Tapping Into Inspiration
It's been a while since I've posted.
It's not that I haven't had any thoughts - quite rather the opposite is true - but it just seems that I have such trouble getting my thoughts organized into meaningful reflection.
Having struggled through the trials of Step 2 studying and having currently placed them on hold for the time being, I have thoroughly loved every moment of Neurology. It has been everything I have wanted and dreamed about. The patients are exceedingly interesting, and I am learning so much everyday - tirelessly absorbing like a newly diagnosed diabetic patient (polydipsia for that knowledge)
I love the satchel of tools that seem exclusive to neurologists. I love the subtlety in physical findings that are necessary for diagnoses. I stand in awe as the attending and residents discuss neurological problems at all levels. It's a different kind of awe that I experienced during third year. In medicine, I remember rendered speechless by the vast knowledge repertoire that physicians exercised daily. It was incredible to watch them pull out bizarre diagnoses out from their hat and piece together seemingly random pieces of information. It was inspiring because these are features that I still struggle with now.
But neurology.
It's the depth and thorough understanding of such bizarre and complex diseases that astounds me. Everyday, I learn that there is so much more to these seemingly straightforward diagnoses. I am humbled by the easy acceptance to my eagerness to learn and their eagerness to teach. Their patience is so nurturing. So permissive. Why wouldn't anyone want to learn and grow from these opportunities?
Today, I got to attempt a lumbar puncture. We had a few opportunities to practice on models before, and I watched one done prior, but I had never thought I would be allowed to try one. Thankfully, we had an extremely compliant patient who was knocked out, so we weren't afraid to try our hand at it. It was an enlightening and humbling experience.
I felt so lost and uncertain of what I was trying. Once again, I am reminded that textbook descriptions are such pale representations of the reality. The distinct "pop" was ever elusive, and I felt I was fishing in an ocean of uncertainty, the needle aimlessly wandering for its target. The resident coached me through it and provided me with suggestions of adjustment. I was looking for a change in texture. It wasn't supposed to be earth-shattering.
I tried many times, feeling that I had it a few times but only found frustrating dryness when I retracted the needle to test for flow. A few times, I even felt certain there was a change in density and texture, but alas, no luck. I caught a glimpse of glistening wetness at the puncture site, but no matter how I tried, I either hit bone or I found more dryness.
My body felt hot. Warm with embarrassment and frustration.
I felt like a failure when I pulled out the needle and handed it to the other student to try.
When the senior resident came over to try after our failed attempts, I was amazed by the assertiveness that which he conducted himself. Even when he was unable to find a tap at the level we were working with, he showed no signs of panic and methodically adjusted the needle whilst explaining his thought process. When he decided to go up a vertebral level to attempt the tap, the fast success and clear dripping of precious CSF left me humbled and awed. To me, the stark contrast in our capabilities is separated by experience. How impossible that seems. At my level, I cannot even fathom that kind of confidence. I know that doing many of these over and over again will eventually come to this level of expertise, and it simultaneously terrifies and excites me.
It wasn't a phenomenal milestone, but I felt like I have made another small stumble towards my dream of neurology. Being able to attempt a lumbar puncture felt so tangible, as if some sort of rite of passage - a step of commitment towards this lifelong passion.
Well, I've ranted long enough. I hope this was entertaining at the very least.
I love the satchel of tools that seem exclusive to neurologists. I love the subtlety in physical findings that are necessary for diagnoses. I stand in awe as the attending and residents discuss neurological problems at all levels. It's a different kind of awe that I experienced during third year. In medicine, I remember rendered speechless by the vast knowledge repertoire that physicians exercised daily. It was incredible to watch them pull out bizarre diagnoses out from their hat and piece together seemingly random pieces of information. It was inspiring because these are features that I still struggle with now.
But neurology.
It's the depth and thorough understanding of such bizarre and complex diseases that astounds me. Everyday, I learn that there is so much more to these seemingly straightforward diagnoses. I am humbled by the easy acceptance to my eagerness to learn and their eagerness to teach. Their patience is so nurturing. So permissive. Why wouldn't anyone want to learn and grow from these opportunities?
Today, I got to attempt a lumbar puncture. We had a few opportunities to practice on models before, and I watched one done prior, but I had never thought I would be allowed to try one. Thankfully, we had an extremely compliant patient who was knocked out, so we weren't afraid to try our hand at it. It was an enlightening and humbling experience.
I felt so lost and uncertain of what I was trying. Once again, I am reminded that textbook descriptions are such pale representations of the reality. The distinct "pop" was ever elusive, and I felt I was fishing in an ocean of uncertainty, the needle aimlessly wandering for its target. The resident coached me through it and provided me with suggestions of adjustment. I was looking for a change in texture. It wasn't supposed to be earth-shattering.
I tried many times, feeling that I had it a few times but only found frustrating dryness when I retracted the needle to test for flow. A few times, I even felt certain there was a change in density and texture, but alas, no luck. I caught a glimpse of glistening wetness at the puncture site, but no matter how I tried, I either hit bone or I found more dryness.
My body felt hot. Warm with embarrassment and frustration.
I felt like a failure when I pulled out the needle and handed it to the other student to try.
When the senior resident came over to try after our failed attempts, I was amazed by the assertiveness that which he conducted himself. Even when he was unable to find a tap at the level we were working with, he showed no signs of panic and methodically adjusted the needle whilst explaining his thought process. When he decided to go up a vertebral level to attempt the tap, the fast success and clear dripping of precious CSF left me humbled and awed. To me, the stark contrast in our capabilities is separated by experience. How impossible that seems. At my level, I cannot even fathom that kind of confidence. I know that doing many of these over and over again will eventually come to this level of expertise, and it simultaneously terrifies and excites me.
It wasn't a phenomenal milestone, but I felt like I have made another small stumble towards my dream of neurology. Being able to attempt a lumbar puncture felt so tangible, as if some sort of rite of passage - a step of commitment towards this lifelong passion.
Well, I've ranted long enough. I hope this was entertaining at the very least.
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