Overall thoughts of Neurology

I've been so busy so it's been a while since my last post, but I wanted to give my overall thoughts on my first week of rotations. I had a wonderful experience in the Neurology Department. We started each session with a lecture from different attending physicians on each of their specialties; these include Epilepsy, Multiple Sclerosis, Stroke, and Vertigo just to name the most discussed topics. Amazingly, I found a lot of what I learned in Biochemistry came back in helping me understand these lectures, so that felt awesome! It felt really good to be able to take knowledge I’ve learned from such a short amount of time in medical school and apply it to real-world scenarios.

After the lectures, I rotated in different areas of the department each day. I already talked briefly about the second ward in my last post, but I was lucky enough to see a lot of exciting patients in the 1^st ward and ICU.  One patient I saw had suffered a stroke a few days prior, so we got to see a CT scan where the bleeding had occurred and watch the draining of cerebral spinal fluid (CSF) while the doctors explained his bleeding was massive because he was on blood-thinners. Another patient we saw that day had a tumor on his medulla, and as a result had issues swallowing as well as Horner’s Syndrome, a situation I completely understood from gross anatomy! This was so exciting for me.

Another patient I saw was probably the most exciting, where we watched a man get some sort of spinal procedure which involved a lumbar puncture. I’m still a little confused about what was going on exactly, but the man had scoliosis, therefore the doctor had an extremely difficult time inserting the needle between the vertebrae. After many attempts and about 20 minutes going by, the needle was inserted and some kind of fluid was being inserted to measure intracranial pressure (I believe they called this a Tap Test); after the nurse monitored the pressure and took down the pressure every minute for 10 minutes, they released some CSF to relieve the pressure.

In addition to seeing the patients, I really enjoyed seeing real-world MRI and CT scans. St. George’s really emphasizes getting us used to radiology, but everything we see is without pathology. Seeing scans on real patients that had disease or accidents was amazing, especially when I felt like I was actually able to see what the problem was. This scan in particular was the most shocking to see:

This patient was born with congenital hydrocephalus and showed no symptoms until he was in his 60s! pretty amazing he lived such a normal life up until this point, considering how much CSF is built up in the brain!

In Ultimately, I had a very enlightening week in Neurology and felt like I learned a lot about the clinicalaspects. While I’m very interested in Neuroanatomy, I’m not quite sure this is the specialty I would go into myself, but I definitely have a new appreciation for it. Next week is pediatrics, so that should be a very different experience. Having grown up with my parents in this field, I’m sure it will be much more familiar territory for me, but still excited to get a new perspective!