Renaissance Doctor

As I continue through my journey through the junior year of medical school and explore various fields, I have found that my interest in Vascular Neurology, particularly stroke and Interventional Neurology, has grown and is gradually solidifying into a mature interest. Despite my interest in specialization, I have typically followed the behavior pattern of a jack of all trades, dabbling in many different interests without becoming a true maestro in any one. Medicine, as a career, is offering me the chance to truly become an expert in one area of interest, but this particular subspecialty furthermore may allow me to enjoy the many aspects of medicine I am interested in and pursue goals in each:

• Clinical Work – I decided to pursue a career as a physician because I want to be a clinician, not an MD-clad bench researcher or other MD-variant. At the heart of my motivation is the desire to treat and care for patients on an personal level, to engage their troubles and diseases directly with my hands, senses, and mind, as have many generations physicians and healers before me.

• Research – A year ago I decided that I did not want basic science research to be a part of my career. At this time, I still feel a similar sentiment, but I am now exposed to research in which I do find passion that covers the range between transitional and clinical research. I have recently added Stroke (the journal) to my RSS feed, and I have started reading the abstracts with the same magnetism that would draw me to Sunday comics.

• Teaching – I love teaching, and I look forward to being able to teach medical students and residents someday. If I become an Interventional Neurologist, I would be very excited about being part of a training program for physicians in this new field.

• Broad Impact – Stroke, like heart attacks, affects such a large population around the world: no age group or race or socioeconomic group is immune. It is the second leading cause of death worldwide and a leading cause of morbidity (e.g. disability). If I become a subspecialist, I don’t want to deal with a rare disease or a set of uncommon diseases: I, as an individual physician, want to help as many people as possible.

• Public Health Education – Stroke is only now beginning to develop public health education campaigns; hopefully someday “brain attack” will be as recognizable as “heart attack,” because we want to get people to the hospital as quickly as possible after symptoms first appear. Just as “Time is Muscle” in Cardiology, “Time is Brain” in Vascular Neurology. Some education campaigns are being tested in schools: what a wonderful extension from my leadership experience with Doctors Ought to Care if I get to have the chance to teach kids about health again!

• Interventional Procedures – I love working with my hands, but I also want to use my brain’s analytical skills on a daily basis. An interventional field offers me the best of both worlds. (Not to mention that it will certainly help pay off my student loans!)

• Invention – Interventional Neurology is a very new field with the potential for the creation of many new tools and devices. Maybe someday I’ll be able to contribute in this fashion!

• Critical Care – Stroke patients are often admitted to the Intensive Care Unit (ICU) or even a Neurology ICU. My previous interest in Pulmonary and Critical Care may still live on here: I will have the opportunity to work with very sick patients with complex, multi-system management issues.

• Working with Paramedical Professionals – As I have found working with the Stroke Specialist at Tulane Hospital, a good Vascular Neurologist can benefit from building connections to multiple employees inside and outside the hospital: the paramedics that bring in the stroke patients, the ICU nurses that need to aggressively monitor and treat hyperthermia and hyperglycemia, the physical therapists and occupational therapists that are essential for the post-stroke rehabilitation process, etc. One can hopefully build a real dream team!

• Healing the Mind and Soul – It is increasingly becoming apparent that post-stroke depression is a major factor in the outcome of the disease. Although I don’t have any aspirations of being a psychiatrist, I would be excited and vigilant about helping to identify and treat depression in my patients.

• Treating the Whole Body – Stroke, in its management, is a “medical” rather than “neurological” disease: besides the diagnostic and interventional processes, one treats the patient’s high blood pressure, high blood glucose or diabetes, high cholesterol, heart disease such as atrial fibrillation, coagulation disorders, sickle cell disease, etc. The brain is the endpoint, but a stroke specialist must also consider and manage the disease of the body that supports the brain.

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