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Can You Stop Someone Else’s Bad Choices?

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One of the neat things about being an optometrist is the variety of people I interact with on a daily basis. While some days make me wish for people with no vision issues, I tend to enjoy figuring out problems and helping people coordinate eye health and vision as a part of maintaining overall health. I learn lots of things from my patients. Sometimes they inspire me to be better or smarter. Sometimes I see examples of what I don’t want to do. Many times, it’s really hard to be neutral and keep my emotion in check. I’m sure most jobs in the public sector are similar. How do you deal with keeping personal emotions on the sidelines when all you want to do is scream at the top of your lungs when someone is making a bad choice?

It’s funny what people will share with an eye doctor. I do get a full medical and family history on every patient, so maybe they feel I already know their story. Maybe some just need to talk. While I am bound by patient privacy laws when it comes to sharing identifying personal information, I am allowed to share cases if I don’t identify the patient. If you’ve ever read a medical journal, you’ll realize all case reports are shared this way so that we can learn from other doctors and their cases. One commenter was very upset with me for talking about patients, but if I can’t do that, it leaves very little for me to say about my job. I am in no way disparaging anyone, but merely sharing stories that certainly make me think, and hopefully, they’ll make you think a little bit too.

One such patient story really makes me sad, and I feel maybe there is more I should have done. When I first began in my current practice, I had a patient in his mid 30’s who had a hereditary retinal disease. It gets progressively worse and eventually leads to blindness. There is no treatment or cure. This particular patient knew he had this disease, but really had nothing other than a diagnosis. At that point he was already legally blind due to loss of peripheral vision, but he still had pretty good acuity in the very center. (Imagine looking through a keyhole all the time).

I was taught that giving a diagnosis is no good unless you can offer the options of what to do with it. It’s never an easy conversation to tell someone they are going blind and there isn’t any treatment, but it’s part of the job. I also think it is my responsibilty to be aware of services that might benefit patients such as this and ask if they need help in applying. This patient was very proud. He was a pipe layer for one of the oil companies but was let go because he could’t see to do the job, and he was a danger to himself and others. His wife was a teacher. They were also trying to earn money by growing hay on their family farm, but they were struggling. I suggested he apply for disability.

Now, I am not one to go around suggesting disability status. I have tons of patient who have applied on the basis of everything from eye inflammation to just having a strong prescription. Those are not disabilities, and I strongly point that out on the forms I have to fill out for the state. This gentleman was truly disabled. Legal blindness limits your ability to do most jobs and to be able to drive yourself to and from work. It was a very legimate case, but you would have thought I threw acid in his face. He was very upset with me for suggesting it, but he eventually came around, and we helped him get approved. He has continued to refuse help from services for the blind as far as classes to read braille or how to navigate with a cane. It’s painful to watch him stumble around, trying to act like nothing is wrong.

The family still struggles, not just financially, but with having a very proud bread winner who cannot support them anymore. They have three kids, two boys and a girl, and with this particular eye disease, there is about a 25% chance that the sons will develop the same problem. I began seeing them in their early teens, but signs don’t show up usually until the 20’s, so I’ve always, in a very nonchalant way, tried to stress the need to find a career that doesn’t rely on good eyesight. I always kept it lighthearted and never said things like, “What will you do if you go blind?”

Both boys are smart. The younger one was actually  an honor student and very excited to major in political science and move to Washington DC. They also are from a very rural farming town that often feels leaving home to get an education is like thinking you’re better than all the rest, and it can certainly ostracize anyone without a thick skin.

I was incredibly happy when the older son went away to college. He was the iffy one as far as leaving home, and although I only see him once a year for his eye exam, I was really proud. I was equally as sad when he dropped out after two semesters. I know he enjoyed school, had decent grades. and made some good friends. I can’t say for sure why he quit, but I believe money was a big problem. Not necessarily for school, but with his family. I think he felt a need to help out since his Dad wasn’t able to. Anyway, he is working as a ranch hand and general laborer currently. He got married this summer.

The younger son was much more cerebral, so I wasn’t worried about where he would land. He got several scholarship and ended up at a small school in Minnesota. I found out last week that he too dropped out and is now working in the oil fields, just like Dad used to.

I hope as hard as I can that the eye disease gene has skipped these two boys. I hope they have long lives as fully sighted individuals and can earn good livings for their families. However, if they do end up going blind, they will likely struggle financially without the training and skills to get a job beyond heavy labor. Maybe I’m wrong, but I can’ t help feeling like these boys passed up some opportunities they will regret  later.

I can’t help but wonder if it would have made any difference if I’d become one of those doctors I can’t stand who lecture patients about bad things that will happen if they don’t do exactly as I say. Maybe I should have been more blunt and less nonchalant? We’ll know pretty soon as both of them are approaching the age when symptoms of the eye disease should show up.

How do you handle seeing people make choices that aren’t in their best interests? Should I have been more forceful? Would it have mattered? Would you change anything if you might lose your eyesight?

Image: Freedigitalphotos.net

About Kim Parr

Kim Parr is a private practice optometrist, freelance writer, and personal financial blogger. You can follow her journey to 20/20 financial vision at Eyes on the Dollar.


  1. I would be lost without my eyesight. I don’t even know how people with glasses or contacts handle things.

  2. That is so sad. My grandma had a degenerative eye disease that made her go blind as well. It was really hard on her.

  3. Its a sad story to hear and I feel for you having to tell the person the issue and the fact that there is not cure or treatment. As for telling people about their choice’s I think if they ask you should be honest. What I have found though is that many people only want to everything is ok and its not your fault. They get upset about you being honest and open. If they are your friends they will understand and hopefully respect you for trying to help. Never be pushy though if they ask answer and let it be. If they don’t depending on the relationship maybe ask why they do certain things. It really depends on your relationship with the person.

  4. Very difficult issue to deal with, and I pray medical advances help people who have these kinds of problem. I think it would be huge if we could “cure” blindness, though I realize that may be a long way down the road. At minimum I think businesses should be more accommodating to blind and deaf patients alike. I get irate when companies only have options to call them when some people can’t hear!

    • It’s one thing when someone does something stupid to themselves, but hereditary stuff really sucks. Just being born kind of sets you up for problems. That’s why I think it’s so important to take advantage of opportunities if you know you are likely to have something go wrong.

  5. I’m honestly not sure if I could live without the power of my sight. I think of all the senses it has to be the hardest one to lose as it changes every aspect of your day to day life.

  6. I probably would have handled it like you did. You can present all of the options, be up front about the realities, but you can’t make someone’s decision for them, and it’s really not your place to do so. I certainly wish the best for those kids as well, and you’re right that they’ve put themselves at risk, but there’s not much you can do about it. I really doubt that lecturing would have done much. Sometimes our ability to affect others is just limited, and in a lot of ways that’s a good thing. But it’s definitely sad when you see people actively hurting themselves.

  7. Some of my favorite role models are very much like Simon Cowell or Gordon Ramsey. They tell me exactly what they think and don’t sugar coat it. I have a ton of respect for those people. I try to be like that whenever possible, but I also try to put just a little velvet on my hammer!

    • I think my hammer is coated in bubble wrap for the most part, except when you get that one patient who just won’t listen and I have to throw out the blind card. It doesn’t happen much, but it usually works.

  8. Tough situation to be in. I don’t deal with the general public, but when I did I wasn’t allowed to give my opinion. I dealt with people late on their mortgages and I could see their issues for the most part. I wanted to say things in order to help them out, but my job wouldn’t allow me to. It was hard for me.

  9. That’s a tough situation to be in as both a doctor and patient. I think there are cases where you can stop someone else’s bad choices, but you have to make them want to do it. If they’re doing it just because someone told them to it probably won’t last, but if they’re doing it because they see the benefit then it may actually work. It’s tough to make this happen, but I think it’s the best way to make someone change their mind on something.

    • I think lots of kids see the dollars they can have right now and think they’re rich. Down the road, it might not seem that way, though.

  10. gosh that’s sad. I hate when people have to or choose to drop out of school. You always ask your readers such great but tough questions. If my 42 years have taught me anything, it’s that you can suggest something to someone, but if they don’t want to “hear” it, they won’t, and you have to let it go. If they learn the hard way, they do. But it is very hard to sit by and watch that happen. Believe me, if my mom listened to me about all her health problems, life would be a lot easier. Instead I have to face the fact that she is going to live her life in an unhealthy way.

  11. What a sad, difficult situation. I don’t think you could have handled it any differently. I understand the boys’ loyalty to the family and desire to help out. It’s too bad the family wasn’t in a situation where they could persuade the boys to stay school, particularly with the youngest. He could have found a better job, where he could have helped out more and still do well if his eyesight failed.

    • I’m afraid family opinions probably did not help at all. Having a paycheck right now trumps what might be in the future.

  12. How do I handle seeing people make choices that aren’t in their best interests? I think it depends who it is – my child, other family member, acquaintance, stranger. The further removed I am from the person the easier it is to let them make whatever choice they want. I’m much more interested in an outcome (and will probably push my opinion more) if it’s someone close to me. But even then, there’s a limit to how much you I can actually say. At some point, we risk alienating ourselves if we discuss an issue too much. People are accountable for their own decisions.

    • I think sometimes, it’s harder when it’s family or at least you see the consequences more if it’s close to home.

  13. I don’t think you can change anyone, the change has to come from within, or people will kind of try and fail and stay miserable and blame you. If I was about to lose my sight I guess I would travel a bit to see places and keep them in my head, then learn Braille asap and get used to going around the house. I do that sometimes, try to walk in the dark, not easy.

    • I think it would be horrible to go blind, but like with any challenge, you can either drive yourself mad wishing for the past or you can accept it and move forward. There are plenty of blind people who have very productive and happy lives. I’m sure it’s hard, but I think I would choose to try and be as happy as I could.

  14. When I was a Consultant, I could only make suggestions, it was still up to the decision maker to implement the change. I think it is true for everyone! All you can do is lay out the facts, it is up to the individual to do what you suggest.

  15. Sometimes we need failure to help us learn. Of course, I see how hard it is when that failure impact other people at no fault of theirs.

  16. I think you handled it very well, Kim. My grandfather, a carpenter, lost his eyesight and it devastated him. He could no longer do what he loved. Maybe your patient could turn to another money – making activity, like blogging? There’s a guy I know who’s a blind magician, and he’s now making money off of the book he wrote too. Maybe his site could help your patient? Jeff’s been blind since he was a kid. Sad story, but he’s thriving in spite of it. http://amazingjeffo.com/blog/

  17. Aw man. That is a sad. I agree, maybe it would have been better if you were born without it rather than lost it when you are already an adult. That’s a lot of adjustment to make and it’s difficult to deal with even with the help of the family. So don’t abuse your eyes. It can only take so much.

  18. I can feel your pain, but all we could do is advice what’s best for them and as possible ensure that they comply. It’s not easy to lose vision, so it’s important to follow expert’s advice to improve and recover from any health risks.

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