This post is yet another that got stuck in the “drafts” folder. It was actually written during my pre-reg and has since languished on WordPress in a half-finished state.  Today, I’ve bitten the bullet and finished it.

One of my patients today was profoundly deaf.  Now, I went to a sign language class last year and I picked up the basics (as well as colours, animals and weather… strange but true) but I still feel a little nervous about practising on someone who can sign properly.  I feel it will be like going to France and speaking French to a native for the first time, probably with a terrible accent and a lot of grammatical errors.  I once told my Russian teacher, during an oral exam, that I had problems picking up what he was saying because I couldn’t “see his mushrooms” (I meant “lips” but, well, griby and guby got mixed up somewhere between my brain and my mushrooms).

Before we get to the actual test, we should talk about what happened before it.  Making an appointment was difficult for my patient, who we’ll call J.  She’d received her recall letter and was given three options to book an appointment: 1) call us, 2) go on-line or 3) come into the store.  Now, J said the easiest way of booking was to come into the practice because using the telephone system was difficult (not impossible, you can get text phones) and the on-line system at that time worked by the patient requesting an appointment and then us calling them back (yes, facepalm).  Things have improved with this multiple – you can now book on-line properly, without having to speak to another human being.

So, J popped in with her partner (who was also profoundly deaf) and arranged her appointment.  She had a mobile phone and requested that we text instead of calling to remind her about her appointment (we would call everyone the day before to confirm) and to also advise her when her specs were ready to collect.

When J arrived for her appointment, one of the optical consultants (R, my work wife at the time) panicked a little about doing the prescreen.  She was unsure about how to adapt her routine.  Seeing her panic, I advised her how I would do it: instruct the patient while her glasses were on, tell her what the test did and how we wanted her to respond and, when the test was finished, we would tap her on the shoulder to let her know it was finished and then we would do the same again for the other eye.  Seeing that the OC was still unsure, I asked if she’d be more comfortable if I did the prescreen while she watched but she said that she felt a bit more confident and would give it a go.  I stood to the side, within the OC’s eye line so I could nip across if she had any problems but the prescreen went well and both the OC and the patient seemed quite pleased.  The visual field test was the challenging bit as we do the screening test that uses multiple points then ask the patient how many they’ve seen before we manually move onto the next presentation.  My patient and the OC worked out a system where the patient would hold up the number of fingers that corresponded to the points she’d seen and if correct, the OC would move onto the next one.  It worked really well and meant that the patient didn’t have to keep coming out of the correct position – she just stayed with her chin on the rest and forehead against the bar and held her hand up to show the OC after each part of the test.  When the OC showed my patient over to my room, they were laughing because she’d said that she had to be careful which fingers she held up for to say “one” and “two”.

There’s only one golden rule for patients with hearing difficulties: ask them how they want to communicate.  If they lip read: make sure you don’t shout (this distorts your lips) and that they can see your face clearly (keep their specs on as much as possible if they have high Rxs and don’t do Hx & Sx while looking down at your clipboard or towards your VDU).  If they are “hard of hearing”, again, don’t shout, just try to speak a bit clearer and louder and again, make sure the patient can see your face.  Some patients will ask you to shout, I try to avoid this because it wrecks my voice – instead, I use my public speaking training* and speak from my diaphragm rather than my throat (weirdly, this also makes you sound more confident so win-win**).

The eye test itself was unremarkable and, at the end, when J came out of the test room, her partner came over and signed, “Do you need reading specs?”  and I signed, “Too young for reading specs” which got a laugh.

He said he had two pairs of specs and was getting fed up of changing between them.  I signed that he needed… um, v…a…r…i…f…o…c…a…l….s.  My fingerspelling isn’t that great, you can probably tell.

In the end, it was a good experience for both me and my OC.  And I was relaxed enough to try out my BSL in a real life situation***.


* Sadly, I used to compete in debating and public speaking competitions when I was at school.  Without bragging, I wasn’t completely awful at it.

** Honestly, Google it.

*** I didn’t/don’t tell people I can sign a little because I’m terrified of being in a situation where I need to be able to sign better than I can – which, of course, puts me in a catch 22 situation where I want to get better at it but I’m afraid to practise it in case I insult someone’s ancestors by mistake.