The ER physician pulled back the curtains of the room and gave the patient a quick hello before reaching over and turning the hospital TV off.
"I'm just going to turn this off for a few minutes or I might start watching TV and stop paying attention to you," he said with a chuckle.
The patient stared back, twisting his fingers nervously, a polite smile on his face. He seemed young, maybe mid-twenties, for his hair was still thick and dark, and his features still carried the reminiscence of obstinatious college days. The physician folded his hands behind his back.
"So what seems to be the problem?" he asked, even though the answer was staring him back in the face, literally.
The patient pointed at his right eye. "My eye. It hurts and my vision is kinda fuzzy." His right eye was slightly protruding, but not too much to notice unless you really looked hard. It looked like he was glaring, except he was only doing it with one eye.
"When exactly did this pain start?" the physician asked, walking closer to the bed and taking a pen light out of his pocket.
"Uh, I don't know, three days ago?"
"Can you describe the pain?"
"Yeah, it's like a pressure almost."
"Okay, I'm just going to ask you to lay back please."
The patient toed his shoes off and laid back on the hospital bed. The physician leaned over and passed the pen light over the patient's eyes, testing his pupil reaction to light.
"Just follow my finger with your eyes. No, no, don't move your head, just with your eyes."
The physician put the pen light back in his pocket and frowned. "I'm not seeing any redness. You don't have a headache, do you?"
"No."
"What about the visual changes you were referring to. You said your vision is a little fuzzy?"
"Yeah, its like looking our of a camera lens when its out of focus; everything is fuzzy."
"Any darkness?"
"Yeah, a little I guess, just around the edges."
The physician nodded. "Do you work?"
"Yeah, I'm the manager of a Walgreens photo department."
"Do you smoke?"
"No."
"Alcohol?"
"Yeah, but just socially."
"Drugs?"
"No."
"And you live alone?"
"No, I have a room mate."
"Okay. So here's what we're going to do. I'm a little concerned about the visual changes, so I'm going to order a CT scan of your head, just to make sure everything's alright there. Then we're going to give you some Percocet for the pain. In the mean time, I'm going to have a nurse come in and give you a visual acuity check, just to see where we stand. Sound fair?"
The patient nodded.
"Okay, I'll put the orders in. We'll talk again in a little." The physician turned on his heel, his white coat flapping behind him, and suddenly stopped short, the curtain in his hand. He paused and looked back at the patient. "Are you on any medication right now?"
"Well, no, not at the moment."
"What about the last twenty four hours?"
"No."
"Any medical problems?"
"No."
"Okay, sounds great."
The doctor left the room, the curtain billowing behind him.
* TWO HOURS LATER *
The physician walked back into the room, followed by two residents in white coats over sea green scrubs. The patient looked at them nervously as they crowded the small room.
The physician spoke. "These are the hospital's OMFS (Oral and Maxillofacial Surgery)residents, they basically deal with dental problems and things of that nature."
The patient blinked. "Dental problems? What's wrong with my teeth?" He absently lifted his hand to the right side of his jaw.
"Did you have any work done on any of your teeth recently?" One of the residents asked.
"Y-yeah, I had one of my wisdom teeth pulled out last week. Why?"
The residents exchanged knowing glances, then the same resident spoke. "And have you had any accidents within the past five years? Any fractures?"
The patient looked worried now. "Well, yeah, I used to skate board back in college. I had an accident and fell down pretty bad and, uh, I fractured my cheek bone."
The other resident grinned. "So you're saying you broke your face?"
The patient flushed. "Yeah, basically."
Now it was the physician who spoke.
"Okay, here's what we think happened. When you had your wisdom tooth extracted, the area got infected, which is common with these kind of things, especially if it was a deep extraction, but that's why the dentist usually prescribes Amoxicillin, or an antibiotic of some sort, just to, you know, prevent an infection, but anyway," the doctor waved his hands dismissively, "what happened is that the infection spread from your mouth up into your head, in the area behind your cheek bone. Luckily, you had scar tissue there from when the fracture healed, and that's what kept the infection from spreading further up. So instead, it kind of stopped there and stared pooling up until it was right beneath your eye, and as it grew in size, it started pressing against your
optic nerves. That's the pressure you said you were feeling, and its also the reason behind your visual changes."
The doctor stared at the patient. "Quite honestly, had you waited a few more days, you would have been blind."
* * *
He was only fourteen when he moved to a new neighborhood and switched schools. It was then that he met one of his to-be-closest friend, who was also a "new kid" and who liked skateboarding. And that was how he decided that for his birthday, he would ask his parents for a skateboard too, so he and his new friend can go skate together. And then one day when he was practicing at the skate park, he accidentally rolled over on a lizard of some sort, and later told his science teacher about it. And that's when he decided he wanted to be a Wild Life Sciences major in college, and that's exactly what he did. And then one day when he woke up late for class, he had to take a back seat in his sophomore English lecture, and that's when he happened to notice the girl sitting next to him, who had brown eyes and a pretty smile. And that's when he decided he had fallen in love, and he switched his major to photography to be with the girl, who dumped him two years later because she was a lesbian. And a few months later, he graduated with a photography degree and was jobless for six months and started drinking. And then one day in the middle of September, his high school friend came knocking on his door, with his skate board tucked under his arm, and a sad smile pasted on his lips, and he told him to put some shoes on, they were going skating. And that's when he remembered how much he liked skating. And then he found out about a skateboarding competition that gave a good wad of money for its first place winner, and his friend told him to sign up. And that's how he found himself in a hospital bed a few hours after the competition, with a fractured cheek bone. And that's when he sobered up and decided to go job hunting again, and that's how he landed a job as a sales associate at a local Walgreens. And two years later, when the manager of the photography department was fired for embezzlement, he told his boss about his photography degree and got the position of photo department manager. And then two weeks ago, he felt annoyed by the pain in his jaw, by his wisdom tooth, and a week later, he had it extracted. And that's when he got the infection.
And had he done one thing differently, had he not moved to a different neighborhood when he was fourteen, or caught his friend's contagious interest in skateboarding. Had he never run over that lizard and taken up an interest in animals, or had he not gone to the college he went to. Had he only pressed the snooze button twice rather than three times, and gotten up on time for his sophomore English class, and had he never asked the girl sitting next to him to a movie. Had she never broken his heart two years later, or had he found a job right after graduating, or had his friend never came back to ask him to skate. Had he never signed up for that competition, had he not gotten that fracture that gave him that scar tissue, and had he decided to ignore his wisdom tooth pain and not go to the dentist to have it extracted. Had he waited just another day before deciding his eye pain probably needed medical attention, and maybe today he would have been blind.
