Chapter 9
Elina
I lean over the desk in treatment room one. My chair squeaks so loudly that it even hurts my teeth. Nonetheless, I give the middle-aged woman in functional clothing on the other side a friendly nod. "How may I help you, ma'am?"
Her bewildered gaze meets mine, and immediately I feel like I messed up. I glance at Helene, who chuckles amusedly. Great. "My eyes are itchy." The patient crosses her arms.
That could have many reasons. Even though the woman doesn’t seem particularly talkative, I can’t spare her further questions. "Do you have any known allergies?"
She responds with an eye roll. "Only city folk have that fancy modern stuff."
I dare not look at my boss again for help even though that’s what I’d prefer. I’ve been here for over a week now, quietly observing how Helene treats her patients. The woman with the eye problem is my first solo case.
My chance to prove that I’m a good doctor.
I can’t afford to fail now.
Better to ignore the patient’s dismissive behavior and continue taking her medical history. "Are there any other symptoms, such as fever or rash?"
She leans forward on her red chair. "I said my eyes are itchy. That’s it."
Well, it’s official. She thinks I’m an idiot. "Alright, then let me have a look at your eyes. Could you please take a seat on the examination bed?" I point at the patient bed behind her and rise from the chair.
Helene remains seated next to the floor-to-ceiling bookshelf, yet I can feel her watching me closely. She wants to find out if she can trust me to work alone.
My patient follows my instructions. I consider it a partial success. I put on gloves, grab the flashlight, and step in front of her. "Please look up at me."
She does. Thank goodness.
Relieved, I turn on the light and proceed with the examination as gently as possible. Until now, I’ve always used a slit lamp microscope for this, but they don’t have that device here.
"When was your last visit to the ophthalmologist?" I ask as I inspect her eyes. The conjunctiva is red, and there is excessive moisture in the tear duct.
The woman shrugs. "What for?"
"To have your eyesight tested, for example. Undetected visual impairments could be the cause of your symptoms." I try to remain as composed as possible even though I’m close to exploding inside. This woman fulfills every stereotype I’ve ever heard about villagers.
"I have eyes like an eagle." Is that pride I see on her face? Just because she doesn’t need glasses?
"Age-related farsightedness is normal in people over forty." I can’t help but make this comment. "Do you have any new pets?" I ask, not giving her a chance to be offended.
"No. What's the point of this interrogation? Just prescribe me something that helps." Her peeved undertone is unmistakable.
"In order to do that, I need to know what’s wrong with you." I smile at her kindly. What else can I do? At least she reciprocates while I mentally review everything I’ve learned about her condition so far. It’s most likely conjunctivitis. Ideally, I would take a swab to identify the pathogen. But there isn’t a properly equipped lab here.
Great.
How am I supposed to prescribe the right eye drops if I don’t even know whether the cause is bacterial or viral?
I try to recall everything I know about conjunctivitis while examining her eyes once again. Viral pathogens are particularly active during the winter months. It’s late April, and although it’s still quite cold here, spring has already begun. "You have bacterial conjunctivitis; pink eye," I say finally. It is the most likely cause, so I try to sound as confident as possible.
Suddenly, her expression softens. "What can we do about it?"
I take off my gloves and return to the desk. "I’ll prescribe eye drops for you. Please use them twice a day. If there’s no improvement after three days, don’t hesitate to return to the clinic."
A quick glance at Helene is inevitable. She nods approvingly.
Quickly, I enter the information into the electronic patient record and print the prescription.
