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Wednesday, October 19, 2005

Mia Listo Sekreto

Of all of the thousands of little 'insignificant' syndromes, tests, and signs we are taught in the first two years of medical school, there are a multitude of syndromes you don't plan on seeing. I plan on not seeing (or diagnosing) sarcoma botryoides, frotteurism, or scientology. They are all too uncommon to be seen by me, especially if I'm looking to go into pain management. There are several more on the list, but they are a secret. (secret=forgotten)

One of those things I thought I'd never see is Broca's aphasia. It's a syndrome where there is damage to the "outgoing communication" center of the brain, usually from a stroke, which leaves the patient unable to form words. They can still understand what is being said to them, unlike the very tragic Wernicke's aphasia. Well, one of our patients came in for treatment of shoulder pain and had symptoms of a somewhat resolved Broca's aphasia from a previous stroke. WHOA! Broca's! Here! As soon as that synapse connected in my brain the rest of my brain was engaged in inhibiting my excitement from causing me to blurt out "BROCA" several times in a Tourette's type manner.

Twenty painfully long minutes later the patient left the room and I struck an aloof pose on the side of the doorway, looked at my cuticles, and breezily told the doctor, "that was a pretty textbook case of Broca's if I've ever seen one." I'm not sure whether the phrase "if I've ever seen one" is a valid one if you've only seen one and there was no "if" about it, but I tossed it in to accentuate how aloof I was in the face of such a brilliant discovery. The discovery was, of course, that medicine includes things other than hypertension, high cholesterol, allergies, and low back pain - it includes those things we missed test questions about.
The doctor looked at me as though I'd just spoken in Esperonto.

"Broca's aphasia", I clarified.

His head tilted slightly to the side.

"From the stroke, affecting her speech", I stammered.

I wasn't sure whether he didn't understand or if Broca was a stupor inducing trigger like in Manchurian Candidate. Before drool started to gather at the corner of his mouth I went ahead and explained the condition. Deflated, I continued the rest of the day, deftly caring for hypertension, high cholesterol, allergies, and low back pain.

I apparently discovered something that was on his secret list.

5 Comments:

Blogger Anon Emous said...

Hey, I will take anyone that can cure lower back pain! Seems no one can. Been suffering with it for the past 35 years.

Last diagnosis: "Oh, you have degenerative disc disease. Sorry, but it is not operable, and there is nothing we can do. Might try swimming."

Great news!

It is hard to believe in this day and age of modern medicine, no one can cure lower back (L5S1) problems!

12:26 PM, October 20, 2005

 
Blogger Nelson said...

Man, your blog cracks me up. Cracks me up to the point where I think I may not be quite so abjectly terrified about what 3rd year will do to my health/psyche/relationships...

What's your RSS feed?

3:08 PM, October 23, 2005

 
Blogger DocAMAZING said...

http://docamazing.blogspot.com/atom.xml

Well, I'll let you know how my psyche is doing in a few weeks. I've just started my psychology rotation, and I've heard the conditions are contagious. If you've ever talked to a psychiatrist, you'll understand what I mean. You will never see a well adjusted psychiatrist.

7:52 PM, October 23, 2005

 
Anonymous Kopti said...

You know there was a time when I thought I would go back to school and become a psychologist. I told my then girlfriend that I was interested in doing so and she said "so whats wrong with YOU?" She naturally grew up with one for a mother. You are on to something.

6:55 PM, November 23, 2005

 
Anonymous Anonymous said...

WOW, I'm a first year and just took an exam on Brocca's (Area 44&45 dominant side; i said that just to prove my credentials, lol) and thought I would never ever in a million years come across someone that has it. After reading this post it does seem like there is light at the end of the tunnel, and all the details might be important at one point.

2:28 PM, May 13, 2008

 

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