Dashing Thru Neuro

Shhhh…..do you hear that?

No? Really??

Listen closer…..now I KNOW you can hear them bells ringing!

That’s right! Santa Claus is coming to town!!

santa claus GIF

It’s the most wonderful tiiiiime of the year, where the brisk & chilly winter air (if you live in the Northern Hemisphere) reminds you that you belong indoors with your family drinking some hot cocoa while listening to holiday music and laughing about stories that are being shared, half of which you’ve probably already heard like ten times. Christmas dinner is beginning to be prepared, extended family is arriving, and your parents are telling you to run last-minute errands before Christmas day. Then as Christmas Eve starts drawing closer and closer to an end, the anticipation of Christmas morning overcomes everyone, especially the younger children in the family and everyone in the house entertains one another in a merry fashion. Then Christmas morning arrives and just like magic, there’s a ton of presents under the tree and everyone is all smiles and just happy to be in each other’s company! It’s a wonderful experience every year and being able to see everyone all together happy and healthy is enough of a gift for me every year. I wouldn’t have said this same thing 10+ years ago, back when Christmas meant getting the newest toys and gadgets to entertain myself with. But alas, we all grow and mature and eventually realize the true meaning of Christmas and the holiday season in general!

I love this season as much as anyone else, but I didn’t come here to write up a Christmas novel or memoir. Y’all know the real reason why I’m here. So let me get straight to it.

My experiences at the various outpatient clinics I visited last week were overall positive ones! The atmosphere at the clinics was very calm, laid-back, and educational. The patients that we treated were very nice and appreciative as well. I was at five different clinics throughout the week, most of which were general neurology clinics. So with that said, I ended up seeing several cases of myasthenia gravis, peripheral neuropathy, and headaches. I was even able to witness a case of newly diagnosed ALS, a diagnosis that was not easy for the patient and his family to accept. In addition, I did get the opportunity to observe procedures involving electromyography in one of the clinics, which was pretty cool the first couple of times I saw it. It actually looked quite uncomfortable for the patients, for they were getting pricked by needles in various parts of their body so that we could study the muscle activity in those areas. And it wasn’t a quick procedure either. On average, it took maybe about 20-30 minutes to complete. After the second time around, I had pretty much gotten the gist of the procedure. Hopefully I never need an EMG study done on me. 😅

At some point during the week, my rotation group and I all participated in a coma simulation lab, where we were divided into two different groups by a Neuro ICU attending and were assigned the task of managing a dummy who came into the ER in a comatose state. You know, it’s always funny realizing how much you don’t know when you’re thrown in a situation that you thought you knew how to handle. After managing the ABC’s (airway, breathing, circulation) of the “patient”, my group was at a loss at what to do next. We threw out different ideas and acted on them, but none of us really had a structured plan in place for a situation like this. After exhausting all of the options we could think of as a group, including asking for a CT scan that came back normal, I sure as hell had no idea what to do next. So I just kept sternal rubbing the dummy and calling out “Mr. Jones”! (That’s the name I made up for him on the spot lol.) After both groups had their turn, we critiqued each other and learned some valuable lessons from the attending about managing a comatose patient. It was a cool learning experience and it further proved the point that there is a very clear difference in reading about doing something and actually performing the task in real life. I’m absolutely sure that I’ll get the opportunity to learn more about emergency care later on in the year during my Emergency Medicine rotation.

Speaking of emergency care, I was participating in just that during my night shift last Thursday. Boooyyy, was it busy. Soon after arriving for my shift, we were literally bombarded with pages about the patients that we were covering and about new patients coming into the emergency department. There were several patients who came into the hospital with active strokes and it was fascinating to watch how all the residents in differing specialties worked together in concert in the ED. The neurology residents would perform a patient interview and neuro exam while the patient was being wheeled to the CT scanner, and after being scanned the neurology resident would continue the exam while another neurology resident would assess the CT scan with a neurosurgery resident in order to decide if the patient needed immediate surgery or not. Everything would happen so fast, and all my classmate and I could do is watch and try our best not to get in the way, which we managed to fail at on several occasions. It’s almost impossible to get out of the way in a cramped place like the emergency department, just saying. Apart from answering pages from the ED, we checked on other patients in the hospital who were suffering from other conditions such as seizures and headaches. I definitely learned a lot that night from the awesome residents who were very willing to help us learn things, no matter how busy they were!

The final thing I want to touch on is the mid-rotation feedback session that I had with my clerkship director. It was a very helpful session filled with comments about my strengths and practical feedback that I can utilize in the second half of my rotation when I get back from winter break. I also got my quiz grade back (the one that counted for 30% of my grade) and I must say, I was quite pleased with my score. 😄 The director and I discussed several things, but the main lessons I took from the session included: 1) developing a mindset of thinking in which I’m actively looking to figure out what important lessons and/or techniques I will be taking away from each rotation and 2) focusing my history-taking and neuro physical exam performance on what the patient is complaining most about. She told me that her main goal for me and the other students in this rotation is to have us really learn and appreciate the neuro physical exam so that we are able to use it comfortably in not only our future rotations but also throughout our careers. So guess what I’m going to do? Yup you guessed it; adequately learn and appreciate the neuro physical exam so that I can comfortably use it whenever I feel that it’s necessary to do so!

With two weeks of a solid performance in Neurology behind me and another two weeks of relaxation in front of me, I’m in a fantastic spot mentally, physically and spiritually. I’m planning on this winter break to be an amazing one!

Have a very Merry Christmas and a strong finish to 2017!

“Learn to enjoy every minute of your life. Be happy now. Don’t wait for something outside of yourself to make you happy in the future. Think how really precious is the time you have to spend, whether it’s at work or with your family. Every minute should be enjoyed and savored.” – Earl Nightingale

– Black Man, M.D.

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