If Only The Neuro Exam Was LAST Week

…Said no one, ever.

I know last week I wrote a fairly graphic account of what it’s like to do a pelvic and butthole exam for the first time. Also, there’s no way I can ever top that on this blog, so don’t expect it. We actually finished our reproductive unit before the end of April; the practice exam itself was just rescheduled till recently. Our current unit is called Brain, Behavior and Movement, and covers head and brain anatomy, neurology, psychiatry, and the musculoskeletal system.

When we finish “BB&M,” we’ll be done with first year and start rotations. Woof.

We ended last week with a lecture on the musculoskeletal exam. This exam is one of the most challenging skills to learn because it requires integration of a lot of anatomy with a lot of different tests you can perform.

Our lecturer was a resident orthopedic surgeon. He was funny, engaging, and informative. He also thoroughly fulfilled the “ortho stereotype:” I place the odds of him lifting weights in cutoff surgical scrubs at about 80%, and probably posts on Facebook about PR’s and WODs at Crossfit. [I do not know what PR’s or WODs are, but I still have enough meatstick friends to know they are Important Things That Facebook Friends Must See.] The lecture was especially interesting for two reasons:

– He thought we already knew our limb anatomy, when in reality the knee and ankle to me are just the parts of your body that hurt when you run (wait, that’s normal, right?). He kept saying, “as you know, the calcaneus bone connects to the tibia via the whatever ligament,” as we all nodded like idiots. Except for a few people, which brings me to…

– I now know who the future orthopedic surgeons in the class are. My roommate Ryan is one of them: he sat for the full two hours with his elbows on the table, leaning forward intently. It’s the only time I’ve ever seen him forego taking notes in class. His attention could not have been more, uh… rapt if Stone Cold Steve Austin were standing at the front of the room narrating a documentary about the 2008 Giants and the Helmet Catch (Ryan loves the Giants enough to destroy living room furnishings when they lose. He also loves Steve Austin because he still loves wrestling; we get along because Ryan is emotionally thirteen, just one year older than me). The other future orthopedic surgeons in the room were frequently seen adjusting themselves.

Oh, come on. First of all, that’s true, and second of all last week you read about lubing up for a butthole exam. Get over it.

Ryan was not alone; at least four people volunteered as “patients” for the surgeon’s demonstration of the physical exam. Those same people, plus a handful of others, raced down to the front of the room when lecture ended just to say introduce themselves.

It was also easy to pick out those who were not interested in a career that relies on power tools from Lowe’s. Those people were asleep and left immediately when lecture ended. I was already at home on the couch by the time Ryan left the lecture hall.

More power to the interested ones. But sitting here today, I can’t help but think that it would have been better to have next week’s neurology exam lecture this past week and do the joint testing stuff once we’ve dissected the arm and the leg. This makes sense, but it’s also selfish: you see, I probably need a neuro exam.

On Saturday afternoon I went out for a run to exercise my own musculoskeletal system. About halfway in, I was running on the sidewalk through a leafy neighborhood when a dog barked.

I turned to look and say hello. At that exact moment, out of absolutely nowhere a low-lying tree branch hid itself in some leaves, swooped down, and caught me right above the right eye.

I recoiled. I was running at my usual 8:15 mile pace (shut up), which I think translates to just over seven MPH. It hurt, but I swiped my hand over my forehead, didn’t see blood, and figured I was fine.

The woman walking her dog looked at me in horror. She mouthed, “are you okay?” I didn’t actually hear her say it, probably because of the music in my headphones. Or I was suffering temporary hearing loss. I don’t actually remember. But I assured her I was fine, more embarrassed than hurt, and started off running again. I figured I had to run home anyway, and the distance would be about the same if I turned around. So I just decided to finish the run.

Along the way, I started blotting at my head, and realized my shirt was getting progressively bloodier. Uh oh. For the rest of the run I left it alone, not wanting to jam whatever gross bacteria living on my shirt into a scalp wound.

I actually felt okay. I knew I’d probably have a nasty bump, but otherwise I thought I’d be fine. Until I started noticing that I was running past people on the street who were stopping and staring at me.

When I got home, of course I went right to the mirror. A ghastly sight awaited me: rivulets of dried blood ran from a two-inch scrape clear down under my shirt. The worst part, where my head took the brunt of Mother Nature, had split the skin a little. So I cleaned it up a little, and then came the obvious next step: I took a selfie.

sweatyscalp

It actually looks a lot better than it did when I first got home; I went through a whole dishrag applying enough pressure to stop the bleeding. I should also note that I am shirtless not out of thoroughly undeserved vanity but because I wanted to spare you what looks like a Game of Thrones field dressing.

And yes, I know that my existing medical knowledge should have kicked in and told me, “hey, maybe you shouldn’t apply a sweaty shirt/dirty dish towel to an open wound,” but probably my head trauma erased that particular nugget.

I then took the opportunity to play doctor on myself and whip out my medical kit, full of pilfered supplies from my days as an EMT. I cleaned it up, put on a couple of steri-strips, grabbed an ice pack, and was good to go:

headcleaned

Or so I thought.

I assume the neuro exam we’ll do next week will teach us all of this, but over the following hours and into today I learned there are consequences for slamming your head into an inanimate object at speed. As a sneak preview here are some of my signs and symptoms of what I assume is a mild concussion (also, Grandma, I’ve had a concussion before. This is not new. Do not freak out. Do not send brownies, soup, or other items. I am fine and my sense of humor is largely intact, although that may not be a good thing):

  • Headache: oh man. This one felt like… well, it felt like I got punched in the face by the ortho surgeon who gave our lecture.  It hurt to exist.
  • Dizzy spells: thankfully, these have been infrequent, but if I stare at a point too long, the room starts rotating around it.
  • Photophobia: I feel a little like a hungover vampire. Light kind of hurts.
  • Convergence issues: If I look at something too close to my face, my headache gets much worse.

That said, all of these symptoms except the convergence part got way better this afternoon once I drank a lot of coffee. I assume this is accepted medical treatment for concussions because I read it on a blog, although it was written in Comic Sans and thus invalid.

I also just feel dumb. Dumber than usual, I mean – which is saying a lot given my baseline level.

Maybe I’ll volunteer as tribute this coming Friday for the neuro exam….

 

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6 thoughts on “If Only The Neuro Exam Was LAST Week

  1. Your mother is trying SO hard right now not to over react. Do you need me to come down and adjust the steri strips? If I leave now, I’ll be there by midnight

  2. Pingback: “Elegant” is Med School for “Really Hard” | Laughter is the Best Medicine

  3. Pingback: Neurology is Hard | Laughter is the Best Medicine

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