how not to tell your patient they may or may not have eye cancer...

so today was fun. during clinical skills we were using our opthalmascopes on our partners, practicing checking eyes, when my partner finds a "black dot" on my left retina... looks again... yes, the black spot is still there. we call over our overseeing physicians, he looks into my eye, looks at me, asks when the last time i had my eyes checked were (7 months ago), asks if this black dot has always been there (ummm... no?), tells me "in all my forty two years of practice I have never seen this before. could be melanoma. you should see a specialist"... at this point i'm in shock, considering crying, remembering i don't have eye insurance, i joke - pretending i'm not completely frightened... he realizes maybe he should not have thrown out that diagnosis, "oh don't worry it's probably nothing, i mean i've never seen it, and you don't want to mess around with those kinds of things.... something, something.... melanoma... something, something... i would just get that checked out as soon as possible if i were you".... i start crying... my classmates attempt to comfort me... and now i'm expected to go back to class and pretend like i'm not dying from cancer...

drama takes over: frantically googling black spots on retina, calls mom in hysterics, [I PROBABLY HAVE CANCER], tries to buy eye insurance, leaves class, makes an appointment with the student health center, [I'M GOING TO BE BLIND], tries to make an appointment with the specialist (cannot - i have to go in to make an appointment), [HOW AM I GOING TO BE A BLIND DOCTOR], friend comforts and reminds that the spot is only in the left eye,  [HOW AM I GOING TO BE A ONE-EYED DOCTOR], friend continues to comfort, [I'LL PROBABLY HAVE TO USE A MONOCLE], decide i should not freak out until i actually see the specialist, return to class, sit in class in a pool of self-pity completely distracted...

i decide i can't wait for my scheduled student health center appointment at 3pm and leave school since i can't pay attention anyway and head over to the student health center - i was hoping someone there would tell me it was nothing and i wouldn't have to go see the specialist, but that wasn't the case. they take me as a walk in, my blood pressure is 145/98, the nurse asks me if i ran there (no. no, i did not.) the nurse begins to do a vision test on me. she covers my left (spotted) eye, asks me to read the chart with my right eye... letters... then she asks me to read the chart with just my left eye... it's fuzzy (probably because it has just been closed), i can't focus, i convince myself i have been losing my vision this whole time and i'm just now realizing it so i start crying again, the lady is asking me to read the letters, i say some... she writes down my vision as right eye: 20/25; left eye: 20/80. the doctor sees me, tells me he is not sure what the spot is, and tells me to go to the specialist...

i drive to the specialist office, tell them my story, tell them i was referred... they tell me they can make an appointment for me next wednesday...  i start crying again, how am i supposed to do anything (like study) when i'm worried that i have cancer in my left eye? now, i hate crying in front of people, i hate that i can't control it and hate being vulnerable, so i don't even feel bad that my tears worked in my advantage for once... she feels sorry for me, tries to make me laugh, and says she will squeeze me in.

while i sit in the waiting room, i begin to realize i'm the only one there under the age of 70 - of course, i would have old people problems.... they squeeze me in, dilate my eyes, take pictures of my retina... the doctor comes in and tells me i have two benign pigmentation tumors (like a freckle) called choroidal nevus on my left retina, one is on my optic nerve the other is to the side... says it could develop into malignant melanoma but its rare and i will just have to keep an eye on them.... (get it? keep an eye on them... haha jk, that wasn't actually a joke) anyway, three hundred dollars later, crisis averted, for now...