The rise (and fall?) of an unwelcome presence

Abstract

This article discusses the personal experiences of the author regarding the journey of a neurologist right from the childhood. As children, they experience a transient neurologic syndrome. As teens, they explore popular neuroscience, meeting up with Oliver Sacks’ patients in the middle of the night when we should rather be studying. They train by riding the gurney of the stroke patient, watching the body with tubes and wires in every orifice shudder with each blip on the screen, and looking into the faces of the children of the aged farmer, his skull full of blood. Then they see a lot of people who think they have Lyme disease but do not. Next, they see the fallen matriarch in her diapers for a dementia follow-up and lament with her heartbroken son about a terrible disease. Finally, at the end of a long day, they jab a needle in someone’s neck and say, “At last! I’m helping someone!” But gradually, the neurologists become aware of an unwelcome presence. The presence starts to ask for little things at first, like letters with specific sentences, or just a few more irrelevant facts. After a while, the presence deposits a clunky machine and asks for just a few hundred extra clicks a day. The presence uses ancient telephone lines to send audits on their prescribing practices, issuing from countless different species called “formularies,” complex beasts that shape shift every 6 months but always seem hungry for paper and time. (PsycInfo Database Record (c) 2022 APA, all rights reserved)