Is neuro over yet?

3 more weekdays of neuro rotation (not that I'm counting), +/- 2 weekend days if I'm unlucky and manage to snare an inpatient for the 4th weekend in a row.

Sigh.

I did get to visit the VTH on each of the 3 mornings of this past holiday weekend (self-pity much?). My inpatient was a 12 year old Beagle who had an acute onset of inability to walk on her hindlimbs on Thursday, which is when she came to the VTH. MRI on Friday showed spinal cord compression, probably due to an acute disk herniation, so off to surgery we went on Friday afternoon. What with 12 year old dogs not healing quite as fast as 3 year old dogs, and all that, the dear Beagle got to spend a "bonus night" in CCU, beyond the usual 2 nights post-op. She went home with her owners yesterday, just in time for me to start my second (and final!!!) week of neuro.

Last week was okay in some ways and annoying/frustrating/irritating in others. The "okay" part was that we got done pretty early in the day (and by "early" I mean that I usually left between 5:30 and 6:30). My weekly hours from Monday through Sunday totaled a mere 54 -- positively relaxing!

I guess that's all I can think of for the "okay" part. On to the irritating parts: The doctors (1 faculty neurologist and 1 neuro resident in her last week of residency) had very little interest in teaching us. They showed up late almost every morning, whether that was late to rounds or late to a morning meeting time we'd agreed upon over the weekend. They would blithely rush through procedures and exams with nary a word of explanation to us students, and often with a great sigh or eye roll if we dared to ask a question about what the heck they were doing.

The faculty neurologist in particular had a horrendous attitude toward just about everybody else in the VTH -- clients, interns, lab personnel, receptionists, other departments, etc. I'm not sure I ever heard him speak to or about somebody else without a tone of arrogance, condescension, and derision. As an example, one of the patients we saw had been referred to the teaching hospital by another board-certified neurologist about an hour's drive away. Upon hearing her name, instead of saying, "She's not one of my favorite people" or "I prefer not to work with her," our faculty neurologist stated, "God, I hate that f***ing woman." Professionalism, where are you??

This attitude continued: About a prospective client trying unsuccessfully to send digital video of her dog's neurologic signs, he commented "Are they stupid or idiots or just trying to make my day even worse?" There was a huge fiasco when the doctors were only able to obtain a small amount of spinal fluid during a spinal tap, and thus had to submit several slides of the fluid to the lab rather than vials of fluid, as is usually preferred. On the lab report, there was a comment about the results being limited because the submitted sample came in the form of slides, not actual fluid to work with. Our faculty neurologist flipped out, raging about how condescending the clinical pathologists were, how it was so out of line for them to imply that he was stupid or incompetent, and how he was sick of people trying to tell him how to do his job. When he received a page from someone saying "If you're not busy or you have a moment, could you please call code #11," he derided the caller, muttering "Oh, like I'm not busy? Like I'm just sitting here twiddling my thumbs just waiting for someone to page me?" One of my favorite occurrences was when the faculty neurologist and the resident walked into the (approximately 10' square) neuro rounds room, loudly discussing how the senior students that come onto neuro rotation are never prepared and can't remember even basic information and how frustrating it is to deal with all of us, when us 3 seniors were already sitting in the rounds room, and the doctors continued their conversation about our incompetence as though we weren't even there. (Never mind that they are the ones that have been teaching us neurology for the last 3 years; never mind that theirs is one of the only specialty departments in the VTH that doesn't provide an orientation handout or list of topics to review before starting the rotation; never mind that, although we are still student doctors with a great deal to learn, we are nonetheless human and don't enjoy being mocked.)

Teaching moments last week were very sporadic; we never had afternoon rounds and only had limited morning rounds due to the doctors' tardiness and disinterest in going through learning topics. After the first couple days, we gave up trying to ask questions and get explanations for things.

Well, fortunately both of those doctors are off clinics this week and we have the other faculty neurologist on with us. He certainly has his own quirks and isn't perfect by any means, but in relative terms, it's a complete 180 from last week. We spent probably 4 hours during the course of today just sitting as a group and discussing cases and topics. He asked us to start a list on the board of things we'd like to discuss in morning rounds. We actually had case rounds this afternoon. We were invited to come along to help with neuro consultations for other departments, rather than being left in the rounds room to wonder where the doctors had disappeared to. Best of all, there was no mocking or deriding anybody all day!

Neuro is still not my favorite rotation, and I'm greatly looking forward to its conclusion. But it's nice to see how a simple change in faculty can make all the difference in a rotation.