One of my patients today was an Indian lady in her 60s who spoke very little English. Her daughter had come along to translate, but to be honest she was very little help, and the patient and I spent most of the time communicating with each other in pidgin English.

When I tried to administer the drops, the lady had great difficulty keeping her eyes open, so having placed a couple of drops on her eyelashes, I told her to keep her head tilted back and blink a few times to let them run in. She managed to follow the first bit of that instruction, but failed to comprehend the second part. From the way she suddenly started going "owww", however, I guessed the drops had successfully entered her eyes.

So I asked her to take a seat back in the waiting room. At which point she stood up, eyes still closed, and called to her daughter in another language. The girl responded by taking her mother's hand and leading her out of the room like a guide dog for the blind. I assumed it was a melodramatic reaction to the pain of the eye drops (some patients do tend to act like they've been shot in the face), and thought nothing of it.

When I went outside to collect the next patient, the Indian lady was sitting slumped in a chair, head right back, with her eyes closed. I assumed she was having a nap, and ignored it. It wasn't until I called her back in that I realised something had apparently had been lost in translation.

On hearing her name, the lady stood up, eyes still closed, and held out her arms like a sleepwalker. Her hands found the shoulders of her daughter, and they proceeded down the corridor like the world's shortest conga line. I wondered if I should say something, but to be honest, my first thought was that the longer she keeps her eyes closed, the better dilated her pupils will be, so I decided to stay silent.

Upon entering the consulting room, the lady's first words to me were "Can I open my eyes now?". I said yes. And chose not to tell her that she could have done so twenty minutes ago. I didn't want to risk her misunderstanding, and keeping them closed for another twenty minutes.

When I went to lunch, one of the ladies on the reception desk called me to one side and told me that when I'd sent my Indian patient back to the waiting room, she'd walked all the way there with her eyes closed and her body bent so far back, they'd all thought she was entering some kind of limbo dancing contest for the blind. Next time I tell a patient to tilt her head back, I'll remember to add "And now sit up straight again".