Post Traumatic Stress

It's been difficult to get into the rut of studying again. Perhaps the fact that the reference is to a rut bodes poorly. That is not necessarily a positive portrayal. One of my partners believes it to be a form of PTSD. All of us who do this for a living have spent many years of our lives alone with books for more days than we can count; perhaps for more days than we have spent with our spouses. We were the types that would pride ourselves on being the first one at the library in the morning and the last one to be kicked out that evening. We were the ultramarathoners of the studying world.
But that was then. While not afraid to work long hours and to give up sleep and time with the family to get the job done well, studying is simply a different skill set. Reading up on a real case is one thing, going back to college and med school studying is another.
I can spend hours reading the latest Le Carre novel or treatises on theology. But picking up the medical texts and perusing that which I have known and read before is as appealing as a root canal. Being dragged through town by my tongue sounds more appealing.
Well, enough of the pity party. Rereading this is painful. This guy sounds like an introspective idiot. Just get over it! You have a job to do....do it. All right, I will.

Deep Brain Stimulation

Polishing up on the minutiae that is a part of this profession can be both stimulating and tedious. Stimulating to reaquaint oneself with the interesting rarities of disease and the beautiful anatomy that is the human nervous system. Tedious because much of that information is so rarely used and therefore difficult to store away for immediate retrieval. When one of those rare diseases present, one has ready access to volumes covering every possible aspect of the specific disorder. That coupled with a good residency in which one was exposed to all of the once-in-a-lifetime problems should be more than enough for one to make sound diagnoses and recommendations. But the Boards are not such a real world assessment. Or maybe they are.

When one talks to those who have both passed and failed the Boards, many different views are reported. Many say it is absolutely fair. Others disagree. Some relate sheer terror. It is likely that keeping one's head is at least as important as the knowledge base possessed. After all, you cannot even sit for the Oral Boards until you have been forged in the furnace of residency and passed a written test that can be equally as daunting. So no problem, right?

The fact that a general neurosurgeon sees just that, a general representation of surgical neurology is comforting. It gives one a broad knowledge base from which to start. Many 'super-specialists' only see a thin, albeit deep, slice of pathology. It would be petrifying to prepare for the oral boards if one had spent the last 3-4 years treating only a selected subset of neurologic pathology. However, because there are so many disease processes that are rarer than honest thieves, even a community neurosurgeon who treats a broad swath of neurologic 'badness' never sees it all again once out of training. And it is only by constant practice that one becomes facile enough to prove oneself before the group of very intelligent men and women sitting across the table.

All of that being said, reviewing my specialty is gratifying and humbling at once. Its been a while since I have reviewed DBS (deep brain stimulation). Its one of those surgical procedures mainly performed in tertiary medical centers but also a subject about which an examinee needs conversant. Then again, this whole process is a form of DBS in which this surgeon is also the patient.

Good News?

The notification came today that my Oral Boards have been moved up from November to this May. It rather brings things into perspective and definitely focuses things a bit. More than anything else, it feels as if medical school has reconvened with me as the only student and the most important exam is only a few weeks away. To say that the sheer volume of information is staggering would be akin to standing in the face of a tidal wave and describing it as humid. Well, to be fair this is not furthering my journey to mental serenity so I had better go unroll the firehose and begin imbibing.