I sighed when I saw her name on my list again.
A.N. was one of my favourite patients. She had rheumatoid arthritis–an autoimmune condition, where your immune system attacks your body . A chronic condition that may need lifelong medications. Her grandmother had it. She knew for her grandma it made her hands deformed and caused her a lot of pain.
Not something a 29 year old young woman wanted to hear.
I had just seen A.N. 6 days ago and she was back again in an urgent spot.
“What’s up?”I asked smiling and knowing she’d laugh as I teased her for coming back so soon.
“I can’t really see out of my eye Dr. B.”, she said with a smile that was more of a grimace.
“What? Since when?” I examined her eye as she reviewed her story with me.
Damn, I thought. Of course it was the afternoon before a long weekend. She needed a specialized exam so that appropriate treatment could be provided. For a person who was on drugs that weakened her immune system, she could have a few things that were urgent so she didn’t lose her sight.
And my hands were tied. Our only option was for her to go sit in the ER. She needed to see a doctor who had access to a slit-lamp exam (a special way to look at the eyes), and we both knew that meant she was in for a long evening.
I called her a few hours later to see if she had seen anyone–she said a doctor came by, and told her the slit lamp in the ER was broken. She had an exam that was similar to what I had given her in the office and booked in to see the eye specialist the next day…
Oh. My. God. What if she loses her vision? The possibilities ran through my head. What could I do? Even though I knew how to treat her, without the proper equipment, we couldn’t be sure what to treat her with.
At that moment, I despaired. As I’m sure the ER doctor did that evening. Our hands were tied due to broken equipment. Our hands were tied due to broken budgets.