Neurological Wizardry

Too many of my posts lately have been negative.  Here’s some positive stuff that’s been going on:

I was supposed to see a patient with Common Thing.  But I came away suspecting it was actually Uncommon Thing.  So, with the patient’s permission, I called one of their family members to confirm that the patient actually had symptoms consistent with Uncommon Thing.  And I presented my case to the preceptor, and he said, “I agree”, and he changed the course of the patient’s management, and then I died of shock, the end.

(To be fair, this was not a difficult diagnosis.  But people were nice enough to make me feel good about it because I called family members when no one else had the time to do so.  Because they were all busy doing actual work.
…  turns out my lack of any meaningful purpose is an attribute!  I’ll take it.)

Also, there’s a lot of psychiatry involved.  In one week, I’ve seen more Axis I disorders than I did in a whole semester of psychiatry proper – and I’m not sure there’s anything in life more satisfying than working up an undiagnosed Axis I disorder.

In conclusion, 1) Neurology is the most intellectual fun I’ve had in years, and 2) I am clearly getting cocky about it.

Even though 75% of the consult cases are requested in the spirit of “Hey, you know that WE know this isn’t neurological, but we want to cover our collective asses legally” – to me, each consult sounds more like “We have summoned you from afar to solve an intractable clinical problem with your wise neurological wizardry.”

… which I don’t actually, you know, have.  At all.  I have the opposite of that.

NEUROLOGY. The answer is CALL NEUROLOGY.

But I work for a doctor who does, and I’m armed with a tuning fork.

So, you know.  Samesies.

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