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Stuck in Limbo

Posted by on February 20, 2014

Sprinting through January in the blink of an eye, we barely caught our breath between an action-packed ski trip to Killington, Vermont, and the glittery excitement of Vegas Night held each year at our school.  In contrast, February seems like a sticky mud puddle impeding your every step.  As I pass third-years in the hallway en route to class, they genially ask, “How is second year going?” and I nonchalantly reply, “fine.”  However, contrary to appearances, my brain keeps insisting: “It’s more like an infinite stack of papers continually thrown your way.  You try to catch them all, but soon it becomes overwhelming and you are left covered in pages of PPO notes and paper cuts.”  It’s a challenging semester because the finish line appears so tantalizingly close.  All you want to do is dash forward at top speed, expertly clearing the many obstacles blocking your way, notably the formidable hurdle called Proficiency.  However, the most feared portion of the race marks the halfway point.  It is no grotesque, beastly Yeti, nor an infinite avalanche of paper waiting to ambush you.  No…it is the scariest, most terrifying thing a second-year optometry student could possibly imagine.  It is a place in which you are forever stuck between the two worlds of student and doctor…the Land of Limbo.

The Land of Limbo is like the video game “Zelda.”  You haphazardly run around seeking advice from wizards as you try to collect enough coins to gain access to the other world.  In our case, the wizards are preceptors and coins are skills.  Here, you must master the skills, including 90 lens, BIO (binocular indirect ophthalmoscope) and gonioscopy that you will require to defeat the dreaded “Proficiency,” which guards the gates to the next world called “Third Year.”  All of these magical items allow you to see clues otherwise hidden from the naked eye that will help you to vanquish this monster.  However, the feat is formidable.  It takes many months to master these skills.  Apprentices must practice every day in order to stand a chance of victory.  There exist masters of these arts, known as “Preceptors,” whom you can beseech to help guide you.  At first, they will grant you the answers freely, but the longer you roam this land, the less they reveal, until it is only you who can unearth the keys to the riddle.  You start off timidly, confused and unsure; your “power bar” filled with only half the knowledge and tools necessary to defeat Proficiency.  However, with each patient treated and each skill set mastered, your power bar slowly increases, until it is finally reads “full power” and you are equipped and ready to face the demon before you.

Just last week I reached my half-power mark.  A patient requested to have his DMV forms signed since he had failed the vision portion of the test.  Thinking that he simply needed an updated prescription, after finding only +1 graded cataracts, I was puzzled as to why I could not get him to the 20/20 line.  Presenting a long-standing history of diabetes and high blood-sugar levels, I began to suspect that his diabetes must play a role in his reduced VA.  With only a faulty view of 90 lens and minimal practice with BIO, I could not determine the answer and sought advice from my preceptor.  After performing 90 and BIO effortlessly, she was able to point out exudates, hemorrhaging and even a possible retinal tear, all of which were hidden without proper command of these tools.  Feelings of disappointment surfaced; if only I were better with my skills, I, too, would have found the missing puzzle piece!  I felt my power bar slowly sliding down towards the quarter mark.  The preceptor then asked me, “So what would be your plan?”  When I told her that we should immediately refer and not sign the DMV form yet, she concurred.  Upon hearing her approval, my power gauge once again zoomed back up to the halfway mark.  It is like this all the time, a thrilling roller coaster ride of losing and gaining power, until the day we will have finally reached the top of the power bar.

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