My 5th term as a medicine resident, and my neurology rotation. Eager and excited i began two months ago, hoping to finally solve some of the mysteries that have so far always eluded me. But as i understand more, i also realise ,just how much we still dont know. The human brain is probably the most intricately designed circuit of all time! And the more we image , the more we biopsy, the more we study, we still so very often draw a blank, at what it is that has actually gone wrong.
And besides the neuropsychiatry component can never be ignored. A patient so often confuses you, and the most important, is to distinguish whether the complaints are organic or functional. Or simply put , whether his brain is conjuring them up or he actually has a disease to go with them.
The importance to be patient, understanding has never been more strongly impressed upon me. An important part of a neurological examination is history taking. A good detailed history, can be extremely helpful, and many a time extremely misleading. But that is where our skill as doctors comes into play, to separate and sieve through the mishmash of symptoms presented to us and figure what may be relevant and what may not.
And so as i learn and understand more, i also realise just how much i dont know.
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