No, Doctor: Hillary’s eyes are just Hillary’s eyes

Dr. John Coppedge recently offered his thoughts on Hillary Clinton’s eye movements following his observations of her at the Democratic National Convention a few weeks ago. This was followed by some extrapolations about what caused the observed abnormalities, and how they have affected her over the past several months.

Public figures such as politicians, professional athletes and actors, to name a few, are subject to all kinds of scrutiny about practically every aspect of what and who they are perceived to be. In today’s world there’s constant buzz on your social media forum of choice, allowing one to weigh in as definitively as one may desire on any topic one feels compelled to comment on.

{mosads}It is liberating not to have to show the world your credentials or justification for your pontifications — just fire away the way you see fit, and maybe millions will find it interesting. After all isn’t that freedom of speech in its purest form?  

Perhaps, but sometimes lost in all of this is the need for accountability and authenticity. As much as we deserve to invoke our right to communicate openly, we must also vehemently fight to protect our privacy and dignity. Public figures recognize that it may be necessary to open up parts of their personal lives that the rest of us wouldn’t dream of.

That does not mean that this should extend to speculating about details regarding their health, postulating in-depth diagnoses or drawing distant conclusions of how the proposed diagnosis influenced some behavior. This not only is going way too far, but it’s also a dangerous practice for anyone, let alone a fellow physician.

As physicians, our patients expect more from us, irrespective of whether we are sitting across from them in a clinic room, offering our opinions in scientific journals or even giving our thoughts for an online publication. Appropriately, they expect us to be simultaneously definitive and confident in our diagnosis, while keeping an open mind about all of the possibilities.

Patients expect us to call for help when needed, and demand that we comment within our areas of expertise and not beyond. Perhaps most importantly, our patients expect our opinions to be based on solid, soundly interpreted evidence, and not speculation.

Our very discipline is based on assembling a body of evidence to support our thoughts before drawing any definitive conclusions. Its reversing the process to publish your thoughts based on a virtual, extremely limited evaluation, and then say, “But we should have an expert perform a real exam.”  

For the record, eye movement abnormalities and determining what causes them can be a very challenging clinical endeavor. There are many connections between various brain structures to coordinate our eye movements.

A unified, properly processed signal is sent to our eye muscles (six around each eye) to ultimately move our eyes in a beautifully synchronized manner. This occurs virtually seamlessly, only appreciated when this coordination breaks down due to one of many possibilities.

Although the evaluation of such disorders falls squarely within my areas of training, expertise and daily practice, given that the diagnostic possibilities are numerous, I would not feel comfortable arriving at such conclusions without performing an in-depth evaluation of the patient’s eyes (inside and out), a neurological exam and personally scrutinizing all brain imaging studies. Only then could I arrive at a definitive diagnosis and management plan.  

In the end, this rebuttal is much less about the clinical conclusions purported in Dr. Coppedge’s article than it is about reminding ourselves of the relative sanctity of human health and our need to respect each other’s rights to it. The practice of medicine ultimately relies upon a genuine and complex relationship between health care provider and patient unlike any other.

We must be diligent in our fight to preserve the authenticity of this interaction, more so today than perhaps ever before. We simply cannot allow ourselves, no matter how accomplished, to make conclusions about others’ health (public figures included) without the utmost regard to assembling a body of evidence required to support our opinions.   

Vivek R. Patel, MD, is an associate professor of clinical ophthalmology at the Keck School of Medicine of USC. His specialty at the USC Roski Eye Institute in Los Angeles is neuro-ophthalmology and adult strabismus. Strabismus is a disorder in which both eyes do not look at the same object at the same time. It is more commonly called “crossed eyes.”

The views expressed by contributors are their own and not the views of The Hill.