I know your brain better than you do.

Well, that's done. Neuroanatomy, I mean. For four long weeks, I suffered struggled through Neuroanatomy. (We've actually already cranked out 3 physiology lectures and had a physiology exam, but that's block schedule for you.)

Preamble.

Don't get me wrong, I love neuroanatomy as a subject. If I had to get a Ph.D. instead of and M.D., I would probably go for neurophysiology. It's fascinating stuff, folks. You can study the cool stuff like hemineglect (you don't bathe or clothe half your body, and you only eat from one side of your plate). But the class was painful.

First off, the brain is the part of the body that we understand the least. We think we know what each section of the brain does, to an extent, but it is an overwhelming and somewhat impossible task to identify what every individual neuron does. Everyone's brain is different, and our brains have the ability to mold and change if we lose a leg or a sense (e.g. hearing).

So we take this little-understood part of the body, and we learn everything we do understand about it in excruciating detail. I think this is where neuro lost me.

I understand where in the cortex certain things project, and I understand where tracts cross over in the spinal cord and brainstem. I understand where each path individually exists in space, and I know the locations of cranial nerve nuclei. But when I have to integrate all those locations in my head.. and know all the things that will be affected if you have a lesion at the left lateral caudal medulla, MY brain shuts down.

I'm hoping this isn't something that will continue to plague me as I move through medical school, this inability to integrate. It is perhaps the most important part of neuroanatomy to be able to diagnose the location of a lesion based upon a patient's symptoms. However, it seems to be the one thing I cannot do.

Looking at cross sections of the brainstem will forever haunt me. I know where each thing is in theory, but by the time I figure out where everything is one at a time, my patients will die of old age before I locate the source of their ipsilateral hemianesthesia.

I'm excited to hear how I did on the shelf exam. I really hope I did well enough to pass the class. I was borderline before the shelf, thanks to a "deer in the headlights" first exam that lost me quite a few points. (Pass is 70%.) In hindsight, I think I would have rocked this class without block scheduling. I think the immense detail just takes longer to absorb... at least for me. Despite the fact I spent 6-8 hours per day studying, I didn't do all that well, mostly because I felt I was always studying against a ticking clock. Not an excuse, just an observation.

In the long run, even if I didn't pass, I know I will pass the retake. Because... as much as I hate to admit it... I learned a SHITLOAD by having to struggle so hard in this class. Who knew? Drowning helps you swim.

Photo swiped from here.