Neurology, week 4

too-close-for-comfort.jpgAs I sit down to write this I realized that the week passed in a blur. It’s week 5 of 19 in this long semester, and the end of my first PBL group of 2008. I think I’m going to miss the group as it was one of the most laid back, fun to be with groups I have had since the beginning of medical school. The next group has some intense personalities which may or may not be problematic – I guess I’ll see. Unfortunately, it is most often the personalities of either the tutor or your peers that make the PBL process more painful than it needs to be. For example, I remember being in one particular group where there was an individual who wanted to debate whether or not we should bring food on Fridays! Good grief! Food on Fridays is one of the few things I actually look forward to, and usually people are into bring food to share at the Friday sessions. It’s simply one of the few decent social interactions there are in PBL, and this wanker person had (for whatever reason) taken issue with it. Needless to say the rest of the 5 weeks of PBL (that is 3x a week for a total of 15 sessions altogether) went as smooth as sandpaper. I digress here – there’s a new PBL group starting next week, and I hope it’s as good as the one I left.

The material we cover this week involved strokes. It’s interesting stuff and aside from a couple of lectures that were horrible, I thought everything went well. Perhaps one of the highlights was a talk by Dr. Klein and his wife, Bonnie, who had previously suffered a stroke. They covered what it was like to navigate the Canadian medical system when Mrs. Klein first suffered from her stroke and the problems they encountered as they moved from the acute episode to recovery. On numerous occasions if it hadn’t been for Dr. Klein’s advocacy for his wife she most likely would have died, or at the least suffered needlessly. It is truly eye opening to see the power that people possess when it comes to determining their outcome in the medical system, and it is frightening to think that someone who was less connected or less well versed in Canadian medicine could have had a completely different outcome.

At the end of the talk I was left with the question: Was it the system, or the circumstances of Mrs. Klein’s case that lead to difficulties? Even after hearing them speak, I’m still not sure. Mrs. Klein suffered from a stroke which resulted in a “locked in” syndrome, a condition where she was aware and awake, but could not move or communicate due to complete paralysis. It is hard (no doubt) to treat and in her particular case it was only after a experimental type of surgery that she started to show improvement. Her condition even though it was hard to treat, certainly wasn’t helped by the fact that she moved through a number of different hospitals and had to deal with a number of different “experts” which at times hindered her recovery. This is where Dr. Klein helped the most, and in each instance was able to overcome the (sometimes large) obstacles which impeded his wife’s care. The Klein’s were a fantastic way to end the week, and we (as a class) were very privileged to have them speak to us today.

To read more on the circumstances surrounding Dr. Klein and Bonnie, read the article (here) published in the CMAJ (Don’t worry it’s a short article (3 pages) and interesting). If you want more information on Bonnie’s story she published a book about it called: Slow Dance: A story of stroke, love and disability. It’s a good story with a happy ending.


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