Neurosurgery begins

Today I spent most of my time in clinic, usually regarded as a painful experience by most surgeons. It's easy to see why, as one of the staff docs saw thirty patients between 730 and noon. But thankfully, I have an out from some of the craziness. One, the surgeons know I'm likely to slow them down with some of the patients, so I'm not expected to see follow-ups or patients I'm not going to learn from. And two, I signed up earlier this year to teach the first year students about medical interviewing, which will take me away from this madhouse at least one afternoon a week.

Still, there is a charm all its own to this clinic. The surgeons themselves are much more laid back than might be expected from the reputation of neurosurgery. One of the senior staff members has a wonderful sense of humor as well. Today, I was presenting a patient to him, who had come in solely to get Dr. Lest's opinion on another doctor's advice. When, as part of my presentation, I mentioned that this patient "respects your opinion, in his words" Dr. Lest shot back "that's the narcotics talking." When, later in the day, he was describing a procedure he will be performing shortly, he said "Not a big deal. I'll just make an sagittal incision, expose the cerebellum and occipital lobe, and do the resection around the tentorium. It's not brain surgery." He smiled and paused. "No, wait..."

And I got the word that, this being a surgical service, I am welcome to wear scrubs, even in clinic. Wonderful.