shadowing.... a long one
I realized something while shadowing today.
This is the bad thing:
As a neurologist, I'm going to be around very sick people all the time. But it’s not just that their sick, sick I could handle. Instead of being around a lot of joy- like an obstetrician who delivers babies- or being around people that will get better from their injury- like orthapedic sureons, most surgeons in general, or family practice doctors, pediatricians, etc- im going to be around people all the time that probably wont recover from the things they come in with. What are some of the diseases you associate with neurology? Stroke, alzhiemers, parkinsons, congenital malformations and diseases. All things you never fully recover from- some things get progressively worse. Just think of the term “neurodegenerative disease”. Sometimes I have to give people (and family members) terrible news, and not just about maladies that affect their or their loved one’s bodies; things that affect who the person is, their personality, their behavior- everything you come to love about a person. And not only do you have to deal with these diseases, you have to deal with them in an organ that doesn't heal. Neurologists and cardiologists have the unique job of dealing with tissues that don’t heal themselves or make new cells. And cardiologists' patients always have the possibility of a transplant- even if the hopes are slim. I've always loved studying the brain, and I've always loved helping people- but I don't know if I can combine these in to a career. This feeling seems to have been plaguing me for a while- maybe kind of affecting my enthusiasm about the shadowing... I just haven’t been able to put my finger on it.
This is the good thing:
I did see some hope in one patient of ours today though. She came in with her 40-year-old son that she takes care of. He has spina bifida (occurs when an embryo's neuronal plate doesn't fuse during development, causes birth defects) which forces him to be confined to a wheel chair and gives him some other issues, though not cognitively (his cerebellum extends onto his spinal cord, giving him balance issues, etc.) She sat through his appointment kind of worried looking, even though her son was just getting a routine check-up. She had an appointment right after his (because she has migraines) and she told him to wait out in the waiting room while she had her check-up.
When we came back in and were with just her, Dr. H asked her about her migraines and whether her Topamax was working, etc, and she said they were OK. Then she described what she called “senior moments” she had been having- like sitting in the car and just forgetting what to do to turn the parking brake off and after probably thirty seconds, what seemed like forever to her, she remembered what to do. And when she was making her son oatmeal, which she’s done several times a week for years, she forgot how long to put the oatmeal in for. She dug the wrapper out of the trash to see- it said 1 to 2 minutes. That didn’t help her at all. Finally her daughter made it. She looked very concerned while she was describing this. A few moments later as Dr. H was examining her ocular nerves (as he does on every patient), she just off-handedly said “I’ve probably got Alzheimer’s or something” but it looked like it meant something to her. Dr. H said “you definitely don’t have Alzheimer’s disease” and to that she said “are you sure?” He told her that Alzheimer’s patients don’t realize what is happening to them- they don’t recognize that things are going wrong. At first she just said “Oh that’s good.” Then Dr. H told her that patients often describe the symptom she had just described while taking the drug Topamax- momentary forgetfulness. So not only is she free from Alzheimer's disease because she wouldn't know it if she had it, the drug side-effect explained the spaceouts she's been having.
I think it took a while for those two facts to sink in, because she didn't seem especially elated while we were still in the examining room, but when we met her in Dr. H’s office afterwards, she revealed how happy she was about there being no possibility of Alzheimer’s disease. She said she had been so concerned coming into the doctor’s office and she will be so happy when she leaves! On the way out she told me how lucky I was to be with such a good doctor- actually several patients have told me that. I can't imagine how much she's been through caring for her son; she was probably more worried about his sake than her's in losing her memory and the other cognitive changes that are associated with Alzheimer's disease. I guess that means there will still be good news to give to people as a neurologist. And there are some things you can really help patient's with by perscribing them medication, for their migraines or seizures, for example.
So what should I do? Should I stick with neurology?
What do you think?
This is the bad thing:
As a neurologist, I'm going to be around very sick people all the time. But it’s not just that their sick, sick I could handle. Instead of being around a lot of joy- like an obstetrician who delivers babies- or being around people that will get better from their injury- like orthapedic sureons, most surgeons in general, or family practice doctors, pediatricians, etc- im going to be around people all the time that probably wont recover from the things they come in with. What are some of the diseases you associate with neurology? Stroke, alzhiemers, parkinsons, congenital malformations and diseases. All things you never fully recover from- some things get progressively worse. Just think of the term “neurodegenerative disease”. Sometimes I have to give people (and family members) terrible news, and not just about maladies that affect their or their loved one’s bodies; things that affect who the person is, their personality, their behavior- everything you come to love about a person. And not only do you have to deal with these diseases, you have to deal with them in an organ that doesn't heal. Neurologists and cardiologists have the unique job of dealing with tissues that don’t heal themselves or make new cells. And cardiologists' patients always have the possibility of a transplant- even if the hopes are slim. I've always loved studying the brain, and I've always loved helping people- but I don't know if I can combine these in to a career. This feeling seems to have been plaguing me for a while- maybe kind of affecting my enthusiasm about the shadowing... I just haven’t been able to put my finger on it.
This is the good thing:
I did see some hope in one patient of ours today though. She came in with her 40-year-old son that she takes care of. He has spina bifida (occurs when an embryo's neuronal plate doesn't fuse during development, causes birth defects) which forces him to be confined to a wheel chair and gives him some other issues, though not cognitively (his cerebellum extends onto his spinal cord, giving him balance issues, etc.) She sat through his appointment kind of worried looking, even though her son was just getting a routine check-up. She had an appointment right after his (because she has migraines) and she told him to wait out in the waiting room while she had her check-up.
When we came back in and were with just her, Dr. H asked her about her migraines and whether her Topamax was working, etc, and she said they were OK. Then she described what she called “senior moments” she had been having- like sitting in the car and just forgetting what to do to turn the parking brake off and after probably thirty seconds, what seemed like forever to her, she remembered what to do. And when she was making her son oatmeal, which she’s done several times a week for years, she forgot how long to put the oatmeal in for. She dug the wrapper out of the trash to see- it said 1 to 2 minutes. That didn’t help her at all. Finally her daughter made it. She looked very concerned while she was describing this. A few moments later as Dr. H was examining her ocular nerves (as he does on every patient), she just off-handedly said “I’ve probably got Alzheimer’s or something” but it looked like it meant something to her. Dr. H said “you definitely don’t have Alzheimer’s disease” and to that she said “are you sure?” He told her that Alzheimer’s patients don’t realize what is happening to them- they don’t recognize that things are going wrong. At first she just said “Oh that’s good.” Then Dr. H told her that patients often describe the symptom she had just described while taking the drug Topamax- momentary forgetfulness. So not only is she free from Alzheimer's disease because she wouldn't know it if she had it, the drug side-effect explained the spaceouts she's been having.
I think it took a while for those two facts to sink in, because she didn't seem especially elated while we were still in the examining room, but when we met her in Dr. H’s office afterwards, she revealed how happy she was about there being no possibility of Alzheimer’s disease. She said she had been so concerned coming into the doctor’s office and she will be so happy when she leaves! On the way out she told me how lucky I was to be with such a good doctor- actually several patients have told me that. I can't imagine how much she's been through caring for her son; she was probably more worried about his sake than her's in losing her memory and the other cognitive changes that are associated with Alzheimer's disease. I guess that means there will still be good news to give to people as a neurologist. And there are some things you can really help patient's with by perscribing them medication, for their migraines or seizures, for example.
So what should I do? Should I stick with neurology?
What do you think?