Transcript

Will: [00:00:00] Today’s episode is brought to you by Microsoft Dragon copilot, your AI assistant for clinical workflow, which helps to ease administrative burdens. I hate those. Lots of burdens. There’s the worst. Lots of burdens. Yeah. Automatically document care, streamlined workflows, and promote a more focused clinician patient experience.

I know you love that. Yes, I do. Learn about how Dragon copilot can transform the way you work. Visit aka ms slash knock knock high. Again, that’s aka.ms/ knock-Knock high. 

Kristin: Hey Will. Hey, what’s up? I’ve been thinking the US healthcare system. It needs some improvement. 

Will: Yeah, it’s, it’s, there’s room for improvement for 

Kristin: sure.

Yeah. It’s a confusing, scary place for everybody involved. 

Will: Absolutely. 

Kristin: Physicians, families, patients, everybody. 

Will: Everybody. And I’ve experienced it from both sides, right. I’m a physician, I’ve also been a patient, so I wanted to use my platform to give people practical education. Really the only way that I know how.

By [00:01:00] making jokes making, so Dr. Glaucomflecken really fun and super uplifting. Guide to American Healthcare is Out and it’s a free resource that includes all my videos from the 30 Days of Healthcare Series, alongside deeper explanations, also reliable facts. Emphasis on reliable. Yes. All right. Uh, uh, figures, uh, numbers, insights into how each of us can fight for a more humane, better healthcare system.

I. Also it has jokes. 

Kristin: Did you mention the 

Will: jokes? I did. I jokes. Okay. Yes, definitely jokes. Well, 

Kristin: this guide is great for anyone looking to learn more about US healthcare, but especially if you are experiencing it from the clinician side for the first time. That’s right. We really hope you’ll check it out.

Will: Get the free guide sent straight to your inbox by signing up for our mailing list. Glaucomflecken.com/healthcare Enjoy.[00:02:00] 

Knock, knock,

knock, knock. Hi.

Hello everybody. Welcome to Knock, knock Eye with me, your host, Dr. Glaucomflecken. Thank you for joining me today. Uh, this is of course your one-stop shop for all things eyeball related. Uh, I got some good eyeball knowledge for you today. In fact. Here’s the rundown, here’s the rundown. Um, uh, we’re gonna start, uh, by talking about crying in medicine.

Like producing tears, not from a medical sense because I, that, that is a part of my job. Uh, the lacrimal glands are very important. Also, your accessory lacrimal glands. Uh, there’s, there’s different ways. There’s different types of tears. I don’t know if you knew that. Maybe I’ll, uh, I’ll incorporate that into my discussion about crying.

But we’re gonna, we’re gonna start off with that and then, um, uh, we’re gonna talk about the sandlot. The movie, the Sandlot, which I watched with my kids for the first time. I’ve seen it before. They saw it for the first time. And then, uh, I’m gonna [00:03:00] go over some, uh, some of your, uh, YouTube comments because, uh, we had, um, uh, the, the, the episode where I talked about Dr.

Mike debating the anti-vaxxers. Uh, that was the last episode that was published as of this recording. And so, um, I’m gonna, uh, talk about a, uh, some of the responses that, that we got from that episode. Uh, and that’ll be it. That’s our knock, knock eye for the day. So let’s start with crying first.

Physiologically, you know, crying is okay. It’s a, it’s, it’s normal to cry. I think we all should cry from time to time. Uh, and, um, uh, you’re physiologically, uh, you know, you have different types of tears. Uh, this is kind of a, an aside, but you know, because it’s somewhat related to the eyeballs, I feel like I need to say it.

Uh, you have your basal tears. Those are the, the ones that just, you constantly have the tears that are being made and draining, and those are the ones that just keep your eyes lubricated. Those are your. Your accessory. You have these accessory lacrimal glands, not the big ones [00:04:00] you have. You have smaller ones, tinier ones that produce tears pretty, pretty regularly to keep those eyeballs nice and lubricated.

Also, your goblet cells that are on the surface of your eye producing mucus, that also helps as well. But you do have baseline tears. When I look at your eyes in the slit lamp, you have what’s called a tear lake. I can see your tears accumulate, right? At the bottom of your eye, kind of right, uh, uh, you know, resting on your lower eyelid if that tear Lake is very small.

Very tiny, or you don’t even have a tear lake at all. I know that you are not producing tears like you should. And we see that in, in diseases like Sjogren’s disease. Uh, there’s other things too that can produce that. But you have, you have, you have pretty dry eyes if you don’t have a, a nice, robust, love that word by the way.

Robust. What a great word. If you don’t have a robust teared lake. Call it a lake. It’s the smallest lake you’ve ever seen in your life. [00:05:00] Then you got some problems. You got some dry eye issues. All right, so you have your, your, your, uh, your, your, your basal tears, and you have, you have reflex tearing. Now this is the reflex tearing.

That’s when we start getting into your lacrimal glands. So let’s say it’s winter, you go outside a a, a blast of icy. Air hits you right in the face. You’re in Iowa and a a, a polar vortex blows through and all of a sudden it just gets you right in the eyes and you tear. You produce all these tears. That’s reflex tearing.

Your body’s reacting to all of a sudden something that dried your eyes out like crazy or. Just caused a lot of, uh, a lot of, uh, maybe particles like sand if, if like debris gets in your eyes an irritant. Basically, that’s what it is. It’s an irritant if you have some kind of irritant, whether it’s cold. Air, uh, whether it’s sand, whether it’s it’s dirt, whatever it is, uh, your eye wants to get rid of that [00:06:00] irritant.

And so it makes a bunch of tears. Those tears come from your big lacrimal glands, the one that are like a upper outer corner, uh, up there. Um, and then you have. Emotional tears. Now, this is more of a complex pathway ’cause it, it very much involves your brain, um, and your, your limbic system. But you have emotional tears that, uh, uh, that also come from your lacrimal gland.

But you don’t have to have a noxious stimulus to produce those. You just gotta be sad or maybe very happy or something touches your heart in a certain way. Um, and so with that in mind. Let’s talk about crying in medicine. And the reason I I, this came to my attention is ’cause I saw an anecdote from somebody on, on social media, um, just, uh, discussing, you know, a an an event that happened to them and they cried about it.

And, uh, it got me thinking what were the, what are the times [00:07:00] that I personally have cried in my medical career, like at work? And, uh, I, there, there have been a, a handful of them. There are four that really stick out to me, so I’m gonna describe four. There’s probably been more, but, uh, you know, uh, I’m not a huge crier.

Uh, I, I probably should cry more than I do, but, uh, sometimes I just don’t let my brain go there, which is a, a, a whole other issue. So, um, but four times, four times, that’s really, um, uh, comes to mind. The first. Very first time I cried, uh, was at the, at the like probably the first or second week of my third year, um, um, of med school.

So my first clinical rotation, which is actually kind of surp surprising to think about, like I managed somehow to get through step one, studying without crying. Usually, um, the, the med student, USME world relationship produces [00:08:00] some tears. It’s an abusive relationship. It’s not, it’s, it’s not healthy. And often there are tears involved there.

I managed to, I think, as far as I can remember, I managed to get through that step one, studying, taking the exam itself, uh, with, without, without, without breaking down, without crying. Um, but the first time I remember was my OB GYN rotation. It was early on. I do remember that, uh, we were in the emergency department and, um, there was, uh, a patient that had an intrauterine fetal demise.

40 weeks. 40 weeks, the baby died. And, uh, I’ll, I’ll never forget the, the wailing. The screaming from the family. It was the most heartbreaking thing I’ve ever experienced. And, and I, I, I cried. And [00:09:00] the attending actually, who, there were two attendings there at the time, uh, ob, GYN attendings, one of them was in with the patient, consoling them, hugging them, and the other attending came and gave me a hug, which was very thoughtful and, and certainly helped.

Helps me feel better. You know, sometimes you just need that. And we had a, a, a, a good relationship and, and it, I, I still remember that to this day. And now we’re, this was 2010, so now we’re 15 years later and I still remember it like it was yesterday. So that was, um, that was the first time. Uh, and certainly the saddest I, you know, that alone.

And, and at the time that rotation, I loved that rotation. I was in Nashua, New Hampshire, and, um, the wonderful people, wonderful residents. The first time I ever got to do a suture, I. I put a suture in was during that rotation. [00:10:00] Very supportive people. I, I, I love the OB, GYN residents and the attendings. I think they get a bad rap.

That’s why I, I had no excuse. I need to do more content about them, but I just, I love them so much. Um, I. And, uh, and so that rotation, it almost like got me thinking like, could I do OB GYN? Um, but it turns out I’ve, I, I don’t like the hospital that much, so I, I went away from that probably pretty quickly.

But that moment with that, that death was, uh, it left a mark on me. Uh, so that was the first time. Second time was during residency. This was, I, I got destroyed. During morning rounds one day, so we would do this thing in ophthalmology residency. Um, people think it’s all fun and games in ophthalmology residency.

It’s tough. Every residency program is tough. I don’t care what specialty you’re in. It’s hard. [00:11:00] Residency is hard. I don’t give you a dermatologist, ophthalmologist. Internal medicine, general surgery, whatever it is, it is mentally and emotionally taxing to learn how to practice medicine. I’m not just talking about med school, I’m talking about residency, where you’re in it, you are the patient’s doctor, you have oversight, but you’re making a lot of decisions.

You are, um, you’re, you’re, you’re working the hours. For us as home call. And so what we would do is every so often we’d have morning rounds that were like on call rounds. So basically all it was is the, the, the resident who was on call, the, the, like the previous two or three nights, we only took one night at a time, but, so it was like two or three residents would, would get up in front of the department and just talk about the calls they received.

And it was actually some of my favorite rounds, uh, to listen to and to [00:12:00] give because you, you got great feedback. Most of the time. You, you heard about interesting cases. These are all the emergency, this, you know, things that came in the most interesting emergencies at a level one trauma centers. You can imagine you heard a lot of really interesting stuff.

Um, but, uh, I, this was my first. Call rounds to participate in. I was a, pretty much a brand new first year, um, PGY two, so my second year of postgraduate education, but my first year in ophthalmology, ’cause you do a, we did a separate intern year at that time and, uh, I, I just didn’t handle a couple of phone calls like the way I should have handled them.

And I had a couple of attendings that just laid into me and, uh. Uh, it, it was for like a solid, like 20 minutes just talking about all the things that I did wrong and, uh, and that was, I think part of why it affected me so much was because [00:13:00] I had been up all night, one thing and so, uh, and, and, and it was, um, and, and not, some of the criticism I’d say was, was warranted.

I would say in some of the ways it was delivered to me, it didn’t need to be so public and so. Painful to listen to. Uh, you know, I’m up there in front of my peers, in front of, uh, all the attendings and everything. Uh, it hurt. And also there was some anger mixed in with it, with the, the, the embarrassment and the shame that I felt in that moment in front of the department talking about these things.

’cause I, in my mind, I did my best with the limited amount of education that I had. And the, the anger though came from the feeling like it was Monday morning quarterbacking like, here are these people that, yeah, they’re much more knowledgeable than me, but they were not up all night dealing [00:14:00] with angle closure, glaucoma or whatever it might be, of open globe, whatever.

They were not fielding calls from patients all night, and they’re gonna come in and, and in hindsight. You know, tell me all the terrible things that I did and the way I handled it was not okay. So, um, and so after that, I held it together during my berating beratement, the, the, the session where I was berated, I, I held it together.

Thank them. And then I just, I kinda let it out, uh, when I was alone, uh, in the workroom, uh, and, and just it felt so bad. It just, like my confidence just tanked. And since that time, and it wasn’t because of me, uh, although I did have people come up to me afterwards and be like, Hey, don’t worry about it. Like, don’t, don’t let it get to you.

All my, my co-residents who are also fantastic, even some of the fellows. Um, but, uh. Since that time, there was actually a [00:15:00] rule, which I think is great that that’s been instituted, which is that the resident who was on call, who’s presenting the, the things that they saw and did on call, they cannot be questions.

Cannot be asked of them during that round session. Questions can be asked to other residents, but you have to at least give that person a little bit of a break. Because they’re putting themselves out there and showing what they did. You can still educate. Alright, but they’re, they’re basically trying not to, to just, uh, uh, just straight up embarrass the, the person who’s presenting.

So they, they have changed those call rounds a little bit. Still very effective. Um, but it probably would’ve saved me a little bit of anguish, um, that really wasn’t necessary. I mean, we are in medicine like we are so hard on ourselves. That it doesn’t take much to get your point across. [00:16:00] If, if you screwed up, like you can tell me I screwed up, uh, but there’s a line you don’t have to cross, um, you know, to get your point made because don’t worry, all it, all you have to say is, Hey, this is what you should have done.

That’s it. I’m good because my brain is so wired to not make mistakes that you just tell me I made a mistake. You don’t have to be mean about it. Just tell me the mistake I made. Tell me what I did wrong. That’s it. I’m never making that mistake again. I, it’s already embarrassing enough. You don’t have to belittle somebody.

You don’t have to, to really just hammer ’em that point. Just, just, you know. Anyway, I, I feel like that’s. That’s a distinction that I think some attendings out there have trouble with. And, and they, they feel like they really gotta lay into you whenever you make a mistake. It’s not necessary. Nobody is harder on med students and residents [00:17:00] than the med student resident.

Nobody is harder on me than I am on myself. And so I, and I wish people understood that. So anyway, that was the second time. Um, third time was, um. When I, you know what? Let, let’s, I, I’m, I’m going. I’m really, I’m taking more time than I thought going through these. Uh, let’s, let’s, let’s take a, a, a short break.

We’ll come back with my, the other two times. I, I can recall that I’ve cried during medicine.

Hey, Kristen. Yeah. I’ve been, you know, grossing you out about these dex mites, although I’m not sure why they look like adorable. Well, 

Kristin: these are cute, but it’s the real ones that kind of freak me out a little bit. 

Will: Yeah. But I have some new facts to share with you. Oh, great. About Dex. 

Kristin: Alright. 

Will: These mites have likely lived with us for millions of years.

Kristin: Oh. 

Will: Yeah. Does that make you feel better? 

Kristin: No. 

Will: Like they’re passed down through close contact, especially between mothers and babies. 

Kristin: Oh, wow. Such a special gift for our daughters. 

Will: They’re [00:18:00] born, they live, they crawl around and then they die on your eyelids and in your lash follicles. Their entire life cycle lasts about two to three weeks, all spent on your eyelids.

Kristin: Well, thank you for that. This isn’t 

Will: helping, is it? 

Kristin: No. How do I get rid of them? 

Will: Well, it’s, it’s. It’s fun to gross you out, but we do have all of these, it’s really common, but there is a prescription eye drop to help with these now. 

Kristin: Okay. 

Will: That probably excites you. 

Kristin: That makes me feel better. Yes. 

Will: Any way to get rid of them, right?

Kristin: That’s right. 

Will: All right. 

Kristin: Sign me up. 

Will: Visit Mites love lids to learn more about Dex Ble Rayes, which is the, the disease that these little guys. Mm-hmm. Cause mm-hmm. Sure. Again, that’s M-I-T-E-S. Love lids, L-O-V-E-L-I-D s.com to learn more about Dedex and Demodex blepharitis and how you can get rid of it.

Alright, here we go. Se uh, third time. Third time. We’re basically going in chronological order here. Uh, was [00:19:00] the, at the beginning of my senior year of residency, um, when I. I woke up one morning and I found a lump in my testicle. It was my only remaining testicle because I had already had testicular cancer in an orchiectomy.

So I had at that point that that was in med school. Um, and so I had, I. Um, I had, uh, only one testicle at that point and doing a self exam, I found, I was like, I knew exactly what it was. ’cause I had been through this rodeo once before. I knew what it feels like when your testicle is misshapen, something’s growing out of it.

Uh, and um, so I was, I had this, this like pit in my stomach. I, I knew kinda what was going on, but, you know, I’m, I was a, I was a resident and. And I, I would’ve done things a little bit differently, uh, if I could go back, but, uh, I was, at the time, I was doing what’s called day call. [00:20:00] So we had day call, which is somebody who’s in clinic, one of the residents who’s in clinic that day, who like during the hours of like eight to 5:00 PM they’re the ones that are taking the emergency calls from urgent cares, from the emergency department, from the hospital.

Any consults that come in during business hours, I. They go to the day call residents and usually you’re, you’re also working in clinic, so you’re taking, you’re, you are carrying the pager, you’re taking those day call emergencies while also doing clinics. So it’s just a very busy time. Well, I. The morning I found this thing, this, this cancer, which I assumed was cancer, was I was on day call that week.

And, and so I went in, I found some time over like a lunch break. I, I went in to radiology. Um, and I, I, I got an ultrasound diagnosed with cancer. As I’m walking out of the radiology department, my [00:21:00] pager goes off. And this is like, I don’t know, 11 o’clock in the morning, noon to one, somewhere around there.

The pager goes off and, and I, I, I call him back and they tell me that there was a patient that had a, a gunshot wound to the face and had, uh, bilateral open globes, which is about as bad of a trauma as you can possibly experience. As a, you know, I mean as a patient, but also just as a, as an ophthalmology resident, right?

It’s, this is, this is a, just really bad trauma. And um, and it was at that moment it was just, it was too much for me all at once. ’cause I literally, I. Two minutes before was told that now I had to, I had to go through another thing of cancer, probably lose my other testicle, have to figure out hormone replacement and, and do we, you know, do we had to, you [00:22:00] know, is our family complete?

Do we, do I need to bank spur all this stuff? Do I need to postpone residency? I’m like, I’m like looking for jobs at this point. And so it’s, it’s just totally upends my life and all of a sudden bilateral open globes in the emergency department that I need to go figure out. And so I couldn’t handle it. I, I grabbed my, a good friend of mine, um, who was the oculoplastics fellow at the time, I pulled him aside.

We went into this, into a room, and I just, at first I was just, I just tried to, I was like, Hey, I, something came up. I gotta give, I gotta, I gotta, you know, deal with this. And, uh, but instead, I just started crying. I, I, I. It was just, I couldn’t even get the words out. Eventually I told him like, Hey, I just found out I had cancer.

Um, and then he took the pager from me and told me to go home. Which was a very compassionate, wonderful thing that he did, which I am forever thankful [00:23:00] I even talked about it. He came to one of our live shows last year, Dr. Uh, Harry Chahal. Shout out Harry, um, and, uh, shouted him out during the show and everybody gave him a standing ovation.

It was awesome. Um, so that’s the kind of compassion we need in medicine. People need to show each other that level of compassion. Anyway, that was the third time I, I cried. The fourth time was last week. Fourth time was last week. Uh, I made the mistake in between patients of browsing TikTok, and there was a TikTok that came up.

Do you remember that show, Rugrats? I ask you as if you’re gonna, I as if any of you’re gonna respond to me. The show Rugrats was on Nickelodeon. I could only watch it. When I went to either my grandma’s house, she had cable or a, a couple of friends had cable and they had Nickelodeon. It was on Nickelodeon, so I didn’t get to watch it often, but I, I was, I had seen enough of Rugrats.

I knew about Rugrats. I didn’t remember this episode, though. And a, a, a clip [00:24:00] of Rugrats came on where? Chucky, the little redheaded, cute little kid. Uh, he, he, his mom died when he was a baby. That’s the backstory. And, and his. Um, in one episode, his, his dad, single dad, um, showed or, uh, uh, told Chucky about how his mom used to garden with him.

He still had like all her gardening tools and Chucky, by this point he is like four, three or four years old. These are little, these are, these are Rugrats. They’re like little toddlers basically. Um, and what got me was that, uh, at the end of the clip, Chucky, um, uh. Take and, and all the, all the gardening, all the, the plants and the flowers and things, they’re all still there that she was, she would work on with, with little baby.

Chucky. Chucky took his friends over [00:25:00] to the garden at the end of the clip and he said, look, I do have a mom. She’s in the flowers.

God damn. I’m, I’m like tearing up, just thinking about it. Now she’s in the flowers. I don’t know. And I, I think maybe it’s because like I, that was almost me, right? I had a cardiac arrest and like, I, I was almost like in the flowers for my kids, except it would’ve been like a, a Morton salt canister. Man, it hit me.

Oh man. So I’m like, in between, I’m like, I gotta go see patients. I’m like, I’ve, I’ve got tears running down my face. I’m like, I gotta collect myself before I go on with clinic. Uh, there, there, there needs to be some kind of a. Of a filter on TikTok where like, no s nothing that makes gonna make me cry.

Please. Like, just check a box, like, no, no, no. Sad things. So, man, but check out if you [00:26:00] don’t, I mean, I’m trying to explain it to you, but go and look it up on YouTube. Uh, Chucky is Mom’s in the flowers. It’s, it’s the sweetest, saddest thing you’ve ever seen in your life. Okay. And that’s it. That, those are the fourth times I, I can remember.

I’m sure there have been more. Um, I’ve, I’ve. Been like filming skits at home, and I’m just so frustrated that may, I’m about to start crying because I can’t quite get the script right, or I can’t find a certain pair of glasses or they broke. That’s, that’s less emotionally charged. That’s more, um, um, I don’t know, just weird content creator stuff.

So, uh, uh, tell me about a time when you cried. During, uh, it can be a happy, funny, sad or whatever. I’d love to hear in the comments, uh, at Glaucomflecken, uh, I always, uh, look through those comments, um, on our YouTube channel. Or you can send us an email, knock knock hi@humancontent.com. I would love to hear your stories.

Um, alright, moving on. So I [00:27:00] promised a little bit of eyeball education beyond where tears come from. It’s like where babies come from. No one, my kids would not ask me where babies come from, but they would ask me, where do tears come from? They haven’t yet. I’m still waiting. I’m still waiting on the day. By the way, I’ve told this to you guys before, but you know why your nose runs when you’re crying?

’cause those, that’s where those are your tears. Your tears are draining into your nose and they come outta your nostrils and your nose runs that. That’s all. That’s what that is. That’s you’re just making so many tears that your body can’t absorb them fast enough and they run outta your nose. There you go.

That’s all the, the tear information I have, although we could get into the chemical composition of tears, but we will save that for another episode. All right. Next, uh, I was watching Speaking of kids. Uh, we watched, um, uh, the whole family lady Glock and Fecking, our two kids. We watched the Sandlot together, and I, I, my favorite thing to do with my kids these [00:28:00] days is put on a movie from like.

1990 or earlier because they, you know, it’s like the, the video, the quality is not what it is now, right? So it looks old and I hear them like, they’re always right away. They’re like, oh man, you, how old is the, they’re kind of like, start to align a little bit, complain a little bit. Um, and then they just, I always pick really good movies and then we start watching them and they get into the story.

All right, LA Lately, uh, recently we watched Jaws. My kids are old enough now to like, not be too terrified of jaws, which granted like not that scary now compared to what it was back in, you know, whenever it was, it was released. Uh, they loved Jaws. That’s my, my youngest, my 10-year-old wants to watch it again and again.

Um, big fan of Jaws in this house. Anyway, we watched the Sandlot. And, um, um, my girls, they, they really loved it. And shout out, by the way, shout out to the [00:29:00] sandlot as probably a, a, a one of the reasons why I never in my life tried chewing tobacco. You guys know what I’m talking about. Uh, if you’re not, if you’ve never seen this movie.

YouTube Sandlot chewing tobacco and you’ll see why. Uh, terrified of chewing tobacco ever since. Seeing that whenever I was a kid. Uh, but the reason I’m bringing up the Sandlot awesome movie. I love it. One of my favorites, um, is because this was the first time I had watched it since becoming an ophthalmologist, it’s probably, I mean, it’s been like 10 years since I’ve probably seen the Sandlot and uh, and we got to the end.

Um. Not, not really a spoiler alert, but anyway, there’s a character played by James Earl Jones, uh, named Mr. Myrtle. Mr. Merle Merle. That’s who? It’s Mr. Merle? No, Myrtle. It is Myrtle, like Myrtle of the turtle, Mr. Myrtle. And, uh, he lives in the house. That’s, [00:30:00] that’s where the, the, the scary, the, the monster, the beast, what they call the beast.

That which is just a dog, just a big dog. He is the owner of the Beast. Hercules is the dog’s name. And, um, uh. And I noticed immediately watching this as an ophthalmologist, the man is playing a blind character. James Earl Jones is, is acting, he’s, he’s blind. The character is blind. He’s wearing the dark glasses because that’s the easiest way to, to, for Hollywood to tell you that a patient or a, um, a person in the movie is blind is by wearing dark sunglasses.

And so immediately I’m like, okay, what, what is it? What’s the diagnosis? What’s he got? Is it macular degeneration? Does he have glaucoma? Did he have, uh, man closure glaucoma? Maybe he is endophthalmitis. Did he have a bad reaction? Did he maybe have ta, which is like a, a post-op inflammatory disorder? Uh, did he have some kind of autoimmune condition?

I was in my, my, my, my wheels were turning, trying to figure this out. [00:31:00] Fortunately, I didn’t even remember this. He tells us. James Earl Jones, Mr. Myrtle, he tells us how he went blind. He was a teammate of Babe Ruth, and he said he was, uh, he was like, his career was taken off until he took a pitch to the temple.

The, uh, hit by a fastball in the temple and the lights went out. He said, huh? The lights went out getting hit. In the temple. So I’ve been racking my brain. I’m just trying to figure this out, what could have happened. Surely he, I mean, he could have lost consciousness. Sure. Um, but that wouldn’t cause you to go blind.

The vision. You should come back. The vision should come back. So he had a, a, a hard enough jolt. Trauma. Trauma that caused both of his eyes to go [00:32:00] blind. To what level? We don’t know. The only thing I can think of is that James Earl Jones had a traumatic optic neuropathy. That’s the only ’cause. It wasn’t a direct hit.

He told you where? He tells us where he was hit in the temple, he points to the temple, direct to the eye, the. It could have, I mean, it could have had a, um, a, uh, a bad hyphema, uh, traumatic, uh, retinal detachment. Even an open globe with hard enough blunt trauma, you can get an open globe. And for a professional baseball player, being blind in one eye is probably enough to totally end your career.

Although the implication from seeing James Earl Jones’ character is that he’s blind in both eyes. So that doesn’t really make sense. I. So it’s uh, it’s gotta be an optic neuropathy basically. And we see this, I’ve seen this mostly in like car accidents. I saw it once in a patient who fell off a ladder. Um, [00:33:00] but car accidents probably the most common because they’re high speed and, uh, um, and basically you’re, the, the fibers of the optic nerve they shear is like a shearing force, basically, the forces of of being hit with something at such high speed that causes.

That causes the, the movement of tissue in the eye, behind the eye, the optic nerve enough to where the, there’s a shearing force that damages those optic nerves, those fibers within the optic nerve, and you get what’s called a traumatic optic neuropathy just. Terrible. A terrible thing. It’s, it’s, and I’ve never seen it bilateral.

And so now we’re getting into just a bit of, a little bit of a creative license here, because I don’t think there’s any way that, uh, somebody can get hit with a baseball, even in the temple, go blind in both [00:34:00] eyes. Now, it’s entirely possible that maybe he did just go blind in one eye, maybe to get a, a monocular.

Um, uh, uh, traumatic optic neuropathy. Still had vision in the other eye, but it was enough to to, to end his career. And then in later life, he developed something that took the rest of his vision, so maybe he still could have glaucoma or macular degeneration. And it was at this point in the conversation that my kids left the room.

They, they, they, they did not want to hear anymore from me. About, about this, about, about the pathophysiology, uh, about the possible treatment options. Well, unfortunately, traumatic optic neuropathy, we don’t have a way to transplant optic nerves. So there’s really nothing, nothing you can do. Um, so, uh, you know.

I wouldn’t say, I won’t say I ruined the sandlot because this was at the end, they got through the end of the movie. Um, but, uh, I, I fear it will be forever tainted by, uh, my, my attempt to [00:35:00] explain and diagnose Mr. Myrtle, the owner of Hercules the Beast. Let’s take a break.

I think one of my favorite things to do, honestly is, is like try to come up with diagnoses for, I. For people in movies and TV shows that have vision loss or, or are supposed to be blind. Um, and I would love to torture my family even more. So if you have suggestions, if you know of any movies with, with, with characters like that, um.

That, that have, have some kind of vision loss or, or maybe during the, the, the, the movie they, like, part of the plot point is they go blind or they lose or something, you know, let me know what those movies are. I’ll include ’em in the pod. I’ll, I’ll look at it. I’ll watch ’em. If I can, I’ll watch ’em with the kids.

Uh, and um, and I’ll talk about ’em on the podcast. It’s, it’s so fun. It’s so fun to, I love seeing what like, Hollywood [00:36:00] producers think is like a cause of blindness. It’s, it’s kind of fun. Um, all right, so finally, let’s, uh, let’s talk about, um, some YouTube comments here. So, um, the episode that was just that I just, we just put out this week, uh, Dr.

Mike versus anti-vaxxers, what went down on Surrounded. Uh, this was our, our most popular. YouTube video of the podcast, uh, since we started the, the, the podcast specific channel earlier last year. Uh, and yeah, it’s probably because I mentioned Dr. Mike, but also thank you, Dr. Mike, for lending your fame, uh, to, to my, to our, the YouTube channel.

Um, but it was a very, it was an interesting conversation. Interesting topic. I hope you guys had a chance to see the surrounded video. I had some interesting, uh, uh, a lot of people agreed with me like he [00:37:00] did the best he could under the circumstances. Dr. Mike, in talking with the anti-vaxxers, um, I had some interesting comments, though I.

Uh, this just really sums it up at Joy. Anna, Joe, uh, said, I agree. Dr. Mike did an amazing job staying level-headed and respectful in such a potentially pivotal moment for laypeople teetering on the edge of medical distrust. I don’t, I don’t know if that’s a point that I really hammered home, but it’s absolutely true.

And several people mentioned this is like, you’re not gonna change anti-vaxxers minds, but. By trying to be on social media and fighting misinformation in whatever way you can, whether it’s on this manufactured, this produced show surrounded or just making content on social media. Can you change the mind of someone who’s just not really sure?

I think that. Absolutely. That’s where we need to be focusing our attention. Right? The people in the comments that are so [00:38:00] far anti-vax that, like the lady on, like the, the, I think it was a woman on the, on the surrounded episode that said, nothing, Dr. Mike says, we’ll change her mind. We’re not gonna reach that person.

It’s done. They, they’re, they’re so far. Into, into, into their, their whole and unable to even consider evidence, uh, for, uh, why vaccines are helpful, that you can’t reach ’em. Not possible. It’s the people who are just not sure they have questions. You know, they, maybe they, they just, they become apparent for the first time and they just, they hear so much from all these different places.

Like what do they, what’s true? Those are the people that we can reach with, with, with, with accurate. Information. So yeah, that’s, that’s a really important distinction. Um, at Amanda 2, 2, 4, 4, the lady on that video who said, HIV doesn’t cause AIDS was the most entertaining and simultaneously the most terrifying because she genuinely [00:39:00] believed this garbage.

I have genuinely no idea how he stayed so calm and lovely the entire time. Absolutely, absolutely agree, uh, at Old Dion. Matt, props to Dr. Mike and I agree it’s important to have somebody out there in the trenches fighting misinformation. I just wish they did a better job of getting good faith actors. I can understand a new mom with questions, but like, uh, what is the point of the lady who said, nothing you can do to change my mind.

Yeah, exactly. And there was one, there was one, um. One idea that, oh, I wish I could, I don’t know if I could find that, that comment, but somebody in my comment section said, I can’t wait for one anti-vaxxer to debate 20 docs. I. Which just made me laugh. That’s such a, such a funny, and also just a great idea, like how, how awesome would that be?

I would love that. Like why not give away [00:40:00] one rabid anti-vaxxer and then surround them with medical professionals and let’s go to work. Oh man. That cinema, absolute cinema, that would be, I would love it. Absolutely love it. Um, thank you all for your comments. I really, you know, I, we’re, we’re seeing the, the people are finding the channel on YouTube.

I really appreciate all of you going there. Uh, or, or even if you watch, you know, apple Podcasts, um, the Spotify, wherever you get your podcasts. Um, um, we appreciate the support and listening and, um, as we try to continue building this up, I’ve, the more I’ve done these knock, knock eye episodes. I just, I, I just love it more and more.

It’s, it’s so much fun. And my wife, uh, or people that know me, that really know me would tell me it’s just because I love to hear myself talk. There’s some truth to that. Absolutely. There’s a reason, like it’s just me and my content. I don’t know. I, I, I, group projects are hard for me folks. There’s gotta be [00:41:00] others like me.

Surely I’m not the only one that has trouble with group projects. I never liked them growing. I was just like, let me just do it. Can I just do the thing? I’ll just get it done real quick. That was like my, my thoughts, like that doesn’t, that’s not a, a good way to be. That’s so, I don’t know. It’s, it’s a, it’s a, it’s a flaw that I have and I’m trying.

Not to pass that on to my children and get them comfortable with group projects. And unfortunately, my oldest, very much a, a a, an individual, um, and, uh, had, feels the same way about group projects. So it, it is genetic. It’s gotta be genetic. I, anyway, thank you all for being here and supporting us and, uh, thank you all for listening.

I’m your host. Will Flanary also know that Dr. Glaucomflecken. Thanks to my executive producers, Aaron Courtney, Rob Goldman and Ashanti Brick Editor engineers Jason Portis. Our music is by er Benz V Knock Knock. High is a human content production. See you next time. Knock,[00:42:00] 

knock, knock. Goodbye.

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