The Soul of Medicine

The Neuro Bootcamp is an intense 4 week program that immerses med students in the field of Neurology, a complex field of medicine focused on the brain and spine. The typical day ranges from 10 to 15 hours. Feeling discontented with the slow pace of Allergy Medicine, I signed on for the last week of Bootcamp, joining other students who had already been training there for three weeks.

It was unsettling, at best, to approach each patient with a sharp pin, with the intention of eliciting a pain response from their forehead, cheeks and chin. This was just one of a number of tests the neurologists used to assess the functioning of the major cranial nerves.

I've always had an interest in Neurology, and so it came as a surprise to realize that I am not meant to go into this field. While Neurology may focus on the brain, it focuses almost purely on the physical aspects of the brain - its electrical activity and chemical imbalances. We would see patients with acquired brain injuries, seizures, strokes, episodes of amnesia, and all kinds of problems that afflict the nervous system. Although I found myself fascinated by this at first, by the end of the week I sorely missed the human, feeling component of medicine. While we would ask patients about their balance and vision, we would rarely explore the emotional context of their illness - their fears, hopes, coping strategies and supports.

This emotional context is addressed primarily by the patient's family doctor or by a psychiatrist. This is done largely for efficiency: the Neurologist, as well as other specialists, face a large backlog of patients. They simply don't have time to delve deeply into the patient's feelings; their goal is to determine the physical defect and address it with medications or therapy, before moving on to the next patient.

I thought that I would like this - after all, I enjoyed reviewing my Neuro textbooks before starting Bootcamp. Unfortunately, the clinical reality of any given specialty often differs sharply from the student's interest in the subject matter. While the brain is fascinating on paper, in reality, Neurology means treating a narrow set of conditions on a "consult" basis - seeing each patient only once or a few times, excluding the development of a long-term patient-doctor relationship.

While I greatly admired the ability of the staff neurologists to "think through" their patient cases, I also realized that I would prefer a specialty with more emotion, more feeling. I think that my strengths are in connecting emotionally with people and being empathetic to their circumstances. These strengths are suited to a field that involves some aspect of psychiatry, which literally means the "soul of medicine". Although I'm not necessarily interested in becoming a psychiatrist, I do need to keep searching for a field that is naturally imbued with feeling and emotion.