Saturday, November 25, 2006

Professor Deacon Barry

Today I did the lecture on retinal detachment. I found it difficult to get to sleep last night, and all the way to the Eye Pavilion, I was going over what I was going to say. I was also wondering if I had enough material to fill an hour, or would I rattle through the whole thing in twenty minutes. I knew I had about ten minutes worth on my starting topic - the anatomy of the retina, so at 9:05 I started with that. I was a bit nervous to start with, but as I warmed up, I relaxed. I finally stopped at 10:25. I have no idea where the time went, but it went well. There were two other lectures, one on diabetic retinopathy, and another on lasers. Then it was my turn again. I took the class up to the ward for a practical demonstration on how to erect a positioning set. This is an instrument of torture used by us ophthalmic types to ensure that patients who have had gas bubbles inserted into their eyes following retinal detachment surgery, lie face down, to keep that bubble over the repair at the back of the eye.
There was more torture in my final lesson, guiding the blind patient. The class got blindfolded and had to make their way about the ward, and do various tasks. The following is the exercise that I devised for this.

Simulated blindness experience
Blindfold or pad both eyes. Double padding is better at keeping the light out.
Ask the volunteer to move from one part of the area to another.
Try it again using a stick.
If there is a sink, the volunteer should try washing and drying their hands.
Be careful of hot water!
They should also try using the toilet.
Take the volunteer up and down a flight of stairs. Make sure they hold on to the banister.
If there is access to a wheelchair, the volunteer may be pushed around in it, without verbal cues, then asked to find their way back to a specified area.
Once they have got used to the layout of the area, move the furniture and put obstacles in their path.
At some point, after they have come to rely on it, remove their stick!
I didn't have enough time for the full version, so I could only give them a taster, but the feedback from the session was good. Try it yourself. Feel free to copy the exercise and use it in your clinical area. Please let me know how you got on.


punchberry said...

We had an exercise similar to this as part of our disabilities unit in med school. It was actually a trip to a museum for a "Dialog in the Dark" exhibit, which I guess they have at locations throughout the world. Visitors are taken through a series of rooms, which are pitch dark, so no blindfolds are needed, and there are different rooms to simulate a house, a busy street, a forest, a restaurant, things like that. Blind people work there as guides, and they showed us how to use a cane, cross the street, pick out fruit at the market, etc. It was definitely a moving experience, and you got to use your other senses in a way you normally wouldn't, but I was very, very glad when it was finally over.

Anonymous said...


I'm a second year medical student in the UK and wanted to comment briefly on the whole 'simulated blindness' thing.

At my medical school, we spend half a day per week on 'Professional Development' teaching, including ethics, law, and the occasional community orientated medicine session. Today, my group had a chance to talk to a severely impaired lady who spoke to us in a very positive way about her experiences of being disabled, but she also made an excellent point about these 'simulated impairment' exercises. Someone who becomes blind does not get out of their hospital bed and go straight down to the shops - they undergo months of fairly intesnsive rehab and training about how they can deal with their impairment in day to day life. To simplify this down to blindfolding someone and getting them to navigate a busy street is both unrealistic and possibly offensive to someone who actually is impaired.

That said, for a situation that you mention in your post where presumably the loss of sight is newly acquired, the exercise has greater merit - for an awareness of how to help a very vulnerable and possibly upset patient, I'm sure it's invaluable, but for disability awareness, the best possible experience you can get is to have a good long talk with people who are actually disabled about how they deal with day to day life.



Deacon Barry said...

I don't get them to navigate a busy street, honest! I would never be that cruel. Hmmm (thinks) maybe a side road without too much traffic....