dance and to the OR has earned us . We perform a stroke-tailored neurologic exam after 24 hours , and compare it to the one I performed in the ER , to document the improvements made .
But in the busy rush of my life , I forget to check the chart the next day . My schedule is frequently disjointed ; I ’ m not on a stroke rotation at the moment , but I come into the hospital for weekend and night calls , where I make life-changing decisions but I don ’ t always get to follow-up . At the end of the shift , I go home and back to regularly scheduled programming , which this month involves outpatient neurology clinic . I get lost in the world of anti-seizure medications and cognitive evaluations and migraine headaches ( sometimes my own ). The clinic days are certainly different from the acuity of being on-call , but they come with their own stresses .
It sounds strange to say , but sometimes the best parts of my day , whether in the hospital or clinic , are the completely unplanned encounters that happen when I step into the elevators .
Once , as I was preparing to ride up to the fifth floor of the children ’ s hospital to start my shift , the doors opened to reveal a baby in a stroller with his parents . This was such a normal image to me that at first I didn ’ t blink . Then I recognized him , and my eyes went wide .
“ Henry ?”
The recognition blooms on Henry ’ s parents ’ faces , and we stand in the seam of the elevator for far too long , holding it up for other passengers , because the last time I saw Henry he was intubated , almost lifeless , having seizure after seizure . Now he ’ s sitting up in his stroller , cooing and grinning , and I ’ m cooing and grinning over him . We get to catch up for 60 seconds , before they have to head home from their routine appointment and I have to get to work . My day is brightened immeasurably to see a patient , one I was scared was circling the drain , looking so healthy and normal .
Once , as I was standing in an elevator heading down to my lunch break , I turned my head to see Mr . Jones , a patient I once evaluated in the emergency room whose Parkinson ’ s disease was so debilitating he was almost frozen , rigid as a board . We said our hellos and how-are-yous and when he got off on his floor , he walked handin-hand with his wife with smooth , uninhibited motions , without his previous stooping posture and shuffling steps . His medication had been optimized , allowing him to stroll down the hall as any normal man might have done . “ You look great !” I called after him .
On this particular evening , I ’ m leaving the hospital after an especially grueling call shift . The best part about my day was that I hadn ’ t crashed my car on the way in . I press the button and wait for the elevator to climb all the way up to the ninth floor and take me away .
A woman travels down the hall , leaning slightly on the arm of her daughter , accompanied by a nurse , bags and a vase of flowers . They have the look of a discharged patient finally heading home . I glance over , and it takes a moment to sink in . She is the patient from a week ago who was paralyzed and mute , who had a thrombectomy and whose chart I forgot to check .
“ Going home ?” I ask them casually .
The daughter nods , and she doesn ’ t recognize me . That ’ s okay . We only knew each other for six minutes .
“ You probably don ’ t remember me ,” I tell them , “ but I was your doctor the night you came in . It ’ s so nice to see you .”
They tell me about how she ’ s doing now . She has some minor weakness in her hand , and isn ’ t as fluent with speech as before , things that can be ironed out with good physical and speech therapy . We get on the elevator , and then go our separate ways with a simple goodbye , hopefully never to see each other again .
The best parts of my day are these simple , chance meetings , in which the previous paradigm of neurology is consistently and wonderfully turned upside-down .
Dr . McCoy is a rising PGY-4 resident in child neurology at the University of Louisville .
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