Category Archives: Internship

When My Writing Was Just Too Late

I enjoy writing and can become engrossed when doing so. I’ve  been known to forget appointments and, on occasion, have absentmindedly left my wife waiting for me at restaurants while I merrily click away at my computer.

What about me? I stood for hours beside an empty feed trough

What about me? I stood for hours beside an empty feed trough waiting to be fed

Buddy at a somewhat older age in the bed of the pickup

Don’t forget, I laid for what felt like forever beside your desk when we could have been taking a walk or herding cattle or doing something fun

In some ways though my writing has been just too late.  What I mean is that timing the appearance of your work product is important. If only this was always possible.

For example I enjoyed a wonderful relationship with my maternal grandmother, Grandma Corp. She was smart, independent, feisty, and not afraid to state her  opinions. She cared for me and I for her. One opinion she shared was that you could tell if someone was “right in the head” by looking into his/her eyes. That is, their eyes provided subtle information about the quality of their thinking processes. I never forgot her observation but it took many years to fully understand it.

Much later when working on my PhD I needed a dissertation topic. My subject matter, oddly enough, became eye movements and eye fixations in various forms of dementia. I wrote of how the eye is the window to the mind and how eye movements (scan paths among other tests) and duration of eye fixations could provide information about how people process visual information and how they think about what they are viewing. I hypothesized varying forms of dementia would process visual information differently and that their eye movement measures might provide diagnostic insight as well as heuristic value.

The direct approach to understanding The Thinker

The direct approach to understanding thinking, if it were only that simple

Yes, the fabric of my thesis reflected the very thoughts grandmother Corp had stitched into my memory at a young age. But by the time I wrote the research grants, received the grant funds, carried out the experiments, wrote the thesis, and successfully defended it, my dear grandmother had become lost in the mental swamps of neuritic plaques and neurofibrillary tangles. Sorry about the jargon, she’d developed Alzheimer’s disease.

I had dedicated my dissertation to my grandmother. Sadly by the time I was able to read to her my endearment that began my dissertation, Grandmother had advanced  too far into her disease to comprehend it. She responded to me though with a wonderful and endearing smile.

Six months ago my first popular book came out, Carrying The Black Bag. At several points in my memoir, I praise my wise mother who offered sound advice and encouragement. I wrote in my book of when she braved a Minnesota snowstorm (worst blizzard in twenty years) to drive my wife, Trudy, who was in labor to the hospital where I was the intern on call for Obstetrics. Mother went where the local ambulances feared to go. She never was one to admit it couldn’t be done. And I proudly pointed out in my book that she was from sunny Texas and unaccustomed to the northern climes. Carrying the Black Bag book

This story of my son Andy’s birth along with others in my book where she offered sage advice captured, I hope, how valuable she had been in my life.

Several weeks ago I visited my now 95-year old mother in the Alzheimer Special Care Unit at Arabella in Athens, Texas. I attempted to update her on the progress of my recently released book and to thank her for all that she had contributed. I again was too late.

Again, Mom was too deep into her dementia to track the meaning of my words. But I know she felt the love I had for her and smiled when I stroked her hand and head. Her endearing smile affirmed my presence and seemed to light up the room.

In some ways, two of my most significant writing projects (my PhD thesis and my memoir) proved emotional busts due to Grandma and Mom’s memory and cognitive losses. My testimonials brimmed with profound appreciation for them, but both came just too late for them to recognize my appreciation for their special roles in my life.4335496

But I’ve learned from these unfortunate events. Recognition and affirmation can’t always be earned but can be enjoyed. Perhaps it’s like grace in the Christian religion. It is beyond our efforts to earn grace just like I was unable to gain the hoped for response from Grandmother and Mom. Their love for me and their smiles, like grace, came automatically. For their endearing smiles I shall be forever grateful. I shall also forever hate the scourge that is Alzheimer’s disease.

Today Sent My Baby Into The Cruel World

As many of you know, I have written two books and have a book proposal placed with a literary agent in New York City. He is at present sending the book proposal to various publishers. The process seems endless.

Almost by happenstance I have had an interaction with a major university press. After reading the book proposal, the Director of the Press asked for the whole manuscript. Today I sent it off.

I have strange and mixed emotions: on the one hand I am pleased and flattered since this press also co-distributes with two other large university presses. This would be a comfortable place to publish although not as prestigious as a national publishing house. On the other hand, I am strangely uneasy sending the manuscript off. Is it ready? Will it be seen as marketable? Are medical stories able to have a wide enough appeal?

As a result I am feeling apprehensive yet hopeful. Time will tell. Will let you know how all this turns out. Hold a kind thought.

What Old Fashioned Neurology Offers 21st Century Medicine

Like other areas of medicine, Neurology has experienced phenomenal technological achievements during the last thirty-five years.  Our current stellar imaging and modern therapeutic modalities couldn’t have been imagined at the time of my training in the 1970s.  Back then we focused on EEG, pneumoencephalography (I shudder even recalling that archaic and painful test), skull X-rays, the “black box” of Dr. A.B. Baker, and the importance that psychological influences had for neurological symptoms.

With improved recall of information via computer searches, current knowledge is more accessible than before.  The practice of medicine has become more sophisticated, and we must never denigrate such great progress. However these wonderful technical successes also place our profession at risk of becoming overly insular.  A tendency exists for current physicians to interact less with colleagues and to spend more time with machines.

During my internship and residency on-call nights, the midnight meal  provided social lubrication that benefited the collective care of patients by physicians of different specialties.  Over the day’s leftovers, the house staff met to discuss cases, tell stories, gossip, and let down their professional guards. We would lay down our stethoscopes and put up our feet.

I don’t know if this quaint custom even still exists.  If it does not, then other means are needed to provide a human interface among physicians, so that our most personal and caring of professions never veers into a numbers crunching, overly compartmentalized group of disciplines.

The evolution of modern medicine will rely heavily on doctors, hospital administrators, and other staff working together to solve common problems. An active exchange of thoughts among all members of the health care team will be required to bring about a truly integrated health care system that reduces costs, cuts medical errors, and advances quality and safety. The neurological approach, despite appearing anachronistic, offers an example that might provide advantage.

Neurology with its reliance on medical history and careful neurological examination remains an anachronism in modern medicine.  Who else but neurologists still tote around little black bags?  Who else but a neurologist spends more time taking medical histories and performing examinations than reviewing laboratory tests?  Neurologists must not avoid the newer technological achievements.   But perhaps by the anachronistic nature of our discipline, Neurology has become a model for a bridge from the present to the more humanistic, interconnected physicians of the past. Such improved socialization of medicine represents my fondest wish for medicine.  Moreover I hope our discipline that parenthetically McDonald Critchley endearingly referred to as “The Divine Banquet of the Brain” and by which I was seduced so many years ago, leads the way toward an improved interconnected clinical effort from which patients will benefit.