Oh, neurology

August 28, 2007 at 8:23 pm (Clinical rotations)

During the height of the Greek and Roman eras, the celestial bodies were worshipped as gods. Good citizens fervently prayed to Apollo and Zeus to grant them good travel and healthy families. Christians who refused to believe in the gods were fed to lions and crucified for their defiance. Eventually, science took over and astronomers demonstrated that the stars’ paths could be predicted-that the heavens above were nothing more than soulless bodies of fire that traveled around the sun. All of that dedication played no role in the day-to-day random events that made people healthy, rich, or fertile. What’s worse, the pagan priests, despite all of their years of training to accumulate such a vast amount of knowledge, now were useless because they could not influence the results of people’s lives by praying to the gods. In a similar fashion, neurology has plenty of highly trained physicians whose knowledge will play no role in how their patients fare.

After coffee hour this morning, my team met with the attending to discuss the previous day’s cases. We spent ten minutes debating whether a patient’s disease was located in the nerve’s cell body or in the axon. Finally, after much deliberation, we concluded that the lesion was in the axon. All I could think of was the absurdity of the conversation. Our patient couldn’t walk. Even after we figured out where the lesion was, the patient still couldn’t walk. In fact, there is no treatment for his paraplegia. Much like the pagan priests, we wasted all of that time getting worked up over nothing.

Don’t get me wrong. I think that neurologists are very intelligent and are experts at treating some of the most debilitating illnesses in America such as stroke and headache. However, so much of what I’ve seen over the past week has been consults where we confirm that yes, the AIDS patient does have a degenerative spinal disease that is slowly leaving him without sensation in his arms and legs. And you know what? There’s nothing we can do about it. I wonder why four years of residency is required to learn the neurological exam only to tell families that grandma won’t be able to eat in the future without drooling on herself.

So much of my day is spent shaking my head and saying, “Oh, neurology,” as if I were watching my cousins expound upon the benefits of astrology and the importance of following the daily horoscope. Maybe I’ve just become jaded too early in my medical training. However, I got into the field because I actually wanted to do things for people. I wanted to serve as a healer. If neurology can’t grant me that, I’ll gladly wait until the donut of misery rounds another next full circle and move on to the next rotation.


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