Monthly Archives: June 2016

I’m a Little More Cynical, But at Least I Still Have a Heart

It’s a well known fact that medical students tend to excessively self diagnose. As we are a generally healthy cohort, it’s highly unlikely that we actually have any weird diseases, but every few weeks I study something and I feel the thought grow in the back of my mind….”I might have that!”. My classmate is terrible about this. He has spent the last week convinced that he was developing ALS, as he thought he was experiencing paresthesias in hands. He even went to the EEG lab to try to get them to “demonstrate” a nerve conduction study on him. I have a hard time believing anything he says, but I¬†know what he’s thinking.

Most recently, I’ve been thinking I might be coming down with early onset dementia. Technically, I suppose it is now called neurocognitive decline, as dementia has that whole connotation of being possessed by demons, and people tend to not like that as much. I have been noticing some early symptoms of early neurocognitive decline, and my wife could certainly vouch for several of them, so I’m still a little worried.

Essentially, I have the same problem as my aging laptop computer. I don’t multitask well, randomly lose important items in my memory, and overheat when I am even mildly exerted. My procedural memory is still intact, and I am pretty sure I am lucid, but here I am writing to strangers (and my mom) on the internet about my perceived medical conditions, so that even my sanity could be questioned at this time. Plus, I keep showing up for medical school every day when all I really want to do is sleep and pursue my budding career as a musician. Just kidding. I can’t sing worth anything.

I only joke about my own neurologic decline because I have to take a test soon, and those are regular reminders of my below average-ness. I have been fortunate enough to see some real, true neurologic dysfunction over the last few days, and it’s affecting me quite a bit.

First of all, my standards have dropped significantly. Coming from a family of high functioning people, I have spent most of my life expecting quite a bit from other people at their “baseline”. There are many reasons for this, but I used to expect people to be able to hold down a job, pursue hobbies, actively work to accomplish their dreams, and take care of the people in their lives who depend on them. Now I’m just excited when a patient shows up sorta on time for their appointment while wearing pants. “Normal” people that come in are unusual and really enjoyable to treat as patients.

A few days ago I traveled to the county jail and did a forensic psych eval on a patient to determine their competency to stand trial. This guy was nuts. He would sing random words, complained of multiple hallucinations, and would repeatedly interrupt you by screaming, then humming loudly with his eyes close. Here’s the thing: he was faking every bit of it. He was not schizophrenic. It was all a show. He was playing us in an attempt to get a court ruling of insanity. I’ve also seen kids faking seizures (while hooked up to EEG monitoring) for attention, I’ve seen inmates faking seizures and psychosis, I’ve seen addicts faking pain and withdrawal. I’ve seen patients get arms hacked off by machetes and drunks get in motorcycle accidents at 10am on a Tuesday. Overall, I’m just a little bit harder to impress than I was last year (but I’m still gullible and really dumb, so don’t get too carried away).

The best part about this whole crazy experience is that I really do like it. Of course there are rotations that I would describe as “less than interesting” but even then I can usually find something in their to improve on, whether it be physical exam skills, bedside manner, or just a lot of time to read and study (looking at you, family medicine), I feel like each day can be thought provoking if I want it to be.

And for the rotations that I like, days go by in mere seconds and weeks pass like nothing has happened. I enjoy those rotations and love the feeling of working hard. In that sense, medical school is pretty cool. I’ll graduate in less than a year now. If I still think medical school is pretty cool after this long, I can’t be that cynical, right? Right?

Thanks for reading!