in memory of
W.H. Bates, M.D. 1860-1931
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STORIES FROM THE CLINIC
CHAPTER 1
EXPERIENCES WITH SCHOOL CHILDREN
HYMAN
Hyman, a Jewish boy, aged ten, was not a patient, but his mother's escort. She was having her eyes treated because of headaches, but her trouble was not half so bad as that of her son. His poor eyes stared painfully behind his thick glasses, and in order to see through them at all he made the most awful grimaces. His head moved constantly in all directions, and later on I learned that he had chorea, or St. Vitus' dance. He was an unusually bright boy, and was never satisfied unless he saw everything that was going on in the clinic. Whenever he was in the room he would stay as close to me as possible, listening eagerly to every word I said and watching every movement I made. One day I said to him: "Look here, young man, I don't mind having you watch me, but I don't think the patients like you to stare at them so much. If you want to know how I help people, why don't you let me treat you so that you won't have to wear glasses?" "My teacher says I must wear glasses, because I cannot see the blackboard without them," he replied. Later I told his mother that I was sure I could help not only his eye trouble, but also the nervous twitching of his head. She did not seem to understand me, and appeared to doubt my ability to do anything for him.. She had been told by a doctor that perhaps some day he would outgrow his nervousness. The boy himself seemed to be equally skeptical, but was, nevertheless, much Interested. Me was evidently curious to know what I would do for him, and quite willing to let me entertain him. I tested his sight with his glasses on, and found that he was able to read only 10/50, all the rest of the card being a blur. I took the glasses off, and noticed that he stared less without them. With his glasses on, his face looked hideous and wrinkled like that of an old man. When Dr. Bates examined the glasses, he said it was quite evident that they caused the St. Vitus' Dance. Straining to see through lenses that were not suited to him, produced this nervous condition. I told the boy to cover his eyes with the palms of his hands so as to exclude all the light and to remember one of the letters of the test card perfectly black. He seemed to think this was a game of hide and seek, and kept continually looking through his fingers. My patience was tried considerably, but I did not let him know it. Instead I told him that I was especially fond of little boys, and wished to help him. He squared his shoulders and made an effort to keep his head still, but failed. Finally I succeeded in making him understand that if he wanted to stop the twitching of his head, he must keep his hands over his eyes until I told him to remove them. He became as serious as I was myself, and though I watched him while I was treating other cases, I did not once see him uncover his eyes, or peep through his fingers. No doubt the fifteen minutes that he spent in this way seemed like hours to him. When I was able to return to him I said very gently: "Now take your hands from your eyes, look at me, and be sure to blink often to atop your staring." He did so, and to my surprise his head was perfectly still. Then I told him a story -- being careful to preserve the same gentle tone of voice -- about a boy who lived in the country town where X live and who stole some delicious big apples from a farmer. He ate too many of the apples, and soon began to feel that there was something wrong with bis stomach. The farmer caught him and punished him; so he suffered both inside and out, and came to the conclusion that stealing apples was not very much fun. I took as long as I could to tell this simple tale, for my object was to keep my patient from thinking of himself, or his eyes. He seemed to find it hugely amusing. His eyes beamed with fun while he listened to me, and his head never moved once. "Now," I said, "do some more palming for me, and then we will read the card." When he uncovered his eyes the second time, his vision had improved to 10/30. His mother's indifference vanished. She did not know how to show her gratitude for what had been done for her boy, but promised to see that he spent a sufficient amount of time palming every day. The next clinic day she told me that the twitching of the head had become less frequent. She was instructed to watch the boy, and have him palm at once whenever she noticed the twitching. This always relieved the trouble. Hyraan was anxious to be cured before vacation began, and was quite willing to do as he was told. He and his mother practiced reading their test card every day for an hour at a time. During the summer they came quite regularly and the mother was cured of her eyestraln and headaches. Hyman looked like a very different boy, and in the fall when school began he was apparently cured because the twitching had ceased, and his vision had Improved to 10/10. |