Agraphia Medical Tragicomedy

25Oct/05Off

I really have meant to write about Friday and Saturday, but time flies when you're having fun.

Friday we saw several neurology patients with different diseases. The first woman had ALS (Lou Gehrig's disease)... I never realized how horrible it actually is. ALS slowly paralyzes your muscles, inexorably over the course of several years. Patients start tripping first, then begin falling. They need a cane, then a wheelchair, then are bedridden. Eventually they start needing respirators to sleep at night, since the muscles that help them breathe start to fail. Finally swallowing muscles and voiding muscles go, so they need a GI tube and colostomy bag. The only muscles that don't die off are the eye muscles- so eventually the patient becomes confined to a bed, completely unable to move, and only capable of looking in the direction that
their head is facing.

The awful thing is that there is essentially no degeneration of the mind. I suppose that's a good thing in some ways- it's not a descent into dementia like many other neurological diseases- but at the same time, that means that you become a shell. Your entire body shuts down around you and you watch, knowing full well exactly what is happening. The neurologist put it very delicately. "Patients can be kept alive using ventilators, GI tubes, and colostomy bags- but when all you can do is look straight ahead, day in and day out... most of our patients... reject that life".

I guess I can't even imagine what it would be like to have to decide to take yourself off a ventilator and die, knowing full well what you are doing. It's not even that you're in pain all day, or near the end with terminal cancer, or anything. You just can't move.

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Saturday I had my first patient EVER! I volunteered at a clinic and screened a few people for glaucoma. It was a slow day, but since it was my first one I didn't mind- gave the medical students time to practice all our tests on each other (like putting eyedrops in and such). Anyhow, his name was Frank, he was 75, and turned out to be totally fine. His vision was awesome for his age (no cataracts), and he was a really nice guy. I don't really know what else to say about him... I only saw him for about 15 minutes, tested his visual acuity and peripheral vision, took his blood pressure and intraocular pressure (which is one of the hallmarks of glaucoma), and checked out his eyes with my sweet opthalmoscope.

I think it made an impression on me specifically because he was the very first person I ever took care of myself. I presented his case to the doctor working with us, who then made the diagnosis, but basically, Frank was MY patient. I gave him medical care... and while it wasn't much, and was pretty basic, it was still what I'm here for. I had a great rest of the day . I can't wait to sign up for more clinics... it really puts into perspective what we're learning here, and why.

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