The Patient Without the Earpiece

An image of a glasses.

Quick Summary

  • The author describes the pre-surgery routine of patient assessment, local anesthetic infusion, and marking the surgical area.
  • During a scalp cyst removal exam, a young man appeared withdrawn and depressed, and the procedure was observed by another physician for certification purposes.
  • The observer was impressed by the author’s incision technique that avoids hair loss and decided to adopt it.
  • The author noticed the patient’s glasses were missing a left earpiece and learned he couldn’t afford to replace them.
  • After learning he needed a new eye exam and prescription, the author arranged an appointment and offered to pay for both the eye exam and new glasses, emphasizing seeing patients as more than “cases.”

Prior to every surgery in our clinic, we conduct a final examination consisting of a patient assessment, an infusion of local anesthetic, and a marking of the surgical area.

It was during a recent examination of this type that I encountered a young man who was to have a scalp cyst removed. Normally, while waiting for the anesthetic to fully take effect, I engage our patients in small conversations to help make them feel more comfortable.  But, this young man was different. He wasn’t very talkative and just kept looking down at the floor. In fact, he looked quite depressed.

This procedure was observed by another physician, as part of the criteria for maintaining our ambulatory surgery center certification.  He was greatly impressed when he saw that I used the incision technique for my young patient (so that no hair would be lost). He admitted to never having seen it before and decided to begin using it, as opposed to his current technique.

As I examined him more closely, I noticed his glasses were missing the left earpiece, and I wondered why he hadn’t replaced it. So, after the surgery, I sat him right up and asked him directly, “Why don’t you get a new pair of glasses or replace your earpiece?” He simply replied, “I cannot afford it”.

He mentioned he had been working at McDonald’s and only just started a new job. When I asked him where he went in the past for his eye care, he indicated he had gone to Walmart. Immediately, I asked my nurse to call the Walmart Optical Department to set an appointment for him to get a new pair of glasses.

Later, I called him to find out how he was feeling and to make sure he was going to obtain the new glasses. However, when his wife answered the phone, she informed me that he hadn’t had an eye exam in years and would need a new prescription. So, I told her that I would cover both his eye exam and the glasses. She was very overjoyed and promised he would make an appointment for the exam.


Conclusion: I find it very fulfilling to look beyond the reasons my patients come to our clinic to see if I can make a difference in their lives. They are more than just “cases” to me.

FAQ - Frequently Asked Questions

What happens during the final pre-op exam before a minor surgical procedure?
A typical final exam includes a quick health check, confirming the plan, and marking the exact surgical site. Local anesthetic is then placed, and we wait briefly to be sure it’s working fully. During that time, we also watch for anxiety, pain, or any last-minute concerns that could affect comfort or safety.
The key is choosing an incision pattern and closure method that protects nearby hair follicles and avoids unnecessary shaving. Surgeons may part the hair, use a hair-sparing incision, and close in a way that minimizes tension on the scalp. Scar visibility also depends on cyst size, location, your healing tendency, and how well post-op care instructions are followed.
It’s common for people to become quiet due to stress, fear, lack of sleep, or simply feeling overwhelmed. Sometimes the pre-op setting reveals broader life pressures—like finances, work instability, or untreated health needs—that have nothing to do with the surgery itself. A calm check-in and a few direct questions can help identify what support the patient actually needs.
Repair is usually reasonable if your prescription is current and the lenses are still in good shape, especially for simple fixes like an earpiece, screw, or nose pad. Replacement makes more sense if your vision has changed, the frames are repeatedly breaking, or the lenses are scratched or outdated. If you haven’t had an eye exam in a few years, start with the exam so you’re not investing in the wrong prescription.
Start by scheduling an eye exam, then ask the clinic about budget frame options and basic lens packages—many optical shops can keep costs modest, often roughly $50–$150 depending on prescription and lens features. If cost is still a barrier, ask about community programs, vision charities, or employer benefits that may cover part of the exam or eyewear. Also consider whether a repair or temporary fix can safely bridge the gap until you can replace them.

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