Dr Delbanco: Mrs K is an 82-year-old widowed former seamstress with poor vision secondary to bilateral cataracts. She lives with her daughter and extended family in a suburb of Boston, Mass. In 1977 she came to the United States from Haiti. She receives her primary care at the Beth Israel Hospital from a general internist and a nurse practitioner, Ms M, and speaks only Haitian Creole. She has Medicare without supplemental insurance.
Mrs K was first seen as a patient in 1977, and at that time she was found to have bilateral cataracts. She has complained of poor vision throughout the years and has sought help from a physician for her vision during some of her frequent trips back to Haiti. During 1 of these visits, she was given potassium iodide eyedrops. In the fall of 1995, Mrs K complained of blurriness and a clear watery discharge in her left