Neurologically Intact

Strange, how much we take these words for granted sometimes. How easy it is for us to forget the fact that the brain, with is complex anatomy and mechanisms, could literally make or break us.

The past week, the words 'Neurologically Intact' were passed back and forth so casually that it drove home again, how much I take my cognition and well-being for granted at times.

I had been truly pessimistic about the neurorehabilitation experience at the Wolfson before this week began, moaning about it to anyone who would listen about how this was a huge waste of my sleeping time and effort, and that anyone who knew me would know that I have little patience or empathy when it comes to the word 'rehabilitation'. Horrible as it might seem, the lengthy MDT Meetings in Oncology and Geriatrics had bored me to tears, and I was positive that this would do the same.

Strangely enough, it is the things you have had a mindset about hating, that turns around and never ceases to amaze you.

L and I were lucky to have a structured timetable which enabled us to cover all the disciplines involved in Rehabilitation Medicine, and apart from the session with the Psychologist that almost brought me into a stupor, everything managed to change my mind about associating a Multidisciplinary Environment with a couple of zzzzz's, to realising how INTER-disciplinary all the people there were at working towards those goals.

GOALS. Another word that was the bane of my life that week.

From the Long Term Goal of being able to walk out of the Wolfson, to Short Term Goals of being able to perform independent transfers (from wheelchair to bed, for example), I started piecing everything together and saw how important all these assessments and GOALS were in achieving a successful rehabilitation experience. I was genuinely amazed at the Goal Planning Meeting where each team (SALT, Physio, OT, Nursing) came together to give their input on the steps that had been carried out so far during the patient's rehabilitation process, the progress achieved so far, and any tweaks to the programme in the near future to achieve better efficacy.

I loved how the patient's Physical and Cognitive well-being was taken equally into account and fended for by different members of the team, i.e. Physio for Mobility and Transferring, and SLT/OT for ADL's and Cognitive Skills. And to top it off, my experience in Spasticity Clinic was equally rewarding, despite the patient taking more than an hour because his bones were so deformed and the anatomy so messed up that it had almost been impossible for the EMG to detect actively functioning muscle.

And most of all, I discovered once again that I DO have compassion after all. Deep inside. I had been wondering all year, if my enthusiasm had diminished along with my compassion for patients, not just in terms of managing a condition but also caring and empathising. But there could not have been a sadder story I had come across, than a 38-year-old who previously, was a Highly Functioning individual of the society, only to encounter a horrifying road race bicycle accident and be reduced to an individual in a wheelchair with Post Traumatic Amnesia, a lack of Cognitive Skills, apraxia and to top that off, 3 kids under the age of 4 years.

Or that 25-year-old who had ataxia, a huge lack of insight into his cognitive impairment, and no where to go after his discharge from the Wolfson because his mother refused to take him back, stating that he had changed horribly and she could not take any of this. Tragic as this was, it made me so grateful that my family would never do that to me in any case (TOUCH WOOD), and it made me incredibly sad to realise that someone could be reduced from having everything to literally being homeless in the blink of an eye.

I started off Neurology thinking that I would hate this rotation.

I don't. The people are weird, my Neuro foundation isn't brilliant, and even though my Neurorehabilitation experience has not turned out horrendous, I would still not list it as a first choice of career.

But as with all other things in life I possess at the moment, instead of dwelling on the past, the bad, the ugly and the grey areas, I will wake up every morning being thankful that I am neurologically intact.