A Take on Neurology

“Neurology is a very special field in medicine, it is one field where you will find it interesting to diagnose but saddening for there’s often no cure in neurology unlike other field of medicine.”

That was how one of my clinical lecturers introduce us, the evergreen medical students to the field of neurology,the field of the brain, the king of the body kingdom,to whom all the organs under it listen. Neurology, more often than not, is said to be the pinnacle of the field of medicine,the hardest field to study and master. The cream of the crops is often associated with it. Only the best brains study it. At least, that is what I think.

When I heard those words quoted by my lecturer, I didn’t know how true they were until I come across patients saddled by diseases like Parkinson, epilepsy, paralysis and etc. Those diseases don’t kill you, at least physically. They eat away at people’s lives bit by bit, day after day, often breaking people’s steely determination and stretching the patience and supports of people around them. In those trying times too, one can see how some people can give so willingly and support those who suffered from those debilitating disease. Those times are also when relationship are severely brought to test. I was bout to tell you a stoy here…….
It was another one of those days where 24 hours don’t seem to be enough for a medical student like me to use. For every pages read, there are another 10 behind it. For every diagnoses you manage to give, there is always a few more to throw in as differentials. Tutorials filled most of my time for the day and I had a clinic to attend to around 15 minutes away from the main hospital. Rushing and panting,all the while munching the lunch I just bought, I finally reached the clinic.I knocked on the door just in time to see the doctor warming to his seat. With a practiced tone and lines, I introduced myself to the doctor on duty and duly found a chair to sit down and observed the doctor at work. The doctor then called the patient name through a loudspeaker and then we waited.

Ah…..it was going to be a another sleepy afternoon,I thought. The door then slowly swung open, and a smiling old lady came into our view. One of the most important thing I have learned in medicine is observation. I noticed that her arms made some seemingly involuntary movements and made a mental note of it. She wasn’t very steady on her feet as well. Parkinson’s topped the list of my differentials,more like I had only one thing on my differentials. There were probably other few differentials that the neurologist on duty might know and I didn’t. Mrs. Carter* smiled and greeted us from outside the door, and then she turned around and walked back into the corridor she came from. I was rather surprised and thought probably she thought she had come into the wrong room. The doctor was unmoving. I was about to reach the door when a pair of legs sitting on a wheelchair came into my view at the door.

It was her husband. With some short and slow careful steps, she wheeled her husband into the room and I quietly settled back on my seat. After some short talk, I found out that her husband was a Parkinson sufferer as well and had a couple of falls over the past 6 months due to his unsteadiness and she had been taking care of him. His last fall was pretty bad that he had to be temporarily confined to the wheelchair.The occasional interruption in her speech by the involuntary movements of her arms and body while we were talking didn’t take her smile away,even for a moment.From a clinical point of view, her husband seemed to be in a worse condition at the moment.He couldn’t speak properly or stand up.

In order to have a more objective assessment of the severity of his condition, the doctor had him to write his name and date on a piece of paper. With some difficulty caused by her dyskinesia(side-effects of long term leva-dopa), Mrs. Carter picked up a pen on the table and put it in her husband’s hand. It was no easy task for her dyskinesia was interfering with her voluntary movements. However,she seemed to be happy to put the pen in her husband’s hand on her own,without the doctor’s interference or mine.In a very gentle and sweet voice, she conveyed the doctor’s instruction to her husband. There were a few times the pen fall out from his hand and Mrs. Carter,without a single sign of annoyance and losing her smile,each time,she patiently put the pen back into her husband’s hand.

I couldn’t help but felt touched by such portrayal of love and compassion for loved ones. I was pretty sure the doctor sit back too to witness humanity at its best, despite the long queue of patients outside. The writing task took Mr. Carter around 10 minutes to complete. I was sure that he was trying his best with his wife quietly urging him on. Sadly though, Mr. Carter’s parkinsonism seemed to have deteriorated over the past months despite the best of the medical treatment. Mrs. Carter certainly didn’t show any sign of disappointment despite the bad news. She probably saw it coming. I think the doctor made a few calls and suggested to change his medication and then wait and see. I wasn’t really paying attention. I was trying to hard to swallow what I just witnessed.

The last few memories of her was how she thanked us with her wrinkled smile and slowly and unsteadily wheeled her husband out of the clinic,out of sight.

Honestly,how many among us would love and support our loved ones so selflessly and unconditionally,I wondered.If the guy who once bought you flowers and said the sweetest thing to you is to be paralysed and confined to a wheelchair due to a fall from a horse,would you still stick by his side,supporting and feeding him?If the girl to whom you once said you’d be forever with her had a bad burn on her face,would you still keep your promise?Till death do us part.I wonder whether if I can really hold on to these words at all.Or is it just a part of my idealism?
May God bless their souls.Adios.

*This is a purely fictional story,any similiarities to real a life person’s name or experience is purely a coincidence*

5 Replies to “A Take on Neurology”

  1. sweet. ya here i saw a patient like that too – stroke pt, but the wife takes great and loving care of him. So amazing..