I saw my first retinal detachment a few weeks ago. I have a slit lamp photo I took of my patient in the emergency department using my digital camera. His anterior vitreous was littered with a mix of pigmented and white cells. This finding is dubbed, ‘Shafer’s sign’. Its presence highly suggests a retinal detachment.

For those of my colleagues, this is named after Donald Shafer, of MEETH. Don Shafer graduated from Columbia University and Cornell Medical College. Some texts misspell his name as “Shaffer”.

medicine ophthalmology

An obvious facet of owning a business is knowing your competitor’s prices. If you don’t, then you’ll likely be out of business soon. We see this with taxi drivers. In NYC, there are city-governed yellowcabs and unmarked private cabbies. Most private cabbies command a higher rate, not because they provide better service but because they lurk around areas where yellow cabs are not as readily available. As a customer, the key is to negotiate a price prior to getting into the cab. However, even with informed preparation, you can still run into trouble.

I hailed a grey taxi to help me move an air conditioner 5 blocks away from my apartment.  I offered $10 for his assistance in carrying the unit to and from the cab in addition to driving me. He agreed. Afterward, he didn’t help me move the A/C, AND he charged me $15 because my A/C was “big”. Asshole. A $15 cab fare would normally get you at least 20 blocks.

My friend Bob had a more harrowing experience. After agreeing to a standard $8 fare to travel between hospital campuses, the cab driver demanded $14 when they arrived at the destination. Bob refused, and the driver locked the doors to the cab and refused to allow him to exit. He spent over 30 minutes in the cab until the driver gave in and let him out.

I understand that any business is difficult to run these days, but knowingly ripping off your regular customers is no way to remain profitable.

medicine rant, travel

We have a tunnel system that connects the eye institute with the main hospital.  At times, transport vehicles carrying trash whiz by precariously. The tunnel is usually only wide enough to accommodate unidirectional flow. I have had the fortune to transport patients through this maze. The last guy I moved had platelets of 29k. I had only an oxygen tank and a code box with me. Some say that this tunnel is treacherous for patients.

Well, if you make it out unscathed, you will definitely be stronger (physically and mentally).

medicine ophthalmology

The great aspect of having a small residency group is that we could all potentially get along and have a good time. I’m fortunate that this is the case. Everyone is willing to pitch in and help each other out.

One of my friends at a large ophthalmology residency program recently disproved the aforementioned statement, however; his relatively large class of 7 residents per year get along nicely as well.

What is true about a small residency is that no gossip goes unturned. For some reason everyone knows everything about the patients that roll into our clinic or ED. That’s the disturbing fact. How does this happen? Is everyone nosy?

In fact, I wouldn’t be surprised that the chairman of my program has visited my website…that would be very interesting. I’d better only post constructive criticism from now on… ;=)

medicine ophthalmology

We get many calls from the ED regarding eye trauma by various objects and substances. Some of them are absurd–how did you get nail glue into your eye again?

I always considered these people who roam into the ED as inferior beings, until I experienced a similar episode days ago.

Somehow grapefruit juice managed to circumvent my glasses and splash into my eye. It was painful. I flushed my eye for about 30 seconds with sterile saline, and felt better afterward. Ideally, I should have flushed even longer, but I had 2 consults to see in the ER.

The next time I triage someone who sprays antiperspirant into their eyes, I’ll think twice before ridiculing them…

medicine ophthalmology