Block 3: Neurology

The past 3 weeks have been a blur!  I've loved neuro, but hated my quality of life.  During week 2, I worked 94 hours!  I didn't even know that was possible.  But I loved what I was doing, and I was excited to go to work every day.  I enjoyed neuro much more than I expected, and I think that was because (much like internal medicine) it's a puzzle.  You have to take the history, the physical exam, and the neurological exam, and put them all together to localize the animal's problem.  It was frustrating at first, because we'd only had 1 lab session about neuro exams.  I remembered a lot of what we'd learned, but it takes a really long time to do a neuro exam if you have to pause after each test to remind yourself what's next.  By the end of the block, I was much more efficient with my exams and much better at listing likely rule-outs.  I thought for about 10 minutes that I wanted to be a neurologist, but then I remembered that I don't really like surgery...that won't really work!

I saw 2 surgeries: a cervical (neck) dorsal laminectomy (removing bone to access the spinal cord) to remove a meningioma (locally invasive tumor) on an American Bulldog, and a thoracolumbar dorsal laminectomy for Type 1 IVDD (intervertebral disk disease) in a Dachshund.  My job during the tumor surgery was to flush the site with sterile saline and suture the drain into place.  For the disk surgery, I actually got to chisel away some of the bone...scary but really awesome.  Surgery is a great part of neurology because, depending on the problem, you can improve the animal's quality of life almost immediately.  (Not to mention that it's pretty cool to look down and see the spinal cord!)  It's very delicate, though, and can take hours to complete.

I've now had a euthanasia on every block.  I wasn't there for the first 2, as I had transferred those patients to other services before they were euthanised.  This time, I inherited a patient from a friend who had sent the dog home after seeing great improvements.  He came back a few days later, unable to walk and having seizures.  We nursed him for a week before his condition worsened and he developed complications that made recovery unlikely.  I sat with him for a few hours last weekend while we waited for the owners to arrive, and I hope it made a difference in his last hours.  His owners fed him his favorite treat for his last meal: peppermints.

I've gotten more encouragement to pursue an internship, so that's a decision I'll be making in the next couple of months.  I'll need 3-4 letters of recommendation and an amazing personal statement, so that will take some work.  I've signed up for the NAVLE (licensing exam) and the online study materials.  Things are moving quickly!  Only 2 more blocks before I get to spend 9 weeks away from Blacksburg...3 of them on the OBX!

Speaking of not liking surgery and having a poor quality of life: next block is orthopedic surgery.  I'm on call 1 day every weekend and a couple of weekdays, and I'm sure to have patients in the hospital nearly every day.  I've gotten pretty good at keeping my head above water with very little sleep and an irregular eating schedule, but it's really not a good way to live.  I hope my next entry will reflect that surgery is much more fun than I expect it to be.