Neurology: The Epitome of the Anti-Climax

Neurologists hold a special place in my heart. It's the (hopefully small) place that is full of anger and frustration and black goo. If I ever have a heart attack, it's the weak spot that will blow. And I'll know who to blame.

Of course, I'm here to help the reader avoid this. First, take off any blinders you may have. Just because they are neurologists, don't assume that they know how to think or plan or do anything useful whatsoever. Nothing could be further from the truth.

My Dad has seen his share of neurologists. Most times, the neurologists seem much more interested in, well, something else. Or maybe nothing else, as they are kind of dull. They are certainly not interested in their patients. Especially a patient that isn't all there. A patient who was once light years smarter than the fool doctor but who is now struggling to communicate, to explain, to break free of the chains.

Second, disabuse yourself of the notion that the neurologist is going to use his/her years of education, research, experience, and now highly lucrative practice to provide you with any kind of helpful information. Just because it is your parent's very life we are talking about, just because it is one of the more important appointments they (and you) will ever have, don't think that the good doctor cares. Not one whit. His goal is to get rid of you as fast as possible. They listen for a short while, avoid looking you in the eye, say something unintelligble, give you a few mealy mouthed answers to your questions, then sail smoothly out the door. Leaving you strangely unsated.

I was shocked that the first neurologist used no medical terms to describe the condition. Be sure to request a copy of the doctor's written report (and then you'll have to look up a number of weird terms). That's how I found out that my Dad had hydrocephalus. I think the good neurologist talked about how the brain was eroding, there was an old stroke, and there was a fluid build up that was putting pressure on the brain and needed to be drained, but no one would touch him because of his age (84). That latter part turned out to be untrue.

Neurologists can take months to get into for an appointment, then the Oldster has to go for an MRI, then another month or two to get another appointment so the "neuron" (singular) can interpret the results. They won't talk to you on the phone, even if you have a Medical Power of Attorney, which every other doctor will honor. No, neurons are just too busy to be bothered with the fact that their Oldster patient is living alone (or almost) and the Childster is trying desperately to figure out the best answer for care. That the Childster is on leave, not earning a salary, not sleeping, not knowing how to proceed, not wanting to force her Dad into assisted care if there is some hope he can live independently. Did I mention not sleeping?

Oh no, the neuron doesn't want to be bothered. Your Oldster could be dying of hunger from forgetting to eat and you still won't get by the neuron's receptionist. As gatekeepers, there is none better than the neurology receptionist. You must need a PhD in gatekeeping to get the neurology receptionist job. I called four times and spoke to two different people, and couldn't get the neurologist to talk to me, much less look at the MRI because he "was way behind and actually coming in one extra day a week to catch up." That extra day was a weekday, because he didn't actually work full-time. Poor dittums.

But that's not the half of it. Should you need to check your Oldster into the hospital, you will stay an extra day because Neurology--with it's own wing in the hospital--can't figure out how to schedule MRIs and labs in such a way as to actually do the procedure on the scheduled day. After I threw a fit, they decided to look into this scheduling problem, which they had been having for years. YEARS?

Medicare paid for the extra day in the hospital, so I guess it just wasn't important enough to figure out that patients need to arrive at 10 am instead of 1 pm. I knew the schedule wasn't going to work a month beforehand. And when it didn't, even after I got my Dad there much earlier than requested, I may have had a few things to say about it. "It doesn't take a brain surgeon to figure out that after a one-and-a-half hour MRI, sitting in the lab for two hours, and then getting checked into the room, we aren't going to get the procedure done today as promised. Oh wait a minute...you ARE brain surgeons!" It didn't help my state of mind that my poor Dad probably walked a half mile that day, and the primary symptom of his diagnosed condition (hydrocephalus) is...wait for it...gait problems (difficulty walking).

If you are really, really lucky, the next day you will get to squirm, I mean watch, as an old neurologist with a clearly shaking hand puts a needle into your Dad's spine, while a bunch of young intern neurologists watch. No one mentioning the Parkinsonian-like body stiffness and hand shaking of the NeurOldster. At least five brain surgeons in the room. Hellooooooo. Is anybody home???????

This is not a community hospital we are talking about. It is a nationally respected hospital and neurology program.

Seriously. They are effing brain surgeons!!!!!! I guess you must learn how not to use your brain to think or question or feel in order to become a neurologist. No wonder they are so dull.

In the long run, what became obvious to me is that they are all just guessing, wingin' it. I think that's why they can't look you in the eye. Or maybe they are afraid that people can't handle the truth. But honestly, isn't that their job?

The other thing I've learned is that neurology isn't a very rewarding career. They say if you marry for money, you earn it. Well, I think neurologists suffer the same fate. Great money, if you can stand the monotony. And the shame.