Thursday, January 12, 2012

My Log 283: So, we meet again, Dr. Tuli: A brilliant young doctor saves my sight, as he did six years ago.

I have been sitting here since the beginning of December, immobilized to all practical purposes, by a lack of sight in my left eye. This follows discovery of a detached retina, unfortunately my second, since I had a similar problem in the right eye in 2005.

Fortunately for me, in both cases I have benefited from the brilliant and dedicated surgery of Dr.Raman Tuli, the leading retinal expert in Ottawa.

I learned during my last encounter with this mysterious ailment that the essence is to discover it, and have it treated as early as possible. On my first run around this I succeeded, more by good luck than good management, in doing just that. In 2005, troubled by some sort of strange spot on my eye, I went to the Emergency Room at the Ottawa General, expecting it could be cleared up by a couple of drops of something or other. To my surprise, the emergency doctor declared I had a detached retina, and transferred me upstairs to the Ottawa Eye Institute, where I was examined by two doctors who each came to the same conclusion, “You have a detached retina,” and a third who added, “We need the retinal doctor for this.” And so arrived the ineffable Dr. Tuli, who explained to me that the treatment involved, first, injecting some gas into the eye to reestablish the retina in its correct position, and second, to zap it with a lazer beam to reconnect it. That was achieved by 3 pm on the same day, a relatively painless experience, but one that, within two weeks or so resulted in my getting my full sight back.

This time, concerned that I had what seemed like a detached retina, on a Monday I phoned the opthalmologist who looks after my eyes, whose staff more or less shrugged me off, telling me I could not get an appointment until a week hence. The last thing his receptionist said before signing off was, “If you can’t see anything, go to the hospital.” Is this what might be called concerned care by a doctor? I don’t think so.

I thereafter made a mistake. I tried to get through the week, and then undertake my appointment, but had to surrender and go to the Emergency room at the General on the following Friday. There I was given the unsurprising news that I had a detached retina, and an appointment to turn up for a further examination the next day, Saturday afternoon. At that appointment in the Eye Institute, I was examined by a young intern, who said I would have to be handed on to the retinal doctors. The doctor involved was a very smartly dressed young man of Middle Eastern origin, a Dr. El Kandary, if I remember correctly, who looked at my eye, and before checking out for the weekend, set up an appointment for me on the following Monday for surgery by Dr. Tuli. “I’m sorry the news is bad for you,” he said. “Your problem cannot be settled with a mere shot of the lazer. It needs full surgery on the eye.”

When I turned up at the Riverside on Monday and mentioned I had been seen by Dr. El Kandary, one of the support staff said, “Oh, he’s finished with us now. He is going back home to Kuwait. He has taken his whole training here with us, and now he can’t wait to get back home to his family, who left a few months ago.” Where, no doubt, he will become an important addition to their medical staff, thanks to expert Canadian training.

As I waited for Dr.Tuli I began to realize how fortunate I had been to be squeezed into his schedule. When he arrived he began to work his way through a thick pile of patient files, and as all the people waiting with me filed in and out of his surgery I began to marvel at the responsibility this doctor was undertaking with every patient. In essence, he was saving all of us from a future of at least partial blindness. Six years before, one of his nurses had told me he was the youngest of four or five doctors who worked on retinal problems, but because the others were older, and less inclined to undertake a huge burden of work, Dr. Tuli was undertaking most of the load. Six years before, a visit to his modest surgery in Nepean showed me how huge was this burden of patients, and the evidence this time seemed to indicate it had not grown any less in the intervening years.

Dr. Tuli performed a brief surgery on my eye, conducted under a local anaesthetic, and told me to go to his surgery the next day for a check up. They wouldn’t allow me out of the Riverside by myself: apparently there are legal restrictions against allowing patients to roam the countryside under the influence of whatever drugs they may have poured into you for such an operation, and I had to phone a friend to come and pick me up.

The next day, in his private surgery, I was able to judge that Dr.Tuli had prospered in the six years since I had last come under his care. He had moved into a very much more posh office, and given himself the name of the Retinal Centre of Ottawa, along with one other doctor, presumably doing the same kind of work. Once again, of course, there was a crush of people waiting to be served by the good doctor. When I got to see him he declared that my eye was “looking good” and asked me to return to the Riverside the following Monday, when he said he would give me “a little lazer treatment.” I told him I wanted him t know how very much I appreciated what he was doing for me, and how I thought his skills were amazing. Dr. Tuli is not a particularly gregarious man (a roll of 25 comments on the internet by his patients testifies that most of of them find him slightly too reserved for their liking), and in face of my compliment he sort of waved it aside with an embarressed shrug, held out his hand, and shook me out of his office.

The folliwing week he did his promised “little lazer treatment.” It turned out not to be the sharp, brief jab he had given me six years before, but an excruciating full-blown grinding away at my eye for what must have been almost a minute, a procedure that knocked the stuffing out of me for at least an hour. Fortunately, I had taken my friend along this time, in case I needed someone to show me the way home.

Okay, that was six weeks ago: what follows all this treatment is that a large black blob hangs over one’s eye, a blob that diminishes very slowly day by day. I had been told by one of Dr.Tuli’s nurses that it would take six weeks for me to recover my full sight. It is almost six weeks now, and I still have a smallish black blob hanging over my eye: I am hoping they are as good as their word, and that the blob is not far from disappearing.

Meantime, I feel like repeating the invocation I pronounced six years ago after my first experience of a detached retina.

All hail to Dr. Tuli! I wrote at that time, and this time I repeat it, with knobs on. I feel that I owe an immense amount to this taciturn young doctor with his remarkable skills. And if he is embarrassed to have me say so in public, I don’t care. The guy is a lifesaver, and I am prostrate before him in my gratitude. Thanks a lot, Dr Tuli, and I mean it from the bottom of my heart.

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