Medicine for the brain is incredibly complex. Yet, the joke goes around medical circles that Neurologists are admirers of disease, not treater’s of it. This is far less true now than forty years ago, and is rapidly becoming less and less true everyday, but that small kernel of truth does say something about we who are drawn to the field. I really do find the disease processes that affect brain function seriously fascinating.
We learn almost everything we know about the brain from what happens when things go wrong. Genetic diseases become our laboratory, nature the experimenter, allowing us to learn things we would be monsters for trying to recreate in the lab with people. In fact, Nazi physicians are generally hailed as monsters for doing precisely this, reducing the person to lab rat.
Sometimes I wonder at what point am I supposed to feel guilty about my morbid curiousity. In conversation with each other, making a rare diagnosis, even if incurable, is an exciting development that we discuss with our peers. I am quite certain that the patient does not ever see it quite the same way. It is our curiousity that leads so many into the field of neuroscience. Finding the subject matter fascinating is critical to having robust science.
It has also on occasion caused twinges, or in worse cases, spasms of guilt in myself. This is true of medicine and doctors in general, but neurologists at the extreme. There have been many occasions when I have had to remind myself, I get to do what I love and enjoy for a living because it can be of lifechanging value to other people.
So it is out of a guilt born of an enthusiasm that leaves me struggling to always, always, remember my patients are not their disease. They are not interesting cases. They are human beings first and foremost. So if I ever seem a little self righteous in my fervency advocating for disability rights, please understand it is rooted in my own personal shortcomings.
Lest anyone go away believing the stereotype that Neurology is for people who don’t treat stuff, here is a word in defense of my field. It is very exciting and gratifying to belong to a field where the incurable is becoming curable. We are starting to unravel secrets of the brain and come up for treatments for the incurable or untreatable faster than any other field I know of. Neurology is the frontier, where medicine has work to do. To be a neurologist is to be a pioneer.
It is a great day, when we get someone in the office we can actually treat and fix. I recently saw an absence (Petit Mal) seizure patient in my clinic that made my day. It isn’t often we can take someone who has serious learning difficulties in school, slap them on antiseizure medication and completely turn their academic future around. I can actually say I gave someone’s life back that day. It keeps me going, with a cautious optimism for all the ones for whom I can’t say the same.