Currently on neurovascular ICU at Moffitt and enjoying it. The residents are amazing, the faculty are wonderful and the teaching is impressive and inspiring. In fact, everything about the neurology program at UCSF is inspiring. Tomorrow will be my third day off in 3 weeks, but neuro has been a very formative experience that will help me be a better doctor.
Valuable teaching:
1) from neurovasc fellow: stop using algorithms to treat patients, use them as guides but remember that every patient is different with different treatment plans. being able to manage complex patients and make complex decision-making is the difference between a great doctor and a mediocre one.
2) a good history and physical is the foundation of any good management plan
3) stop giving patients multivitamins, it's just one more pill (again, see rule number 1)
4) always localize the lesion first
5) learning how to sift through information is more important than coming up with the diagnosis when you are learning
6) diagnosing patients early can still help them plan their lives, even if there is no treatment
7) enjoy your life
8) Find your platform
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I really liked neuro at Moffitt-Long. Well, except for Raskin's migraine service. Whole bunches of migraineurs do not make for a fun time.
The senior neuro attendings were distant but the younger faculty were good teachers. The pedi-neuro staff were more casual and warm.
My memories blur together now. A few moments stand out, mostly the ones where I felt bad about something. I remember rounding one morning and getting asked if I'd found the answer to a question. Maybe I was supposed to pull an old chart or call someone and I didn't. I can see the attending's fixed stare at me and hear him say, "That's your job," like I was a fookin' idjit.
The reprimand made an impression. Hopefully I learned my lesson, but who knows?
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