Neurologist savagely mocks Bill. Bill takes Ativan to control humiliation-induced panic attacks. Bill's synaptic function becomes depressed, clinical skills suffer. Neurologist mocks some more. It's a vicious cycle.
Why yes I did run out of neurotransmitters, thanks for noticing. I've not seen a shred of dopamine in years. Any serotonin I have is in my gut, and norepinephrine decided I wasn't worth their time
"Synaptic transmission should only take 0.5 milliseconds. Did you run out of neurotransmitters?" He's so scary....no wonder poor bill is always so dejected 😂🤣
I ☹️ had 😢 a 🥺 neurologist as a therapist for PTSD 😭😭😭. I ghosted him after a year because I was too afraid to tell him how bad he sucked. I went off on him once when he asked, “what the f**k is wrong with you?” I asked him the same question and followed up with, “aren’t you supposed to be helping me?!” Then he wanted a hug at the end of the session. He called me a month after our last appointment. I let it go to VM and never seen or talked to him since leaving. He is a topic of issues I’m working through with a new therapist.
@@OuchingTigerLimpingDragon I know it sounds funny, but it wasn’t. He effed me up mentally big time. If I could punch him in the face I would 🤜🏼😵 Honestly I hope he thinks I’m dead
That was SOOO savage 😂 I remember one time in med school our neurologist asked us to identify the neurological deficit and he was so proud that I stepped up to examine, when in reality, my colleagues had stepped back and I didn't notice 😅
If ur job is to study the brain, u should know. God, I would give anything for the chance to do these things but never could afford the school or establish good enough credit. if I was a Dr, and knew Dr words enough to search for answers and whatnot and could understand medical journals and all that and always brow deep in medical science, I could bet both my nuts id localize the lesion and not even be a neurologist. Wonder if there is a way by joining the military?
@@Wtfinc I can tell just by your comment that you have. in my opinion, exactly the kind of intelligent, compassionate person that is needed in medicine the most. Youre references to the affordability of education, and joining the millitary suggests that you are living in The United States. This is why it's important to fund education for everyone who's willing to to do what it takes. Including paying an actual living wage which right now would be over $30.hour for medical students who are working, and obviously more upon graduation, internship, fellowship etc. We have an epidemic of poverty and greed coexisting within many cultures in the world. It really warmed my heart today as I read it, and I've been going through really rough times and needed it. There are some options out there to help you with scholarships, grants etc. especially for a person without resources. Search in many different countries, ask as many different artificial intelligence models online as you can. But what do I know, I'm just a middle-aged autistic dude who was given a medical textbook as a present when I was a kid. I wanted it because I liked the pictures. I still like the pictures.
Honestly who cares where the lesion is? I used to know all this stuff in med school. but in clinical practice any neurological deficit is.... Neurology's problem... Also any neurological deficit = CT Brain. Which will show you exactly where the problem is. Not to mention you need the scan anyway to differentiate hemorrhagic vs ischemic stroke. On top of that most patients will have some deficits from prior (minor) thromboembolic events in various locations so it will muddle the picture. I literally never hear about neurology discussing where the lesion is based on the neurological exam alone. You need the knowledge for your board exams and if you plan on practicing medicine in Cambodia.
As I neurologist I would be very excited to see this fascinating case of one-and-a-half syndrome (ipsilateral gaze palsy and INO), where you hit the PPRF/abducens and MLF all at once! 🤓 As a neurology attending I would not give full marks to my student just saying pons, as this is localized specifically to the VENTROMEDIAL pons 😂 Real neurologists are way more OCD!
I had a similiar consult today, except less condescending and more like "I am gonna train this little cardiology resident to top neurology diagnosis". It was super interesting, but meanwhile I saw the time fly by and my "early" shift end go byebye. (a max of two hours overtime each day is my goal, preferrably less, obviously) And in the end my patient didn't even had any lesion but "only" a reaction to the contrasting agent we used for her coronary arteries. We still had to make sure though oO
As a neurologist, I will never understand why people think it would be easier to search for a spot in an MRI without knowing where to look instead of at least trying to know where to look by examining the patient.
If everyone had an MRI we all slept in and would use software to look at how they changed over time, you would still need a neurologist to make sure the software didn't get it wrong. Computer diagnostics still suck with differential diagnosis. A lesion can look completely normal on an MRI, but still hugely impact on neurological function.
I would have cried on the spot... or if I had the strength, find the nearest janitorial closet and cry there. Bill might just end up fighting the neurologist after the cardiologist.
This reminds me of a scary neurologist I was shadowing as a student... Got grilled so much on day 1 that I went home and spent the night brushing up on high yield neuro and stroke stuff. Next morning he asked me in detail about atrial fibrillation including how to read a 24 hour ECG and I had no f clue...
“A tiny little radiologist” 🤣 I can never localize the lesion. This is literally how I feel about calling neuro 🥺 Wish I could just say I didn’t pay attention in med school please help 😫
I'd love to see this sketch too! IRL we get along very well, much akin to the cardiac surgeon and the cardiologist. In shared cases, neurosurgeons mostly take care of the catastrophic structural diseases (or install neurostimulators), neurologists do the fine-tuning of diagnosis, treatments (including neurostimulator adjustments) and prognosis, mostly helping neurosurgeons to manage their patients once the hard part (surgery) is done. A well-known joke in our circles is: Neurosurgeons know nothing but can do everything. Neurologists know everything but can do nothing. Pathologists know everything and can do everything, it's just too late.
I’m really scared for Bill. We had two suicides in my year, and every time Bill gets beaten down like this I’m afraid Dr. G is going to make things go too real.
I’m a neuroscience undergraduate and the struggle to localize extends outside the medical field! The class average for that test was one of the lowest all year!
I started my nursing career in Oncology, stayed FAR away from neuro until I got sent to a neuro unit on contract. I was petrified. Then I fell in love with it, stayed on that unit for 4 years and became and SCRN. Come to the dark side, Bill. I'll make you cupcakes with brain shaped icing.
" synaptic transmission should only take 0.5 seconds. Did you run out of neurotransmitters?" Had me rolling, might have to use that little ditty in the future 😆
Bro this gave me anxiety bcs this is exactly what my supervisor who is a neurologist ask me questions during bedside teaching 😭 yes Dr my neurotransmitter isn't working at all 😭🤧
At least you got to do a full neurological examination.. I remember in one of my clinical tests, the neurologist told me to only do a lower limb examination, I did and afterwards he asked me to localise the lesion, I said I only know its on the left above L3 but I need to have a full examination to localise.. and he was mad and said, well when you instructed the patient, didn’t you notice that she got difficulty answering?! She got Broca aphasia!!! damn it I thought the patient was simply too tired to answer me🥲
Damn that’s evil, that’s how my mother schools me on oncology. People at work think I’m smart meanwhile she’s giving me the smack down on the regular lol 😂
Well, there's always an indication for getting an MRI. Even if it was an Incidental finding, there's always a reason for getting a brain MRI. For example, if they have cancer elsewhere.
@@Liuhuayue Of course, I'm not saying that you don't get an MRI if you can localize a deficit clinically, but that you certainly need MRI if you can't, which is often.
@@thadreimagined9391 Can confirm. I had a tumour blocking my third ventricle that went undiagnosed for 6m, with nausea, vomiting, headaches, and dizziness because 3 e.r. doctors wouldn't bother to do ANY imaging. CT found pressure (thought it was swelling, but it was actually CSF build up) and MRI found the 2in tumour causing the blockage.
@@brendielahooha It was and it wasn't. I had symptoms for over 6 months and saw multiple e.r. doctors who only did urine tests, despite me explaining my symptoms - and the fact that they were getting worse each visit. The doctor who FINALLY listened to me and ordered the MRI was an urgent care doctor and the symptoms + no urine abnormalities concerned him. Not a single previous doctor was concerned up to that point, and had he not ordered the MRI, my Neurosurgeon confirmed I would have been dead within the week.
I hope our boy never has anything present abnormally, or multiple issues at once. Then theyll be treating the wrong issue and so overconfident they wont run tests to verify the issue
And that perfect impressiin of every single condescending asshat (aka neurologist) is why it took10 freaking years to figure out I have chronic migraine with aura and gluten ataxia. The symptoms were temporary & unpredictable but because the MRI was clean I must have just been attention seeking, right? Look, Dr. Douchenozzle, I have PTSD and I'm a medicated bipolar, but I do not have any cluster B personality disorders. I just want to walk!
00:00 ah I just had my worksheet due last week or so ago 0:35 so somewhere on the tract of course, oculomotor nerves, or the superior colliculus? Or is it like a trochlear nerve/abducens thing? Hemiparesis so nonconsensual eye movements...? And uh Oh. Farther back...oh Oh wait I didn't listen to the eye-plegia part before starting, but ... I dunno what INOP is and my worksheets don't go far back as pontile lesions 🥺 I think Unless it's one of the XII ... *repeated page flipping*
Nine Syndrome. Possibly. The Neurologist failed to mentioned whether the facial nerve was involved. Nine syndrome is: INO, horizontal gaze palsy (1 and a half syndrome) + peripheral face palsy (eight and a half syndrome) + contralateral hemiparesis/hemianesthesia = Nine syndrome. It can also present with hemiataxia instead of hemiparesis.
How did my cousin's neurologist make it onto your channel. Went with him for is appointment, and the neurologist was always ranting. Forget HIPAA. Could hear almost everything from the waiting room. Nerdy rage head. Lol
Damnit. Now i'm annoyed 😂 I have crazy weird (in an unpleasant way) neurological symptoms but i had a brain MRI and it was apparently 'normal' so.of course the logical next step for the neurologist was to discharge me from the service despite mme still having a vast number of symptoms suggesting *something* is wrong. The incompetence of both neuro teams i saw was certainly able to be heard 2k miles away 🙄 Some neurologists just deserve to be treated like this 😂
This is why I am not a doctor. I would had slided the consulting MD like the flip flops he was wearing during vacation. His teeth would've been embedded so deep in his frontal lobe, Neuro would had thought he had schizophrenic brain lesions.
Pons is probably correct because it contains the nucleus of CN VI which controls the lateral rectus, hence the lateral gaze palsy. Along with the hemiparesis and internuclear ophthalmoplegia, that paints the picture of medial pontine stroke.
Ouch! Talk about an evisceration! I was in full panic mode when I couldn't figure out where the lesion was! Then I remembered, I didn't go to medical school!
As someone who doesn't know anything about doctor terms I find these very entertaining even though I cannot tell if he is saying a medical procedure or a disease 👍
This reminds me so much of the grilling I used to get not by the neurologist I worked under, but by the radiologist who controlled our access to imaging! Unless I could be clear about where I thought the lesion was, and what I expected the imaging results to be, I couldn't send the patient....and then had to explain this to the Professor who was the one who wanted the imaging in the first place (and who didn't know where the lesion was, either ). Stressful at the time...funny now (when I can freely order imaging)
Poor Bill. Eventhough he will spend the rest of his life in therapy for anxiety and med school induced PTSD, I'm sure Bill is going to be a damn good doctor if he survives.
I already know about my own ignorance concerning the medical field and glasses man made me feel like I got called to the front of the class to be made the fool🤣🥲
Well damn!!! 😂 After working 5,000,000 hours this week for a big corporation, with an avalanche of unpaid student loans, I suddenly want to be a doctor just so I can hang out with them all day long and laugh my ass off. 🤣 I love this guy!!! I mean I have the student loans, and a very catching sense of humor, plus I slept at a Holiday Inn this week when traveling for work.. I think I can do it!!! 🤜🤛💪
Damn, I guessed the lateral geniculate nucleus. Or maybe the medial longitudinal fasciculus? Idk, I usually just Jesus take the wheel when I get those kinds of questions. Looks like it's back to the books for me...
I’m not in neurology or ER. But this gave me anxiety… watched it 7 times in a row and then straight to restudying all the stroke syndromes .. still I may have nightmares
![Cody Johnson - I'm Gonna Love You (with Carrie Underwood) [Official Music Video]](http://i.ytimg.com/vi/yy9PuYMU29g/mqdefault.jpg)
"You can cancel bill's stroke work up and just focus on the patient" I was dying
Neurologist savagely mocks Bill. Bill takes Ativan to control humiliation-induced panic attacks. Bill's synaptic function becomes depressed, clinical skills suffer. Neurologist mocks some more.
It's a vicious cycle.
@@sobel4511 You just described my college experience at multiple points. 🥺
@@KatieCottingham 😭
Omg 😝 indeed hilarious
So was the patient
Why yes I did run out of neurotransmitters, thanks for noticing. I've not seen a shred of dopamine in years. Any serotonin I have is in my gut, and norepinephrine decided I wasn't worth their time
Me on this neuro pharm exam tomorrow
I don’t need to take the exam, I need to take the medicines on the exam
Omg, I thought the skit was funny, but this comment just split my side 🤣🤣
now THIS is an amazingly great answer
I thought I was the nurse version of Bill, but apparently I am actually the nurse version of Sara C.
@@cmoneman3025 Not Sara C, but you need to make sure to mention where this quote came from then.
"Synaptic transmission should only take 0.5 milliseconds. Did you run out of neurotransmitters?"
He's so scary....no wonder poor bill is always so dejected 😂🤣
Literally read this perfectly in time for when he says it in the video 😂
Sheesh this was my favorite part of the whole video. Most savage insult for someone taking too long to respond. Imma have write this one down.
I ☹️ had 😢 a 🥺 neurologist as a therapist for PTSD 😭😭😭. I ghosted him after a year because I was too afraid to tell him how bad he sucked. I went off on him once when he asked, “what the f**k is wrong with you?” I asked him the same question and followed up with, “aren’t you supposed to be helping me?!” Then he wanted a hug at the end of the session. He called me a month after our last appointment. I let it go to VM and never seen or talked to him since leaving. He is a topic of issues I’m working through with a new therapist.
@@OuchingTigerLimpingDragon I know it sounds funny, but it wasn’t. He effed me up mentally big time. If I could punch him in the face I would 🤜🏼😵 Honestly I hope he thinks I’m dead
@@jacobcornelius9273 *imma have to write
That was SOOO savage 😂
I remember one time in med school our neurologist asked us to identify the neurological deficit and he was so proud that I stepped up to examine, when in reality, my colleagues had stepped back and I didn't notice 😅
Like Harry in Prisoner of Azkaban during the Buckbeak flying scene 😂
@@hiyasaha4506 oof! Exactly! 😅
Harry Potter moment xd
They had you like Harry when Hagrid made him ride Buckbeak the Hippogriff
Wait. I thought that only happened in movies. 😂😂
"Cancel Bill's stroke workup and just focus on the patient." Yeah, but now Bill has to go to the burn unit! Fuck!ng savage.
💯🎯💯🎯🤣🤣🤣👏🏽👏🏽👏🏽👏🏽
I heard that and made the OOOOH noise you made in middle school when someone got that sick burn.
Poor Bill! He needs a hug and some burn ointment!
🤣🤣🤣🤣🤣🤣
(Incompetence... ) it was deafening.
Bill lives in the burn unit.
Poor Bill is always so defeated, I just want to hug him and feed him a cookie.
The boy needs love, I know he'll be a great doctor someday just keep buddy
@@ddogvtae9142 😂😂 Poor ol Bill.
I agree. That would make the world for him.
And give him a glass of water because he "doesn't trust his kidneys"
@@chonky_fox4067 was that Bill though? I think that was the new med student, but I could be wrong.
"I could hear your incompetence 2k miles away. It was deafening." Best insult ever.
My thoughts exactly!
"That makes sense" he said in tired resignation
Oh my god to this day localising the lesion is the one task that haunts me the most
Look up the rule of 4 for stroke. Fantastic article and great visual mnemonic for sensory and motor deficits.
If ur job is to study the brain, u should know. God, I would give anything for the chance to do these things but never could afford the school or establish good enough credit. if I was a Dr, and knew Dr words enough to search for answers and whatnot and could understand medical journals and all that and always brow deep in medical science, I could bet both my nuts id localize the lesion and not even be a neurologist. Wonder if there is a way by joining the military?
@@Wtfinc I can tell just by your comment that you have. in my opinion, exactly the kind of intelligent, compassionate person that is needed in medicine the most. Youre references to the affordability of education, and joining the millitary suggests that you are living in The United States. This is why it's important to fund education for everyone who's willing to to do what it takes. Including paying an actual living wage which right now would be over $30.hour for medical students who are working, and obviously more upon graduation, internship, fellowship etc. We have an epidemic of poverty and greed coexisting within many cultures in the world. It really warmed my heart today as I read it, and I've been going through really rough times and needed it. There are some options out there to help you with scholarships, grants etc. especially for a person without resources. Search in many different countries, ask as many different artificial intelligence models online as you can. But what do I know, I'm just a middle-aged autistic dude who was given a medical textbook as a present when I was a kid. I wanted it because I liked the pictures. I still like the pictures.
Yeah depending on age. You might also study abroad instead of dying for a country that doesn't care about you.
@@Wtfinc hm
By this point, i don't even have any myelin sheathe in my neurons
MS buddy?
Lol
Me neither. Crying?? There's no crying in Neurology!! Bill quits crying, sweats and squirms docs job is done.
What stage of MS are you on bro
😂 nerves not firing correctly?! 🤔😂😂😂
The pons is my new instant answer to all neurology questions
It’s a good guess
Everything localizes to the pons
It's always somehow connected.
What the heck is a pons??
@@SundayMourningLove it's basically the meat of the brainstem
"Did you run out of neurotransmitters?" is both the meanest and the funniest insult I've heard lmao
As someone who is taking medications for issues with executive function and neurotransmitter levels I have to say...
This is how you do dark humor.
And they answer is invariably, yes I did. The synapses just aren't synapsing.
Bill: " So now that we've localized it how to we fix it?"
Neuro. "Woah woah woah there, that's not my field"
🤭
Savage
Yeah, that was enough for me to switch from neurology to surgery and I'm never going back
Even though... it is. Depending on what kind of damage it is. The Neuro-interrogation simply wasn't over yet.
5 days iv solumedrol
This physically hurt today since I literally just got out of my neurology final 20 minutes ago and this was about half of it 😂
There’s a saying that neurologists don’t treat disease; they admire it. They also seem to admire themselves.
Yup, med studen here, neurological ICU looks like zombieland, one patient cant move/feel/comprehent/hear/see.... this, other that
By transitive property, that means that a neurologist is a type of disease? 😁
A radiologist's second worst nightmare. First of course, is going outside
🤣😎
*materializes from over 2000 miles with a literal shockwave from the Sonic boom* "how long was I gone?"
As someone who just had their final for clinical neuropsychology yesterday, this hits hard. WHERE IS THE LESION!!!???
It must feel awesome to be done, got my final for my Neuro/Psych clerkship this Thursday and Friday. This video hit a little too close to home
*WHERE IS IT!?*
Honestly who cares where the lesion is? I used to know all this stuff in med school. but in clinical practice any neurological deficit is.... Neurology's problem... Also any neurological deficit = CT Brain.
Which will show you exactly where the problem is. Not to mention you need the scan anyway to differentiate hemorrhagic vs ischemic stroke. On top of that most patients will have some deficits from prior (minor) thromboembolic events in various locations so it will muddle the picture.
I literally never hear about neurology discussing where the lesion is based on the neurological exam alone. You need the knowledge for your board exams and if you plan on practicing medicine in Cambodia.
Congratz
@@ivanmed8568 that's what I thought too
He was like WHO HAFT SUMMONED ME!!!" and bill was like "damn it I was trying to conjure a cookie"
My absolute favorite character (the neurologist). I'm surprised every morning when I localize my shoes.
Now I'm curious about where the neurologist goes for vacation
Marblehead? Braintree?
The medulla oblongata, I hear it’s nice this time of year.
They go 2000 miles away
Inside his head.
2000 miles away, but near instantaneous arival...I think process of elimination suggests a cloaked starship in orbit.
As I neurologist I would be very excited to see this fascinating case of one-and-a-half syndrome (ipsilateral gaze palsy and INO), where you hit the PPRF/abducens and MLF all at once! 🤓 As a neurology attending I would not give full marks to my student just saying pons, as this is localized specifically to the VENTROMEDIAL pons 😂 Real neurologists are way more OCD!
*OCPD. Did you check AChR? _runs away_
This is so funny 😂
Nerd (respectfully)
Someone please give Bill a vacation, several cookies, and a warm blanket
There should be warm blankets in recovery
Did you run out of neurotransmitters?!? Thanks for another laugh
Was kind of expecting Bill to say yes to that question
I had a similiar consult today, except less condescending and more like "I am gonna train this little cardiology resident to top neurology diagnosis". It was super interesting, but meanwhile I saw the time fly by and my "early" shift end go byebye. (a max of two hours overtime each day is my goal, preferrably less, obviously)
And in the end my patient didn't even had any lesion but "only" a reaction to the contrasting agent we used for her coronary arteries. We still had to make sure though oO
Transient cortical blindness after contrast is always a bitch to explain to non neurologists so they believe you.
As a neurologist, I will never understand why people think it would be easier to search for a spot in an MRI without knowing where to look instead of at least trying to know where to look by examining the patient.
When you put it like that it makes sense.
Yeah but if we could all do perfect neuro exams then you wouldn't have a job ¯\_(ツ)_/¯
@@DaveXL495 Wouldn't they still have a job, it'd just be spent doing... their job?
If everyone had an MRI we all slept in and would use software to look at how they changed over time, you would still need a neurologist to make sure the software didn't get it wrong. Computer diagnostics still suck with differential diagnosis. A lesion can look completely normal on an MRI, but still hugely impact on neurological function.
Cuz it takes 2 seconds to spot ischaemia...
Good lord, the sass is just rolling off of the neurologist... great job!
This almost hits like a scene from House.
"Attending, you can cancel Bill's stroke workup and just focus on the patient." Boom! Drop the mic, exit stage left. I love the neurologist so much!
Yo props to Bill for pulling through under pressure.
I would have cried on the spot... or if I had the strength, find the nearest janitorial closet and cry there. Bill might just end up fighting the neurologist after the cardiologist.
This reminds me of a scary neurologist I was shadowing as a student... Got grilled so much on day 1 that I went home and spent the night brushing up on high yield neuro and stroke stuff. Next morning he asked me in detail about atrial fibrillation including how to read a 24 hour ECG and I had no f clue...
“A tiny little radiologist” 🤣
I can never localize the lesion. This is literally how I feel about calling neuro 🥺
Wish I could just say I didn’t pay attention in med school please help 😫
Be honest with him, he'll probably be happy to help you remember just so that you don't bother him ever again...
I gotta say Doc I love the characters you have created lol
They’re all funny … great job
I want bill to get a big win! Make Neuro, Nephro and Cardio stand in awe!
I'm having war flashbacks to learning the Rule of 4s. The HORROR
i kinda want to know how neurology n neurosurgeon meet up would be
Yes!
It's like when an unstoppable force meets an immovable object
A giant pissing match
I don't think the neurosurgeon would even aknowledge that neurology is there...
I'd love to see this sketch too! IRL we get along very well, much akin to the cardiac surgeon and the cardiologist. In shared cases, neurosurgeons mostly take care of the catastrophic structural diseases (or install neurostimulators), neurologists do the fine-tuning of diagnosis, treatments (including neurostimulator adjustments) and prognosis, mostly helping neurosurgeons to manage their patients once the hard part (surgery) is done. A well-known joke in our circles is: Neurosurgeons know nothing but can do everything. Neurologists know everything but can do nothing. Pathologists know everything and can do everything, it's just too late.
Rip to the radiologists out there he's coming for everybody
Bill, don't let him trample on you. Remember that the neurologist knows everything but can do nothing. Go into surgery.
Or become an interventionalist. Residency is more pleasant and you don’t have to stand as long.
I’m really scared for Bill. We had two suicides in my year, and every time Bill gets beaten down like this I’m afraid Dr. G is going to make things go too real.
I’m a neuroscience undergraduate and the struggle to localize extends outside the medical field! The class average for that test was one of the lowest all year!
I don't understand a thing, but it sounded funny. I love it
Needed a chuckle before an integrated final tomorrow. CNS pathology, pharm, micro, and clinical all in one :(
I started my nursing career in Oncology, stayed FAR away from neuro until I got sent to a neuro unit on contract. I was petrified. Then I fell in love with it, stayed on that unit for 4 years and became and SCRN. Come to the dark side, Bill. I'll make you cupcakes with brain shaped icing.
i'm dreading relearning all the neuro lesion stuff for boards lol
Do you have to relearn the basal ganglia pathways? I found those to be a bitch to memorize.
LEAVE BILL ALONE, HE DOESN'T DESERVE THIS. He just wants to eat his applesauce cup in peace before heading back to his 57 hour shift.
Oh god this made me tear up i can feel bill's anxiety so clearly poor baby
" synaptic transmission should only take 0.5 seconds. Did you run out of neurotransmitters?"
Had me rolling, might have to use that little ditty in the future 😆
Back in my Army days
The Lesion was where we went to have a beer
But...we had to find an open lesion...
Ah, so this is how you get hazed into being a Jonathan.
No, Johnathan isn't a medical student nor a physician. Jonathan is a medical scribe (typical pre-med students).
When asked where is the lesion, I’d have answered yes. If then asked what I’d say possibly. Just because
Bro this gave me anxiety bcs this is exactly what my supervisor who is a neurologist ask me questions during bedside teaching 😭 yes Dr my neurotransmitter isn't working at all 😭🤧
At least you got to do a full neurological examination.. I remember in one of my clinical tests, the neurologist told me to only do a lower limb examination, I did and afterwards he asked me to localise the lesion, I said I only know its on the left above L3 but I need to have a full examination to localise.. and he was mad and said, well when you instructed the patient, didn’t you notice that she got difficulty answering?! She got Broca aphasia!!! damn it I thought the patient was simply too tired to answer me🥲
Oh . . . The dog that didn't bark. Now THAT really was savage.
Damn that’s evil, that’s how my mother schools me on oncology. People at work think I’m smart meanwhile she’s giving me the smack down on the regular lol 😂
😆😆😆
The problem is that sometimes patients have no deficits and yet still have a >6 cm brain tumor. That's why you need MRI.
Well, there's always an indication for getting an MRI. Even if it was an Incidental finding, there's always a reason for getting a brain MRI. For example, if they have cancer elsewhere.
@@Liuhuayue Of course, I'm not saying that you don't get an MRI if you can localize a deficit clinically, but that you certainly need MRI if you can't, which is often.
@@thadreimagined9391 Can confirm. I had a tumour blocking my third ventricle that went undiagnosed for 6m, with nausea, vomiting, headaches, and dizziness because 3 e.r. doctors wouldn't bother to do ANY imaging. CT found pressure (thought it was swelling, but it was actually CSF build up) and MRI found the 2in tumour causing the blockage.
@@Amarianee Yes, but you had symptoms, abd that was the indication for your mri
@@brendielahooha It was and it wasn't. I had symptoms for over 6 months and saw multiple e.r. doctors who only did urine tests, despite me explaining my symptoms - and the fact that they were getting worse each visit. The doctor who FINALLY listened to me and ordered the MRI was an urgent care doctor and the symptoms + no urine abnormalities concerned him. Not a single previous doctor was concerned up to that point, and had he not ordered the MRI, my Neurosurgeon confirmed I would have been dead within the week.
I hope our boy never has anything present abnormally, or multiple issues at once. Then theyll be treating the wrong issue and so overconfident they wont run tests to verify the issue
I loved the "your incompetentance was deafening" line. Perfect.
And that perfect impressiin of every single condescending asshat (aka neurologist) is why it took10 freaking years to figure out I have chronic migraine with aura and gluten ataxia. The symptoms were temporary & unpredictable but because the MRI was clean I must have just been attention seeking, right?
Look, Dr. Douchenozzle, I have PTSD and I'm a medicated bipolar, but I do not have any cluster B personality disorders. I just want to walk!
His impression of a neurologist looks so much like my neurologist it's actually scary and so hilarious 😂
00:00 ah I just had my worksheet due last week or so ago
0:35 so somewhere on the tract of course, oculomotor nerves, or the superior colliculus?
Or is it like a trochlear nerve/abducens thing?
Hemiparesis so nonconsensual eye movements...? And uh
Oh. Farther back...oh
Oh wait I didn't listen to the eye-plegia part before starting, but
...
I dunno what INOP is and my worksheets don't go far back as pontile lesions 🥺 I think
Unless it's one of the XII
...
*repeated page flipping*
What happens if infectious disease and neurology meet each other?
Nine Syndrome. Possibly.
The Neurologist failed to mentioned whether the facial nerve was involved.
Nine syndrome is: INO, horizontal gaze palsy (1 and a half syndrome) + peripheral face palsy (eight and a half syndrome) + contralateral hemiparesis/hemianesthesia = Nine syndrome.
It can also present with hemiataxia instead of hemiparesis.
Well done Bill. Was it ever established what specialty Bill is in? Maybe it’s not too late to recruit him to neurology!
His specialty is Bill.
I thought Bill went into Pediatrics
How did my cousin's neurologist make it onto your channel. Went with him for is appointment, and the neurologist was always ranting. Forget HIPAA. Could hear almost everything from the waiting room.
Nerdy rage head. Lol
That's exactly how neurologists ask us when we refer patients to them. 😂
Damnit. Now i'm annoyed 😂
I have crazy weird (in an unpleasant way) neurological symptoms but i had a brain MRI and it was apparently 'normal' so.of course the logical next step for the neurologist was to discharge me from the service despite mme still having a vast number of symptoms suggesting *something* is wrong.
The incompetence of both neuro teams i saw was certainly able to be heard 2k miles away 🙄
Some neurologists just deserve to be treated like this 😂
Go Bill GO!
“I’m surprised you can localize your shoes in the morning!”
SAVAGE
The sassiest specialist is back!
“But I could hear your incompetence 2,000 miles away” 😂😂😂
Oh my gosh, that final delivery from the neurologist was so savage, I can't even. 🤣🤣
I am officially a privileger (credentialer) for my locum company. Next week I will join my new team: Neurology.
I cannot wait :D
How to portray a neurologist as punchable in less than a minute. Well done!
Pons is vague, Bill... say "the medial longitudinal fasciculus"... Ughh
I could hear your incompetence from 2,000 miles away. It was deafening.
This is why I am not a doctor. I would had slided the consulting MD like the flip flops he was wearing during vacation.
His teeth would've been embedded so deep in his frontal lobe, Neuro would had thought he had schizophrenic brain lesions.
Pons is probably correct because it contains the nucleus of CN VI which controls the lateral rectus, hence the lateral gaze palsy. Along with the hemiparesis and internuclear ophthalmoplegia, that paints the picture of medial pontine stroke.
My neuroplasticity is done for the day.....now im just neuroplastic.
I think I killed all my neurotransmitters in college. If I had known I would need every single one of them when I hit 50...
Ouch! Talk about an evisceration! I was in full panic mode when I couldn't figure out where the lesion was! Then I remembered, I didn't go to medical school!
As someone who doesn't know anything about doctor terms I find these very entertaining even though I cannot tell if he is saying a medical procedure or a disease 👍
This reminds me so much of the grilling I used to get not by the neurologist I worked under, but by the radiologist who controlled our access to imaging! Unless I could be clear about where I thought the lesion was, and what I expected the imaging results to be, I couldn't send the patient....and then had to explain this to the Professor who was the one who wanted the imaging in the first place (and who didn't know where the lesion was, either ). Stressful at the time...funny now (when I can freely order imaging)
Poor Bill. Eventhough he will spend the rest of his life in therapy for anxiety and med school induced PTSD, I'm sure Bill is going to be a damn good doctor if he survives.
He just pops in with his hair all froed up, "OH REALLY!?" 😂😂😂 Omg, I can't stop laughing!!
My doctor mind running through differential diagnoses while watching this as if I’m giving viva or presenting in morning round
😂😂😂"I can hear your incompetence over 2000 miles away!" I am sooo going to file that one away! 😂😂😂 And did you run out of neuro transmitters... 😂😂
Lmao I'll be using that too! 😂
I dont understand anything....but i still enjoy watching
Neurology--They hate us, cuz they ain't us. 🤣
I already know about my own ignorance concerning the medical field and glasses man made me feel like I got called to the front of the class to be made the fool🤣🥲
Please respect your dark adapted colleagues. Lol. =))
Localize = MRI
Im giggling so much over “tiny little radiologist” 😅
OMGGGGG SAVAGE 🤣🤣🤣 SOMEONE CALL THE BURN UNIT!!
Well damn!!! 😂 After working 5,000,000 hours this week for a big corporation, with an avalanche of unpaid student loans, I suddenly want to be a doctor just so I can hang out with them all day long and laugh my ass off. 🤣 I love this guy!!! I mean I have the student loans, and a very catching sense of humor, plus I slept at a Holiday Inn this week when traveling for work.. I think I can do it!!! 🤜🤛💪
Pretty sure we're all aware that Bill has indeed run out of neurotransmitters
I feel like everyone's sleeping on "I'm surprised you can localise your shoes in the morning!" Because that took me the fuck out 😂
“replace the prefrontal cortex with a tiny little radiologist “ 🤣🤣🤣
Damn, I guessed the lateral geniculate nucleus. Or maybe the medial longitudinal fasciculus? Idk, I usually just Jesus take the wheel when I get those kinds of questions. Looks like it's back to the books for me...
I thought that it was the medial longitudinal fasciculus as well! Then Bill said Pons..... I dread neuro but I guess time to go back to relearn
Bill shouted out the answer at exactly moment I shouted it out 😅
I feel violated and dirty...
Most if this went over my head, but I could still appreciate the savagery.
I’m not in neurology or ER. But this gave me anxiety… watched it 7 times in a row and then straight to restudying all the stroke syndromes .. still I may have nightmares
Damn the amount of anxiety I got from this is painful.
cancel that stroke workup