Quotes From a Neurosurgery Resident

"You [medical students] are going to get yelled at a lot, but it's only because you're incompetent; try not to take it personally."

It's Not Exactly Rocket Science

Not to be a cranky-pants or anything, but wahhhhh.  Tomorrow I start neurosurgery.


For our psych/neuro rotation we have four weeks of psychiatry (two rotations of two weeks each) and four weeks of neurology (same deal).  So, like everything else in third year med school, you ranked which sites you wanted, and you were assigned via lottery.  I ranked neurosurgery last last last (other options included stroke, general neurology, and pediatric neurology).  Eight weeks of waking up between 3:30 and 4 was more than enough for me - plus I'm pretty positive that neurosurgery is not what I want to do in life (seven years of residency? no thank you).

I'm tryinggggggg to look on the bright side (although anyone who's talked to me all weekend knows I've been pretty unsuccessful at that).  Neurosurgery is going to be cool, right??  I'll get to see inside the brain!  How many people get to say they've done that?  And the residents and attendings I'll work with I'm sure will be incredibly smart and accomplished people, and hopefully I can learn a lot from them.  Also, it's only two weeks long, and unlike the actual surgery rotation, I won't have any overnight or weekend call.  AND labor day falls in the middle, so I get next Monday off. :)


But who knows?  Maybe I'll fall in love with neurosurgery, decide I'm willing to give up every other aspect of my life to pursue it, and then I could be like this guy...

Not What I Expected

When I found out I would be rotating at Greystone Park Psychiatric Hospital for two weeks during the psychiatry rotation (no, for the ob/gyn rotation! ha. ha. pity laugh?), I was very excited.  This was going to be a REAL psychiatry experience.  I've seen pictures of the old buildings, and I couldn't wait to be walking through them, imagining myself as a close personal friend to Dorothea Dix in the late 19th century (I'm very normal, I know).  I had this romantic vision of the historic hospital - even my dad told me stories about how HIS dad would drive him through the grounds as a kid late at night to try and spook him.

not the modern building, just a modern pic of the old one

So imagine my disappointment when I found out that a new modern (and totally boring) building replaced the old decrepit buildings in 2008.  Obviously much better for the patients and the staff, and it really is a beautiful facility.  But it looks nothing like the horror movie-style psychiatric hospital, and there's no history, and I haven't felt the presence of Dorothea Dix's ghost a single time so far!  While I understand this is a very selfish way to feel, it's not that I would wish the hospital to still be housed in dilapidated buildings, it's more that I wish I did my rotations four years ago so that I could see what the old romantic buildings were like.



A few of the old buildings are still standing, and they are gorgeous.  They are covered in ivy, and the windows are all boarded up, just as a historic haunted psychiatric hospital should be.  But there are lots of no trespassing signs around, and I tend to be a rule follower unfortunately, so I'll probably never get to see them up close.

The fate of the remaining standing buildings still seems to be unknown, but I'm hoping they don't get knocked down, but instead can be restored and one day re-opened in some capacity (something educational? a museum? a haunted house?).

view of the grounds in 1899

inside a ward, also 1899

 Disappointment number two came when I found out I would get to watch a court proceeding involving a patient.  There's a courtroom IN the hospital!  Court cases tend to involve renewing involuntary commitment status, and I was expecting something along the lines of the courtroom scenes in Harry Potter, where the poor patient sits in the center of a room, and there are lots of scary judges and doctors sitting high above, waiting to condemning them.  Turns out it's nothing like that at all (obviously), and it's really just a conference room with a judge.  What a let down!!

this is not what the court room looked like

(I really had a wonderful experience at Greystone, and I imagine that if I had had a psych rotation in the "romantic" 1950's or earlier, I probably would have walked away completely scarred for life.  I just like feeling like I'm part of history, and sometimes my imagination over-exaggerates.  In NO way do I wish psychiatry was anything like how it used to be - although, it turns out that Greystone was built according to the Kirkbride plan which was actually supposed to be a more humane and compassionate way to treat mentally ill patients, ruined of course by overcrowding.)



Check out more old-school pictures of Greystone here: 1899 photo album
For more modern (and colored) pictures, as well as info about other Kirkbride buildings: Kirkbride Buildings, Greystone
And lastly, for more info on the history of Greystone: Preserve Greystone

You Know What's Unfair?

The fact that getting anxious about being anxious makes anxiety worse.

Adventures in Nomenclature: Gamekeeper's Thumb

Does anyone else love things that are named after totally antiquated concepts?  When I first read about gamekeeper's thumb in the orthopedics chapter of the Kaplan surgery review book, I felt like I had to really do a bit of research to fully understand the name.

The injury is a tear to a ligament in the thumb (the UCL), and occurs via hyperabduction of the thumb.  Forget the movements of the thumb?  Me too; below is a handy study guide.

hyperabduction. ouch.

So how does a thumb get hyperabducted?  Well, it can happen acutely by falling on an already-outstretched thumb, or apparently in skiing if you fall and your thumb gets stuck in one of the loops of your ski pole (in fact, the injury is also known as skier's thumb).  It also could happen chronically, as with gamekeepers who would kill small animals by breaking their necks with their thumb and forefinger.  And I'm not sure why they got shafted in the naming department, but apparently this was also a common injury among Scottish fowl hunters because they would carry their game home in a bag that they attached to their thumb and threw over their shoulder.

Cumbria. Fun!

Naaaturally, I was curious about gamekeepers, because, um, what the heck is a gamekeeper?  They are usually employed by landowners to prevent poaching and to take care of/maintain the game (not "the game" - oh sorry, you all just lost - but the game as in deer, fish, fowl, etc.).  Turns out there are still 5,000 employed in the UK, and you can even specialize!  Lowlands, uplands, river keepers... the opportunities are truly endless.

If you or someone you know is looking for a career change, you can get a diploma in gamekeeping from the Northern School of Game and Wildlife in Cumbria, England.

gamekeepers gaming

Well That Made My Day

I'm in the elevator in my building after getting home from the hospital today and I'm wearing my white coat, and my next-door neighbor gets in the elevator with her two year old (one? three? somewhere in that range) son.  He's very shy so he doesn't speak the whole ride up, but as we get off the elevator on our floor he calls out, "Bye, doctor!!" before running embarrassedly to his own door.  :)

I didn't have the heart to correct him into saying student-doctor.  He hasn't yet learned what the short white coat means.

Modern Day Fairy Tale

Once upon a time (this Friday night), I was out in the city with some friends (actually enjoying a weekend? add it to the list of what I love about psychiatry), and a young gentleman struck up a conversation with me at the bar.  Normally this type of conversation goes something along the lines of:

"What do you do in the city?"

"I actually live in Jersey - I go to med school in Newark."

"Jersey? Ew."

"I know, right? The worst."

And then we both chuckle and carry on with the conversation like two normal people.  On this occasion though, the gentleman in question had no interest in even continuing a conversation with someone from Jersey (understandable, though - I've heard Jersey-ness can rub off on people who stand too close for too long).  As soon as I mentioned NJ, he - I KID YOU NOT - started slowly backing away from me.

a video of the incident in question

"Jersey?  I don't know how I feel about that."  Takes two tiny steps backwards.

"Haha, I don't know I feel about it either," I self-deprecatingly replied.  He takes another few tiny steps backwards, his smile starting to waver.

"No, seriously," he said seriously.  And after just a few more steps backwards (still facing me of course - everyone knows it's dangerous to turn your back on either the ocean or someone from NJ), he had reached the corner of the bar, and he was able to safely turn away and immediately start a conversation with his friends on the other side without so much as a fake excuse to even pretend to end the conversation.

And we all lived happily ever after.