A day off work to attend a neurology study day. All doctors must do at least 30 hours per year of "CME"- "continuing medical education" And as the secretary acidly reminded me as I collected my all-important proof of attendance sheet, it is not the attendance per se that is important, but the reflections upon that study that are most critical to the annual appraisal, where we all undergo a lengthy peer review of our clinical and professional progress. So, what are my reflections?
Well, firstly, may I say that going right back to my student days, I have been impressed, awed even, by the way a neurologist can learn so much about a patient's problem by examination alone. The slightest weakness in this finger, the transient twitching of that muscle, frequently leads them to a diagnosis that is as reliable as one made with a range of all the most sophisticated scans available. Hence my belief that neurologists are the most intelligent breed of doctors (thickest? it's a toss-up between venereologists and orthopaedic surgeons, but that's my own prejudice)
Part of the session was taken up with this precise area, where an unfortunate individual volunteered to be scrutinised by the doctor in front of the crowd, as it were. Even I could see he was terribly damaged; he seemed as weak as a kitten, with stick-thin arms and a whispery voice. With supreme elegance, the neurologist elicited one sign after another to prove that he had that awful slow-motion killer: motor neurone disease.
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