Patients’ trust still matters to Las Vegas doctor

Even after 30 years as a physician - Dr. Marietta Nelson now runs The Eye Clinic of Las Vegas - she finds the doctor-patient relationship awe-inspiring.

Never, she says, can she take lightly that someone entrusts his own or his child's well-being to her.

"It's a phenomenal responsibility," the ophthalmologist said the other day as she took a break from supervising resident-physicians who were treating children at the Nevada Eye and Ear office not far from University Medical Center.

One of the state's most respected physicians - Nelson is a member of the American Medical Association House of Delegates, helping formulate influential AMA policy on national medical issues - she's also served as president of the Nevada State Medical Association, the Clark County Medical Society and the Las Vegas Ophthalmological Society.

The more you talk with Nelson, the more comfortable you are that her input into AMA policy positions springs from a mindset that places respect and compassion for patients' welfare front and center.

"Her integrity is something we should prize in Las Vegas," local internist Dr. Ivan Goldsmith said.

Consider her position on Lasik eye surgery, which has raked in millions of dollars for eye surgeons.

"I'm not a fan," the bespectacled surgeon said of the laser reshaping of the cornea that may produce better eyesight. "I don't believe in any unnecessary surgery."

Nelson knows Lasik is safer than it ever has been because more ophthalmologists are having it done.

"They used to tell me they couldn't have it done because if there were complications they couldn't practice any more," she said. "I told them I hoped they told their patients that they were willing to risk their eyes and not their own."

Sixty percent of her solo practice is now geared to pediatric ophthalmology. Nelson is always moved by the parents' reaction after she is able to remove congenital cataracts from a 2-week-old child so the infant can see.

"It's so emotional," she said.

It was also very emotional when she did corneal transplants on a man whose eyes were scarred in an industrial accident.

"I took the bandage off his one eye and he started crying," she said. "I started crying, too, because I thought he couldn't see. But he was crying tears of joy that he could see."

That the relationship a doctor has with a patient and family can be unlike anything other people ever experience was driven home to Nelson as a pediatric intern at the University of California, San Diego.

A couple brought in an infant with diarrhea. Nelson examined the child, as did a senior resident - they determined the child had a virus. Stable, able to take fluids, the child was allowed to go home.

The next day, Nelson said, the couple returned with the child in dire straits. The infant died.

"I was so sorry we didn't admit the child the night before, and I told the family that," she said. "IV fluids might have made the difference. It's such a horrible feeling when you think you made a mistake."

The child's parents, seeing how upset Nelson was, assured her that they did not hold her responsible. "Here they were grieving, trying to make me feel better, saying sometimes things happen that can't be explained."

She became the pediatrician for the couple's other two children.

"I think about what happened to that one child every day," Nelson said. "I realize no one is perfect. But I really strive every day to do no harm."

Paul Harasim is the medical reporter for the Las Vegas Review-Journal. His column appears Mondays. Harasim can be reached at pharasim@reviewjournal.com or 702-387-2908