea of questions, searching alone for those elusive answers.

Of course, there are other reasons why this process may seem daunting. In the past few decades, patients have adopted a greater role in their own health care. Visit times have become progressively shorter as doctors’ workloads have increased, thereby reducing the time available for patient education. Paradoxically, this has occurred as the medical field has distanced itself from its paternalistic past and embraced a more patient-centered approach to care, with an emphasis on patient autonomy. Furthermore, although the growing availability of medical information in this digital age has enabled patients to be more proactive, it can quickly become disorienting.

Recently, the field of medical journalism has begun to flourish, as medical health professionals recognize the need for clear and concise writing that distills complex medical issues into understandable, take-home points. From Atul Gawande to Pauline Chen, doctors with a desire to educate and communicate have decided to pick up the pen and contribute to this rapidly growing body of patient-oriented literature.

In similar fashion, this year, students from Weill Cornell Medical College will be writing on various medical issues that are both interesting and relevant to the Cornell population. It is our hope that this column will function as a conduit for health-related information while also serving to bridge the gap between Cornell’s Ithaca and New York City campuses. So, be on the lookout for these articles every two weeks, as they may prove both educational and useful to you.

David Roy ’08 is a fourth-year medical student at Weill Cornell Medical College. He may be reached at dmr2002@med.cornell.edu. What’s Up, Doc? appears alternate Fridays this semester.

Original Author: David Roy