MedEx Day 12

I started off the day very excited to shadow the Neuro ICU, but I wasn't sure what to expect. This was the first time that I would be shadowing in critical care, and I didn't know what I was about to see, and how jarring it would be. I waited for a while in the waiting room before I realized that I needed to go up to the closed doors and press a button. Luckily, I came in at the right time as I was placed with a nurse practitioner as we waited for the arrival of the physician, which was soon. I realized that before the actual rounding started, the staff would catch up with each other, and also tell jokes and laugh. I understood that it in the environment with critical patients around it is important to not be completely solemn, but it felt weird to be talking and laughing in the same area where patient could barely move at all. I realized that there is an interesting duality that has to exist within healthcare. In order for the employees to not go insane, they have to have some enjoyment with each other, but at the same time they are surrounded by people who are having the worst days of their lives. It's the mixture of health and illness, happiness and sadness. Later, Dr. Naresh Mullagari walked into the start rounds. Immediately, all of the nurses and techs started to catch him up on the current vitals and states of the patients. What I didn't expect with a doctor and his team is for him to almost be a "teacher". As they would fill him in on the status of the patients, he would ask thought provoking questions that would stump some of them on the biology/anatomy of what was going on, and possible treatments. There was even a resident doctor that he would ask questions to when looking at a CT scan on what the sinuses were. What surprised me was that the resident doctor didn't seem to know some of the answers to his questions, even though he had already finished medical school and specialized in neurology. I always had the idea that a resident doctor had to know pretty much everything once they go into residency and use that information to work on patients. However, I realized that they are truly still undergoing a learning process with the attending, and it took a weight off my shoulder.

What shocked me most about the neurology ICU was how almost aggressive the doctor had to be when dealing with patients whose state caused them a lack of communication. For example, the doctor came into a patient's room and started yelling directions at him such as "can you do a thumbs up" or "can you stick out your tongue". Sometimes he would even repeat himself. It was truly hard to imagine being virtually stuck in your own body like this patient was, and even worse he was leaking out of his sinuses from his brain. There were multiple patients who were suffering from neurological diseases such as this, and it was hard to imagine dealing with patients at this stage every day. I especially felt for their families who would struggle to communicate with their loved ones.

We also saw a patient with an extremely rare neurological disease that they were struggling to find the cure to. The doctor mentioned there was lots of interesting pathology associated with this disease, and I was immediately excited. They explained his CT scans to me, and I was able to see the dead brain tissue on the scan, as well as the hole that had formed in the brain. It was shocking to see him hooked on to so much medication and vital sign monitors. He also exhibited no movement, almost like he had been in this state for a while. It made me realize that I was still passionate about finding a cure for a disease such as this patient had, but I wasn't sure I could handle seeing the horrific state of this patient. I even saw his wife come into the room and hold his hand, but he couldn't speak or move. It was very emotional to see. Overall, I saw so many loving families come in to visit their relatives and loved ones, and I realized as a healthcare worker that I would not just be helping a patient live a better life, I would also be helping the families have more time with the person they care for so much. It is truly inspiring.

Overall, I find neurology somewhat interesting, but the ideas they talk about are extremely complex, and I still feel as though I have a stronger connection to patients within the oncology field, most likely because of my dad.