The blast of winter weather outside did not help matters. Throw into this somber situation, a good number of patients who seem to be stroking out for no good reason. What did these people do to anger their brain? 20, 30 and 40 year olds showing up in the ER without the ability to speak, numbness...it just didn't add up. There was dicussion of the usual rare conditions that can cause strokes in young folk, but I still refuse to believe that 3 people admitted at the same time all suffered from moya moya, a rare condition typically only found in japaneese kids.
The moya moya discussion was pretty funny, though:
Attending: "So, what's moya moya?"
Student: "Isn't that a kind of fish?"
Attending: "No, that's mahi mahi"
After two more weeks of Neurology, I am going to be in Bowling Green for 4 weeks, doing a homecare rotation. As part of that rotation, I also get to spend a week in Jamaica, doing international work. Afterwards, it's off to Uganda for a month for a peds/adult rotation. All around, it will be fun to try to graduate without having contracted malaria.
Oliver Sacks, the famed doctor/writer, wrote a book called "The man who mistook his wife for a hat". It's called prosopagnosia, one in a number of "agnosias", where a patient does not recognize something, whether it is a loved one's face or an entire side of the his body or even the fact that anything was wrong with him or herself. I saw the first patient with neglect this week, and it was striking. He simply refused to acknowledge the right side of his body. You move to his right and all of a sudden, he would not respond to you, would not even look at you. I wonder what his visual field looks like; it wonder if it is somewhat analagous to watching tv with half the screen blacked out.
The entire stroke team, all 12 of us, crowded around the patient, along with his family, and watched him fail auditory and visual tests. He couldn't speak, his arms limp, his face without any expression.
I watched this documentary once where a pride of lions surrounded a hurt female and simply stood there, their manes hung low, watching the female lick her wounds, knowing that there was nothing they could do.
