Monday, February 27, 2017

A Serious Mental Case And I'm Not Even In My Psych Rotation Yet

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     My brother Matthew is so strapped for cash that he has accepted a job of playing the piano for a local parish's Sunday 8:00 p.m. mass on any Sunday evening that he is not on duty. I went with him last night because he has never played piano or organ for a church service and I'm a lot more familiar with the music in relation to the liturgy than he is. The priest officiating at the mass was raised as an evangelical Protestant and apparently still carries a fondness for some of the tawdry praise choruses frequently sung in such settings. One of the songs the priest chose for last night was my new least favorite song ever composed, and it has been continually playing in my head since then. It interrupted my sleep, and it is interrupting my waking activities. I could tell you the name of it or even link an audio or video of it, but I do not wish to be responsible for the song being stuck in your consciousness as it is in mine. I seriously may have to consult a shrink. I really wish I were in my psych rotation, which I will start in early April, because then I would be seeing shrinks at work on a daily basis and could just ask one what to do when a really bad song is stuck in your head. I thought it was bad when I was stuck with  "The Battle of New Orleans" on continuous play, but compared to this song, "The Battle of New Orleans" is "The New World Symphony."

    Concerning rotations, the good news I can report is that my OBGYN clerkship is history. The bad news is that my neurology rotation has begun, and I wish I was back in the middle of my OBGYN rotation.

     I am made of straw and not of bricks or whatever the stuff is of which neurologists are made. I will get through this rotation, but I'm not quite sure how I will do so. It may involve a hell of a lot of alcohol during my time off. The temptation to turn to prescription drugs is strong, though I will withstand it. i understand now why we were subjected to such a heavy dose of anti-prescription-drug scare tactics.

     Yesterday I read a biography written by former professional tennis player Roscoe Tanner.  Tanner took Bjorn Borg to five sets in the 1979 Wimbledon men's singles final and was ranked as high as number four in the world for men's singles. Unfortunately, he developed spending habits that could not be sufficiently supported in retirement and has had numerous troubles as a result of writing huge checks covered by insufficient funds or no funds at all. His financial and other various and sundry misdeeds have resulted in eviction, bankruptcy, warrants for his arrest, extradition, and jail time. Tanner is an unlimited source of optimism as well as a born-again Christian. After each brush with financial ruin and/or brush with the law, Tanner vows to pick up the pieces of his broken life, but he ends up doing something incredibly stupid and getting himself in serious trouble all over again. I googled him out of curiosity. His most recent hit was in October of 2015, when he was arrested and jailed without bond for driving with a suspended license somewhere in Florida. God only knows how many prior arrests he would have had to incur to have been jailed without bond for driving with a suspended license.

     Roscoe Tanner told in detail of his jail time in his autobiography.  While for whatever reason his time was not quite so harrowing as some accounts of time spent in the slammer that I've read,  it was creepy enough to disturb me and to cause me to have bad dreams, complete with the awful praise chorus from mass playing in the background or forefront. The dreams are gone now that I am awake, but I'm still faced with a sense of foreboding as thought I were the one facing one jail sentence after another. This eerie feeling of doom so perfectly interfaces my rotation in neurology that it is as though I am completely and perfectly enshrouded in fog. 

     Today on the job really wasn't all that bad. I was assigned to intakes and consultations, which I will be for the rest of this week. This involves the residents and attending physicians (obviously not me, because I know nothing; I would probably send all the gravely injured or ill people home and admit the ones who have nothing significantly wrong with them, possibly even on purpose) dealing primarily with E.R. patients with either head injuries and stroke symptoms. This is as sunny as this rotation gets. From here I'll progress to sub-specialties in multiple sclerosis, Parkinson's, and seizure conditions,  then Alzheimer's, then the truly weird neurological diseases.

      I can deal with the fact that if a person's head is hit hard enough, he or she will probably incur some damage as a result. Even with the severely traumatic brain injuries, while I certainly hope never to suffer one or have to deal in my personal life with anyone who has, worry about that prospect is not something that keeps me awake at night or invades my dreams. It's Alzheimer's and the weird stuff that gets to me.

     My single greatest strength (and also one of my weaknesses) is my OCD memory. The idea that there is disabling condition out there that, according to current knowledge, anyway, strikes almost randomly (some of the very early onset cases are documented to have clear familial links, but there's no real proof yet other than that) and systematically robs a person's mind of everything he or she has ever known yet sometimes leaves him or her alive in a virtually- vegetative-to-bona-fide-vegetative state for up to five years, is a frightening prospect.  I can accept the premise that if  a person lives long enough, he or she will quite possibly grow a bit forgetful before leaving the planet. Mildly forgetful and Alzheimer's are two very different states, though.

     The weird stuff is not much better. Guillain-Barre Syndrome seems to strike somewhat randomly, but it's one of the illnesses we've all heard about. There are hundreds more that have very bizarre symptoms. You or I could come down with any one of them. When I committed them all to memory in the first two years of medical school, I was able to distance myself from them because they were only odd symptoms I committed to memory; there were no real people representing these freakish symptoms. Now the real patients will be coming sooner rather than later, and I shall have to see many of these conditions up close and personally.

     The bottom line is that I am simply too much of a hypochondriac to be in medical school, but 2.66666666 years and more than $50,000 (in tuition alone) later, here I am, and I've invested far too much time and money to back out. Granted, there are branches of medicine that will not totally cause me to go off the deep end and in which I can arguably even be happy, but I have to get through the rest of this horrible stuff (for good reason; I'm not suggesting that physicians and surgeons shouldn't have a foundation in all areas of medicine) both in clerkship and internship before I can pursue something that doesn't turn me into a complete raving demoniac.

     Maybe every medical school student goes through some form of this psychosis or whatever it is, though probably not quite so dramatically as I am suffering through it. I'm a drama queen; I readily admit it. I would ask my dad about it except that I refuse to admit to anyone in real life that I am struggling. (They don't bother reading my blog any more, so I can safely say it here.) I positively hated OBGYN, but I got my scores back early because I turned in my paperwork early, and I did remarkably well there as far as test scores and evaluations went. The attending physicians thought I was just peachy. They never deduced just how much I detested their specialty. I'm going to do the same thing here, which is to fake it and make these people think I am the most professional and enthusiastic future neurologist on the planet and that I am positively enthralled by everything they do in their specialty. By that time I'll be through with this rotation and onto the next one, and eventually through my internship as well. Then I will never go near another neuro patient again even if my life depends on it.

     I've been on duty since 3:30 a.m. God help me and every neurology patient who comes anywhere near me. 


  1. Hang in there, Alexis. This will pass like crap through a goose.

  2. Two ways to get rid of an earworm are to pass it on to some other poor unsuspecting schmuck or replace it with something more pleasant.

    I always figured pathology would be a good way to go as less patient contact during my curmudgeon years would be beneficial to all involved. You'll make it through neuro just fine. I always thought the rare and weird diseases were the most fun.