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This is part of the full text of the medical memoir "Cancer Patient" written by Hugh Cook. The full text has been published online on a free-to-read-online basis. This autobiographical non-fiction account deals with the author's initial health problems, diagnosis, and treatment with chemotherapy and radiation therapy.

The complete text of "Cancer Patient" is here on this web site but is also available for purchase from amazon.com as a proper printed paperback book. The full text may also be purchased as a download (a PDF file) from lulu.com for US $5. Go to lulu.com/hughcook

For a chapter-by-chapter breakdown of what's in the book (in its online version, in the PDF version and in the paperback version), see:-

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CANCER PATIENT is a medical memoir which deals with the author's autobiographical experiences which involve, amongst other things, chemotherapy, radiation therapy, a brain biopsy, a lumbar puncture (and then some more lumbar punctures), treatment with Ara-C, treatment with vincristine, treatment with methotrexate, treatment with radiation from a linear accelerator, and a vitrectomy (an operation to remove the jelly from an eye). This is a non-fiction account but it does contain a couple of fictional stories, clearly identified as such, and it also includes some poetry.

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Chapter Four

Summary

The author sees an ophthalmologist in New Zealand, is told that he needs to have some tests, and that he needs to be under the care of an ophthalmologist.

        In New Zealand, I had been under the care of Dr. Lindo Ferguson through to 1988. However, my understanding was that he had retired. (Later, in 2005, someone told me that he had indeed retired, and was living in retirement in Northland, the northernmost part of New Zealand's North Island.)
        Consequently, after arriving in New Zealand in February 2004, I was not sure who I should see about my eyes. I ended up paying a visit to the premises of Mortimer Hirst Optometrists Ltd, an outfit which had made my spectacles (and, at one time, contact lenses) since I was a child.
        It had been so many years since I had visited these people that my records were not on their computer system, and had to be retrieved from some repository of ancient paperwork. That having been done, my eyes were examined by a young female optometrist whose name I cannot give because I have (unpardonably) lost her business card.
        This woman did two things for me, both of which were important.
        First, and this is the most important thing, she apologized. I had been through my story: the initial eyesight problems, a grotesque misdiagnosis by Dr. Quack, a "nothing wrong" verdict from Mr. Goodman, a second "nothing wrong" verdict from Dr. Slipstream, and then a return of the eyesight problems. And she said "I'm so sorry you've been messed around like this" or something like that.
        Maybe it was, technically, more a sympathetic expression of regret rather than an apology, but I received it as an apology, and I was gratified.
        There was no reason why she should apologize, since she had done nothing wrong. However, she did, and this went an enormously long way to making me feel better. I felt (unreasonably as it might seem) that the universe owed me an apology, and at last I had got it.
        The reason why I felt particularly aggrieved about the unsatisfactory outcome of my medical problem was because I had followed the rules but had been denied a solution. The basic rule is very simple. If you have a problem with your eyes then the sensible thing to do is to promptly seek help from a properly qualified ophthalmologist, who should fix your problem, if it lies within the realm of the fixable. This was what I had done (or, at least, what I had tried to do) and yet I was still stuck with my problem.
        As I have said, the optometrist at Mortimer Hirst did two things for me. First, she apologized. Second, she made an appointment for me to see an ophthalmologist, who I will call Dr. Kiwi. My right eye was so full of junk that the female optometrist could not see the retina, the light-sensitive layer at the back of the eye. She considered it possible that I might be suffering from a detached retina, a medical condition which constitutes an emergency requiring the promptest possible treatment.
        One other thing that happened at Mortimer Hirst was that the spectacles which had been made for me in Japan were checked. The people at Mortimer Hirst were a bit sniffy about the choices my Japanese optician had made -- for some technical reason the big frame was not the optimal choice for that particular set of lenses -- but, even so, my progressive lenses were deemed to be adequate.
        The problem, then, was definitely with my eyes rather than with my spectacles.
        The next day, I kept my appointment with Dr. Kiwi. On that trip to New Zealand, I only saw Dr. Kiwi the one time, as I had left the business of attending to my eyes until near the end of my visit, and I was scheduled to get on a plane back to Japan in a couple of days.
        Dr. Kiwi ran me through a bunch of tests and examined my eyes using a slit microscope. A detached retina? No. Dr. Kiwi could understand how the optician at Mortimer Hirst had come to consider that possibility, but my problem was something else.
        The left eye, as far as Dr. Kiwi could tell, was just fine. But, yes, there was a problem with the right eye.
        Dr. Kiwi did not give me a name for my condition but gave me to understand that it was an inflammatory condition of some kind, something which might possibly spontaneously cure itself or which might, in his words, "grumble on" for years. Why was the vision in my right eye blurred? Because it was filled with millions of inflamed cells. It was the inflammation which was causing the blurring.
        This condition could be treated by steroids. At least twice a week, I should check my ability to read fine print. If it became impossible to read fine print then I should urgently seek help from an ophthalmologist.
        Why?
        Because this kind of inflammation can cause a swelling in the light-sensitive area known as the macula, and, if this swelling persists for a month or more, recovery may not be possible. In other words, this condition can result in blindness.
        Dr. Kiwi asked me if I had a dry cough. I did not. He told me that I would need some tests, including a chest X-ray, and that I should be under the care of an ophthalmologist.
        He also told me that he could see, on the cornea or my right eye, two keratic precipitates. (The term "keratic precipitate" vanished from my memory shortly afterwards, but Dr. Kiwi gave me a handwritten note recording the fact that he had observed "2 K.P.", and I was subsequently able to retrieve the term "keratic precipitate" from the Internet.)
        I had a question. Back in Japan, Dr. Slipstream had peered into my eyes and had declared that there was no problem. If in fact keratic precipitates were visible, why hadn't Dr. Slipstream detected them?
        Dr. Kiwi's response was that, in his judgment, probably the keratic precipitates would only have been visible for a month or so, and therefore would not have been there to have been seen on the occasion of my visit to Dr. Slipstream.
        This was probably true, but, at the time, my private thought was "These doctors stick together, don't they?"
        When I left Dr. Kiwi's office, I felt as if I was floating, released from gravity. I had received confirmation that, yes, I did have a problem, something which could be seen under the microscope. The problem was serious, in that it could potentially lead to blindness, but it was manageable. My routine middle-aged life seemed to be back on track.
        As I write this account, I look back at my meeting with Dr. Kiwi, and about his take on my condition. His notion was that I had some kind of inflammatory condition. He did not mention a second line of possibility, just the one. Later, in Japan, a Japanese ophthalmologist, Dr. Lux, assessed my eyes and immediately gave me not just one line of possibility but two. One was, as Dr. Kiwi had said, some kind of inflammatory condition. But the other was cancer.
        And in fact the problem was cancer.
        Plainly, then, Dr. Lux made the better judgment call right at the start, because her range of stated possibilities included cancer whereas Dr. Kiwi's did not.
        Nevertheless, it is still the case that I have an affectionate regard for Dr. Kiwi and a high opinion of his skills, whereas, in the case of Dr. Lux, I eventually fell into an antagonistic relationship with her, the antagonism my fault rather than hers, and I came to distrust her. In fact, I developed the paranoid notion that she was more interested in me as a research problem rather than as a patient.
        It is difficult to explain the discrepancy in these feelings. To be honest, the Japanese woman with the razor-sharp intellect, a graduate of one of the world's elite institutions of learning, was a better diagnostician than Dr. Kiwi, my comfortable old New Zealand ophthalmologist. And yet Dr. Kiwi still stands higher in my regard.
        Why?
        I think the answer boils down to the question of time, pure and simple.
        In New Zealand, I felt I had the time I needed to ask my questions and get coherent answers. In Japan, I never felt that I had that time. I always felt that consultations were rushed, shoehorned into a doctor's day that was way too busy, and that I never had the chance of talking through my problems to the degree that I wished to.
        Dr. Kiwi, then, scores higher than Dr. Lux not on the grounds of greater expertise (because, if I am to judge, his expertise was slightly less) but because he had an approach that I was more comfortable with.


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The text on this page is part of the cancer memoir "Cancer Patient" which has been posted online. All the chapters of this book are on this website and can be read for free online. However, the text is copyright - all rights reserved. For permission to use this text or any portion of it contact Hugh Cook.

Disclaimer

        This personal memoir of the writer's encounter with cancer (non-Hodgkin's lymphoma of the large B-cell type) attempts to cleave to the truth. However, the text may contain information that is wrong, outdated, incomplete or otherwise misleading.
        This memoir has been written in a time of illness by a cancer patient who, though he feels sharp enough, must admit to sometimes misinterpreting things, forgetting things, or, on occasion, quite simply not hearing things.
        This memoir is designed to communicate the writer's personal experience and is not intended as a source of medical information. Got a medical question? Ask your doctor.

Cancer Patient Copyright © 2005 Hugh Cook.

Hugh Cook

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