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   Witnessing a seizure is a very frightening experience.  Parents who witness seizures in children fear for their child’s life.  It is extremely traumatic.  Even now, as a trained professional, knowing all the steps I could ever need to take care of the problem, I will feel my heart rate climb with a knot in my stomach as adrenaline starts to flood my system to this day.

      So it’s not surprising that in the past, seizures were thought to be caused by demonic possession.  Many an epileptic in the middle ages were treated with exorcism.

Matthew 17:15- "Lord, have mercy on my son: for he is lunatick, and sore vexed: for ofttimes he afalleth into the fire, and oft into the water."

Matthew 17:15- "Lord, have mercy on my son: for he is lunatick, and sore vexed: for ofttimes he afalleth into the fire, and oft into the water."

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First Published January 15th 2008.

     I work up close and personal with disability everyday. When people found I was going into child neurology their first question was often, “why”? I often hear about how it’s too sad or too depressing.

Fellow physicians struggle with the fact that there often isn’t anything we can do to fix severe cerebral palsy or neurodegenerative disease, to name but a few. There is something in our nature that makes us shrink from the deformed and debilitated. Read the rest of this entry »

 

    Di at Doctor and Covenants pointed me to this story, where a brain surgeon was operating to remove a mass from a patient and and ended up finding a foot.  The story states that this is either a rare type of tumor called a teratoma or is it a rare case of a twin that remained attached to the patients and was totally enveloped into the skull, a condition called fetus in fetu.

         The image is striking, and gives a certain visceral reaction, which is largely why pictures like this make their rounds on the internet.  Read the rest of this entry »

   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.

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His room was a shrine to his own memory, a eulogy for a still living, and breathing child. Pictures adorned the the door and the wall, smiling, vibrant, full of life. This boy last week was a healthy, happy, growing, developing two year old child. Colorful children’s crayon scribblings were placed at strategic intervals to liven up the cold, stark hospital room. Get well cards from extended family are also peppered around the walls. Over his crib, lies a recent portrait, the big smile and engaging eyes standing in stark contrast to the current blank stare. His limbs lay motionless, stiff, rigid, spastic, with toes pointed, betraying signs of a brain ravaged by lack of oxygen. He has been having seizures, with eye fluttering, and facial twitching about multiple times per day despite two anticonvulsant medications. This and breathing are the only spontaneous movements he makes. All this, the result of a single grape.

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Choosing on a medical specialty involves learning your own answers to a series of questions?

-Do I enjoy patient interaction or not?

If no, consider Pathology or Radiology

-Do I like surgery and procedures more, or medicine and clinical reasoning, or both?

note- Anesthesia is a procedure and OR specialty, sort of surgery-lite.

Both- Ophthalmology, Orthopedic Surgery (well peds ortho anyway), ENT, Ob-Gyn, and Emergency medicine for procedures

-Do I prefer general, broad knowledge or limiting to one area or system, Primary care or specialist?

This is often a question of knowing a little about a lot, or a lot about a little.  However, It also involves whether you prefer relatively healthy patients or relatively sick.

-Do I do I prefer to see kids, adults, or both? (remember you can do almost anything for kids that you can for adults.)

The last question was easy for me.  From my point of view, pediatric care is superior to adult medicine in so many ways. Read the rest of this entry »

    I have always been shy, well, not just shy, but painfully, exceptionally, extraordinarily shy.  I have a deep, irrational fear of rejection, the technical term is social phobia.  One on one, given time to feel out absolutely no threat, I can interact with others very well.  In a new situation, or particularly with groups, I am paralyzed.  It has haunted and hamstrung me most of my life, but never at anytime more than when I decided I might have the ability, the drive, and the heart to be a physician. Read the rest of this entry »

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