Finally! I'm now one step closer to doing what I really want to do with my life. This year I have entered the world of Neurology. The catch is that I have to spend the next 12 months doing Adult Neurology. Sure, they keep us going with one pediatric neurology clinic each week to help us keep the vision of why we are doing this. It is a really different world, though, treating an older population. Not to scare you guys, but I went from treating babies and kids with asthma, gastrointestinal illnesses, and acne to being the "expert" overnight regarding whether an 80-year-old man is having a stroke or an intracranial hemorrhage, or if he is just drunk off his rocker. It's certainly overwhelming to be thrown into this new specialty, but I am loving it!

After only three weeks doing Neurology, I've already learned that I don't have the heart to treat adults. People always comment to me that treating children with chronic life-threatening illnesses must be unimaginably difficult. But for some reason, I can deal with those situations with a sense of optimism and peace, even when the outcome is poor. These adult patients, on the other hand, are absolutely heartbreaking to me. It is incredibly difficult to see patients who have full, complete lives lose the function of their minds and bodies, oftentimes fully aware that they are losing the autonomy they once had. It pains me to see such sweet people with Parkinson's disease and Alzheimer's dementia see their independence and sense of dignity slowly slip away. I can't help but see these patients as they were in the prime of their youth, as young mothers and fathers, athletes, and experts in their professions. It's a tough reminder of my own mortality.

Last week I saw a beautiful young woman with a rare combination of a both a genetic muscular dystrophy and amyotrophic lateral sclerosis (ALS). She had just undergone a surgical procedure to put a feeding tube directly into her stomach because she can no longer control her muscles enough to maintain her nutrition orally. It broke my heart to see this bright individual with her mental capacity completely intact, locked inside her own body to the point that she can no longer communicate verbally. She struggled to let me know that she was in need of some medication, and then she painstakingly tried to mouth the words "Thank you" as I left the room. She will continue to slowly decline until she ultimately dies from respiratory failure as the muscles that sustain breathing fail.

Fortunately, I have been lucky enough to see some very inspiring, amazing, and downright entertaining cases, as well. I've seen a young man struck by lightning with an intracranial hemorrhage from the lightning bolt passing through his head and down his body before leaving through his feet. He suffers from burns throughout the length of his body and a facial palsy from the damage to his brain, but he is alive and stable. Another young man from Mexico who studies medicine was delirious in the Neuro ICU for days due to a case of Herpes viral meningitis. He was able to recover nearly completely and will likely be able to continue his education.

I am sure I will have many more stories to share in the upcoming months, so stay tuned!

COMING SOON: How I am learning to lose my optimism, distrust the crazy patients, and recognize the Fakers. :)