Beginning the Neurology Rotation

The clerkship director for neurology, a very well known professor in the neuroscience blocks of the basic sciences, shared an interesting pearl of wisdom during last Monday’s orientation lectures – “memories are created, not recorded.” He remarked on the fact that when people were asked where exactly they were during the September 11th World Trade Center attack, many have vivid memories of exactly what they think they were doing; however, in reality, these “memories” were entirely false in several cases. Memories are indeed creations of a mysterious conscience rather than “bit-by-bit copies” (for those CS geeks out there 😉 ) of our experiences.

We proceeded to review some neuroanatomy and the neurological exam. That afternoon, we also practiced lumbar punctures (LPs) on dummy simulators. Before med school, I always wished I would never have to do an LP (spare an opportunity to cause pain to a patient, right?), but come to find out, it’s actually relatively simple with minimal risk. As with all procedures, a systematic approach and confidence goes a long way. 🙂

Thanksgiving was uneventful as always. I spent most of the day playing computer games, sleeping, and watching football. Come to think of it, it’s the first “break” I’ve had since summer, and with winter break only three weeks away, this rotation is shaping up to be more conducive to learning than I ever thought. I’ve got a great team, incredible residents, and an attending who routinely goes out of his way to show us bedside procedures with in depth explanations.

When I first studied neurology in the basic sciences, I enjoyed taking on the role of a detective trying to unify a patient’s symptoms to a localized lesion in the central or peripheral nervous system. Now that I’m on the wards, it’s much more real when an actual patient presents with right sided upper motor neuron symptoms and facial drooping, or decreased sensation to touch below the waist, or a change in personality per the family’s report. While we’re caught up in trying to find areas of pathology by exam, imaging, and labs, it’s often easy to forget that an actual human being is on the receiving end of these various tests and has to live with these symptoms.

As medical students, we are so lucky to be exposed to the breadth of diseases we come across every single day. This rotation is inherently “low stress” (only a month long rotation with a departmental exam at the end), so I should be able to learn a lot more from the wards alone. 🙂

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