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Round Two of Neuro Block

Posted Oct 23 2008 2:03pm
I had a lot of work to catch up on from last week over the weekend, which meant that I spent most of a very beautiful fall weekend indoors reading about addiction. It didn't quite drive me to drink, and maybe there's a future career for me here, because I actually got all of the SAQs right. (The SAQs are those multiple guess questions we have to do each week.) I have never done that before. The less good part is that I didn't really have much chance to do this week's reading, which means I am as much behind so far this week as ever. Plus, I have a paper due for my MS class on Thursday, so it's not going to be an easy week.

Monday we started our new PBL case, and the patient is in a coma. That is our theme for this week in general. The neuro faculty have been doubling up on the seminars, where we have two one-hour seminars instead of one two-hour seminar each day. The bad thing about that is that they're also assigning us double the reading in a lot of cases. The seminars have been very good though. Yesterday's were on the anatomy and pathology of stroke. The other good thing is that the readings overlap in topic quite a bit, so I am not totally lost in class even though I've been coming in having only finished half of the assigned reading for each seminar.

Today we had a neuroanatomy session. Like last time, they divided us into two groups. One part reviewed the vasculature and ventricles of the brain using models and preserved brains, and the other was a series of questions and cases. The FCM session afterward was about surrogate decision making, which we had already talked about once last year. It wasn't the greatest FCM session, but it wasn't absolutely horrible either.

I had clinic this afternoon, and it wound up being a busy day. The most interesting patient I saw was a guy who was in for a follow-up for hypertension. That didn't sound too exciting initially. But while I was taking his history, he was telling me about his life. It turned out that he was a retired garbage collector. He never went to high school, and after he retired he decided to start taking GED classes. He is old enough to be most of his classmates' father or even grandfather, but he said he was determined to pass the test and earn a high school diploma. I thought that was incredibly impressive and inspiring. When I presented his history afterward, I was amazed to learn that my preceptor, who has cared for this man for several years, never knew that he only had an eighth grade education or that he was working on earning a GED. My preceptor commented that it was common for doctors to just hand printed instructions to patients without ever considering that some patients might not be able to read them. This just proves the point that not obtaining a patient's education level and occupation as part of the history really can affect the doctor's ability to provide the best possible care for that patient.
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