How I overcame my fear of laser eye surgery

Late last year, I had laser eye surgery and my relationship with the medical procedure I’ve marketed for almost 20 years changed forever. I became my customers’ patient, and it transformed my understanding of the laser eye surgery patient’s psychological journey and what they most fear and desire.

I’ve included the video of the full 16-minute laser eye surgery operation in this post, in real-time from start to finish. As you will see, I’m as cool as a cucumber. I’m not anxious in the least.

But things didn’t start that way.

I now understand what’s beneath the surface of a patient’s experience before, during and after this extraordinary journey.

I’ve spent half a career working to make people aware of laser eye surgery and helping prospective patients overcome the obstacles in their way. Since having surgery, am I throwing out anything I knew before I had it? Not at all. I’m adding a new layer to my understanding of this experience – especially how it relates to fear and how to best deal with it.

Having laser eye surgery will likely to be one of the most memorable experiences of my life. It's all the more notable because I’ve immersed myself in this business for almost 20 years and will most likely remain heavily involved over the next 20 years.

THE BEGINNING

I first noticed trouble reading my mobile and needing reading glasses in dim light. At first, I was 99% sure I was going to get laser eye surgery. This is, after all, an ordinary world experience for most people in their mid-forties. However, I lived with the problem (presbyopia) for about three years.

THE CALL TO ADVENTURE

Unlike most people who discover they need reading glasses, I knew this was coming.

At first, glasses were novel. I’d be lying if I didn’t admit I that I even liked the way I looked in them. A little wiser; perhaps, a tad more seasoned. Over time, however, these glasses became a hassle (as they almost always do), and I began to despise them as the enemies they were.

I regularly felt the call to adventure as I recalled a life without my reading glasses. I felt it in every text message I received, every restaurant bill I squinted at and every book I opened.

Like many people in their 40s, I made more time for physical activities as I entered this decade of life. Today, training at the gym, cycling a few hours a week, snowboarding in the winters, swimming and yoga – are all routine for me now. As are the plethora of devices, from smartphones to watches to cameras that enhance these activities.

What’s worse is that I felt some self-manufactured pressure to have eye surgery. How could I continue speaking and consulting on how to effectively sell and market laser eye surgery without having the courage to go through with it myself?

MY REFUSAL OF THE CALL

Despite being keen to re-engage in the life I had before glasses. However, I repeatedly refused the call for about 3 years. Does this sound bizarre? Why would I needlessly continue to wear glasses when there was a safe and effective alternative without them? I had two reasons.

My public (and rational) reason was that I wanted to have and feel what my customer’s target markets have and feel. I wanted to experience day-to-day life as a glasses-wearer. I wanted to know how people would see me with reading glasses. This knowledge would be grist for the mill for my stock in trade: empathising and inspiring people to overcome their fears and have laser eye surgery. This was all true, but only partly.

Why did I delay having laser eye surgery? To be brutally honest, I was scared.

My more private (and irrational) reason was: I was scared. How could someone who knows so much about laser eye surgery possibly fear it? Was knowledge not sufficient to dispel my fear and insecurities?

“There’s no room for facts when our minds are occupied by fear.”

― Hans Rosling, Factfulness: Ten Reasons We’re Wrong About the World – and Why Things Are Better Than You Think

I experienced fear for the same reason many people fear terrorists, immigration, or dying in an aeroplane disaster. I was being irrational. The seeming comfort of my world with reading glasses, however, did not last. I realised that having laser eye surgery to remove them was a challenge I needed to undertake.

Elective surgery is a significant investment of time and money. People make many excuses and often must deal with other pressing challenges before they seriously consider it.

Fear – of doctors, procedures, surgery, needles, tests, pain, side-effects, poor outcomes, going blind, failure of the operation, health care settings and the people in them (collectively known as “medical fear”) and fear of the unknown is a common objection.

So, what did I do? Against my self-protective interests, on one day, I called up 3 clinics and booked my appointments. I effectively “burned my ships”1, with those phone calls.

Now, I was committed. Now, the discomfort of backing out caused greater imagined anxiety than the prospect of having surgery. The quest was before me.

Fear is common in anything new (not new to you, but new to a patient). Fear in people will never go away as long as they continue to grow or cope with changes in their environment. Susan Jeffers, a psychologist who devoted her career to understanding fear and how to overcome it, said:

“Every time you take a step into the unknown, you experience fear. There is no point in saying, ‘When I am no longer afraid, then I will do it.’ You’ll be waiting for a long time. The fear is part of the package.”

MEETING THE MENTOR

I booked my appointments to meet my would-be mentors – my prospective surgeons and clinicians. They would give me insight, advice, and the green light to have surgery. I also hoped I’d get some borrowed self-confidence, wisdom and experience. These guides and mentors would serve to dispel my doubts and fears and give me the strength and courage to continue my quest.

The only way for patients to overcome the fear of doing something is to do the thing that scares them. Jeffers adds:

“When you do it often enough, you will no longer be afraid in that particular situation. You will have faced the unknown and you will have handled it. Then new challenges await you, which certainly add to the excitement in living.”

The idea of feeling the fear and doing it anyway an is the basis of systematic desensitisation, a well-proven treatment of phobias. This therapy aims to remove the fear response of phobia by systematically exposing the anxious subject to more anxiety-producing stimuli of the thing that induces fear. Then, the therapist can substitute a relaxation response to the conditional stimulus gradually using counter conditioning.

1. Rewarding patients for their demonstrated courage in booking the first appointment can help them to remain consistent with their prior actions and keep their scheduled appointments.
2. For many patients, merely walking into a clinic where surgery is performed will cause anxiety. Making a warm welcome call a week before to let your patient know you’re eager to see them and calm their worries (i.e. buyer’s remorse) serves to reduce DNA rates.
3. Meeting the mentor (that is, the surgeon – or an extremely credible optometrist) is crucial. Importantly, the mentor needs to demonstrate their authority to guide the patient, providing a map and the empathy the patient requires to submit to their instructions.

Many clinics seek to save time and costs, so they skip these steps. I feel that’s an error for various reasons – number one is that the patient fails to meet the mentor who helps them get over their fear (ergo, more delay and more declines).

CROSSING THE THRESHOLD

I willingly crossed the threshold into each of the clinics between the ordinary world outside and the special (clinical) world inside. This step signals a commitment to the journey. The stakes raise further.

TEST, ALLIES AND ENEMIES

I met many allies along my route, in the form of receptionists, healthcare technicians, patient liaisons and clinical staff. I underwent a series of tests and challenges that evaluated me in a variety of ways.

Obstacles were thrown against my path – a surprisingly short eye (I didn’t know I was long-sighted), a strange wavefront, and the first prospect of having SMILE only to realise later that I was having LASIK. I overcame each presented challenge on the journey toward my ultimate goal – freedom from these pesky rimmed enemies – my reading specs.

APPROACH TO THE INMOST CAVE

Almost metaphorically, the surgical suite at the London Vision Clinic is in the basement of the building on 138 Harley Street, very much a deep cave.

All my successful tests prepare me for this moment. Accompanied by my No.1 ally, my partner Laura, the nurse helps me make final preparations before taking that final leap into the great unknown.

At the threshold to the inmost cave, I worry I might once again face some of the doubts and fears that first surfaced upon my call to adventure. I take a moment to reflect upon my journey and the treacherous road ahead, quickly finding the courage to continue.

At the London Vision Clinic, I received a shoulder and head massage from a massage therapist – a standard offer to help calm patients, regardless of their degree of anxiousness. In the uncluttered, designed-for-purpose room I had my massage, the lights were dim, the scents of calming essential oils and the soft touch of the masseuse all helped.

When the nurse explained the post-operative drop routine I’d adopt over the following 7 days, she offered me a square of dark chocolate. A sweet gesture to be sure, but also a demonstrated method of increasing levels of the neurotransmitter serotonin, which may help reduce the stress that leads to anxiety.

THE ORDEAL

The highlights for me where likely not what you might think (if you’re a surgeon):

• Holding on for dear life. The nurse gives me a plush toy to hold onto as I lie down on the treatment bed. Common anxiety symptoms include muscle tenseness, trembling and sweating. Fortunately, I have none of these. I am calm and relaxed. However, I can imagine that the plush toy helps to alleviate these symptoms.
• Snug as a bug in a rug. A heavy blanket covers me. Presumably, this helps to keep me warm in the cool room. Secondly, I imagine it also prevents people from reflexively lapsing into self-protection mode by bringing their hands up to their face in a panic.
• The magically reassuring power of well-timed words.“Perfect… perfect… perfect… great… fantastic… beautiful… you’re doing great… it’s all going perfectly…” In the right hands, having laser eye surgery can feel like a terrific ego boost. I had no idea I could be such a great patient! In reality, Reinstein and his team are pros at relieving anxiety and making you feel like you’re doing everything right while doing nothing but lying there like a stone. If I didn’t know any better, I swear he’s had training in hypnosis.
• The nurse is a fear whisperer. The nurse whispers something reassuring into my ear as the surgeon moved from the VisuMax (femtosecond laser) to the MEL 90 (excimer laser). I later can’t remember what she says, but her tone of voice is like an oral sedative.
• I am experiencing oneness with the universe. Physically and visually, the surgery is a smooth and comfortable ride with a fantastic kaleidoscopic view. The suction ring slowly closing in makes me feel like I am on a spaceship docking to a space station. The under the knee and neck-head support help me feel snug and securely comfortable – enabling me to lie back and relax without the need to fidget or adjust myself. The bed that pivots me from the VisuMax to the MEL 90 gives me the sensation of weightless floating from one position to another. Everything feels efficiently orchestrated to the very last detail.
• A need to know basis (the empty silence is scary)! Reinstein tells me everything I need to know, only a moment before it happens. His timing is impeccable. He says what’s going to happen and it happens a second later. Not once do I wonder: “What’s going on?” I’ve been in a lot of operating theatres, watching this exact procedure. Some surgeons are silent. Others have music playing or only talk to their surgical team. I find Reinstein’s patient-focused approach works perfectly for me and helps me have a stress free experience. I can even say: I enjoy it!

THE REWARD

After successfully defeating my true enemy – fear itself – I experience the instant reward of clear vision. I am transformed into a new state, emerging from battle as a stronger person and with the prize of new eyes. I’m now ready – dark glasses worn and armed with an armamentarium of eye drops and shields – to journey back to the ordinary world.

With LASIK, patients typically experience the “Wow Effect”. It’s a powerful moment that you should help celebrate.

It’s not an experience I have, because my distance vision was perfect before the procedure. As I rise from the bed and walk to the microscope for any final flap adjustments (perfectionism on display). I see everything through what looks like a misty sauna. My near vision, however, is instantaneously better.

THE ROAD BACK

The road back is long. I am now 5 months into the 3-6 month adaptation period toward the vision I enjoyed five years ago. My painless recovery was happily swift and uneventful. My near vision is fantastic, as I can testify by writing this post without the aid of glasses. My distance vision, however, remains a little bit blurry – a known and certain side-effect of laser blended vision that should pass in time (i.e. 6 to 12 months).

On the night of the surgery day, I get an SMS from Dan, asking me how my eyes are doing and if I want to go to the 606 Jazz Club and watch him play the saxophone. Of course, I know this text is coming, as it has for every one of Dan’s patient for years. Still, it reassures me that he’d invite me out, further encouraging me that all is well, and life can now swiftly return to normal.

The next day, I see Dan for my 1st-day postoperative appointment. I’m seeing 20/15 at distance and N4, the tiniest print on the card. We take a few pictures for posterity, and I return to work that day.

Along the road to recovery, I receive loads of good wishes and congratulations on social media and face-to-face. I feel like a hero who’s successfully walked a road that many fear to tread.

The seven-day recovery period has me instilling drops into my eyes every couple hours on a routine schedule. I also need to put eye shields on when I sleep, lest I rub my unconsciously rub eyes.

RESSURECTION

My eyes are anew. I return to the ordinary world, a changed and wiser man who’s learned much and proven himself capable of facing many terrible dangers.

As I reflect upon my journey, I can’t help but think about how easy it all was. Sure, my life has been marginally inconvenienced, but on balance it’s nothing compared to the benefits.

More powerful than the visual transformation, I am again imbued by a sense of self-confidence. I’m reminded that pushing through fear is less frightening than living with the bigger underlying fear that comes from a feeling of helplessness.

RETURN WITH THE ELIXIR

I return with the elixir of clarity destined to bring hope to those I left behind, re-convinced of a direct solution to their problems and a fresh perspective for you – my readers – to consider.

Not only was I afraid when facing the unknown, so is every other patient. But I felt the fear and did it anyway, as likely every patient does. I'm now convinced that if we can only become more effective at helping people overcome the fear of eye surgery it will one day become as routine as flying in an aeroplane.

UNDERSTANDING AND APPLYING THE HERO’S JOURNEY

What I’ve shared above is my example of the Hero’s Journey.

Patient stories are one of the best ways to help people overcome their most significant objections to surgery – fear of the unknown being the most significant.

What would persuade you more, a statistical chart, a 5-star review or a detailed video or textual account of how someone transformed their life through eye surgery? All three are great, but one is far more potent than the other.

For most people, stories are more persuasive than praise and statistics because individual examples play into our natural predisposition to remember stories more than numbers.

Stories are compelling because they can transport us to the journey as it unfolds. Watchers or listeners of a good story can put themselves in the picture and step into other people’s shoes.

The most compelling stories position the patient as the hero, with the surgeon as the mentor or guide. You can do this by crafting stories around your patient’s experiences and the Hero’s Journey – including their fears – and featuring them in every way you communicate.

Please read my blog post: How to best use third-party patient stories to help patients overcome the fear of surgery to see how you can use this character arc in written, audio or video patient stories to help your patients motivate themselves.