I Was Going To Talk About Eye Surgery..

In eye surgery, as in the other specialties in medicine, several languages and idioms are used. Doctors spend a great deal of time learning the esoteric terminology that allows them to communicate with one another and with other “experts” in the medical and pharmaceutical and insurance industries and to the exclusion and detriment of all but a small number of their patients.

For centuries, doctors have been using special abbreviations and Latin phrases not in common parlance, to keep their patients in the dark about what was going on. These were the secret codes to the pharmacists, chemists and barbers with whom the doctors were communicating.

Yes, barbers too. They used to be intimately involved with several important medical procedures, like bleeding patients. Somewhere along the line, the barbers were demoted out of their part of the medical profession. Now they are pretty much confined to cutting hair, the safety razor having pretty much taken care of the need for a barber to shave clients.

Throughout the centuries, doctors pretty successfully went after the white witches, who engaged in a great many of the medical activities not well handled by the medical profession, like taking care of people without the monetary resources the doctors preferred in their clientele, and the midwives, who were generally pretty expert in assisting women during childbirth, but who were seen during many periods, including recent times, as encroaching too deeply in the terrain of physicians.

The doctors had membership in very powerful “guilds,” which were in essence, unions with extremely powerful political lobbying skills. They are at their most powerful today, encompassing the government, insurance industries, and the international pharmaceutical industries seamlessly. Only the “defense industrial establishments and the military have more clout.

When I was a boy, doctors still made "housecalls" now and then. One could speak privately to one's doctor without an insurance company having the right to demand charted information. A few months ago I wrote my (potential) eye surgeon a letter. My printer was not functional. I called her office, wanting her Email address. It turns out that all E-mail goes through an office employee, that the doctor recieves no private E-mail. Exactly when did patient/doctor confidentaility, and the ability to speak frankly to the doctor directly, go out the window?

A lot of lip service is paid to "informed consent." What this means in practical terms is that the doctor needs to tell you somewhere along the line that bad things can happen and that operations don't always work out favorably for the patient. The doctor might cite a statistic like, nine out of ten people have an improvement in their eyesight after a cataract operation. But you really have to probe to find out that two out of three people will need another procedure later to deal with a second cataract in the posterior membrane of the lens cavity, and that procedure too has its' own complications. In my opinion, this does not amount to informed consent. It amounts to a sales job to convince you, that at least statisically speaking, you will probably be better off with the operation than if you do not have it.

As time goes on, and as I see some of the procedures, performed by various surgeons, using different tools and methodologies, I am less and less convinced as time goes on. The patient is kept in a position of ignorance of enough detail that he cannot make really informed decision. He must simply decide to have faith in a physician he may have known for all of twenty minutes, or not.

Well, I was going to talk about some of the things that are currently in vogue in eye surgery, and detail my concerns in greater detail. These operations net the surgery industry about seven billion dollars a year in the US.

Several of the procedural events don’t make a lot of sense to me. But, in spite of the millions of people who have cataract surgery every year, I do not currently see any evidence that the public is particularly interested. I guess I’ll go read a book.