Brains , Billy Joel & The Best Part of My Day
by COLE DOWDY
The sun has yet to rise . And here I am , once again , walking towards the hospital . I don ’ t mind the walk ; it gives me 15 minutes with Billy Joel . I put my headphones in .
“ Slow down you crazy child You ’ re so ambitious for a juvenile But then if you ’ re so smart tell me Why are you still so afraid ?”
If my coffee hasn ’ t stirred me from my slumber , the cold air certainly has . I make my way through the dark , admiring the hospital lights before me . I wonder if there may come a day when the allure of those lights dims . For now , they continue to beckon me .
I veer right and clear the crosswalk . I ’ m almost there . I take a long draw of coffee and soon my feet find steps . Moments later , the sliding doors collapse , and I am welcomed by the sanitized warmth of Jewish Hospital . Another day working on the inpatient neurology service has begun .
This is a busy service . Every day I care for patients with acute strokes , new onset seizures , multiple sclerosis flares ... the list goes on . The rotation is difficult , but my team is a joy to work with . And I have enjoyed the content .
I switch into doctor mode . This mode is analytical and ambitious — predominantly left-brained , a neurologist might say . I walk into the workroom and lay down my belongings . Before leaving to pre-round , I glance at an MRI from yesterday with one of the residents . I try to keep up as the GRE and T2 flair images flash before my eyes . Just look for a different shade of white or grey . Sadly , this time the pathology is obvious , with T2 flair showing an impressive case of temporal lobe encephalitis . I log on to review the chart of a different patient that I am told to go see . My resident primes me that she looked Parkinsonian yesterday .
An elderly woman in her 70s , she has had chronic intermittent syncope ( for nearly 20 years !) without one full workup . According to her , the total number of syncopal events ranges from three to five . We were consulted for concerns of altered mental status during her hospital stay and ruling out seizures as the etiology of these syncopal episodes . Cardiology was also consulted . They completed an EKG , and the echocardiogram results were pending . I gather my tools : a stethoscope , pen and pad and reflex hammer . Alright , let ’ s go .
I walk across the unit to the room . With a knock on the door , I step inside .
“ Oh , she ’ s on the toilet come back in a second !”
22 LOUISVILLE MEDICINE