A healthy recollection of one’s shortfalls as a physician can be a good thing.
One year into my neurology training and listening to a patient tell me a typical story of temporal lobe seizures, I felt struck by a bolt from the blue. In the midst of a young woman describing her deja vu experiences, I experienced an intense deja entendu. Suddenly, I was back in a cardiology clinic in Dublin, and a middle-aged woman was telling me, an internal medicine trainee at the time, an almost identical tale. I, not knowing what the dickens she was describing, decided in my infinite wisdom it was not important, told her not to be concerned, that her heart was fine, and sent her on her way.
The woman’s face is out of focus, but to this day I can recall my location in the medical outpatient department at the Mater Misercordiae Hospital, Eccles St., Dublin, as she and I spoke. At some level, I must have registered the impression that while I did not understand the nature of her complaints, that perhaps they were significant, despite (I’m sure) my confidently delivered reassurance that all was well. How else can I explain the vivid memory of her description?
I have always credited my interest in epilepsy to a wonderful pediatric epileptologist in Dublin, but I can’t be certain that this recollection of one of the lacunes in my knowledge, spiced with the inevitable hubris and immaturity of the early 20s was not an influencing factor. It’s for sure that I heard thousands of stories subsequently about the odd way in which aberrant neuronal behavior of the limbic system can manifest itself. It’s also certain that I reassured patients many times that they were not crazy, and told colleagues that the sometimes bizarre sounding stories of a patient with temporal lobe epilepsy had an organic basis.
I like to think that someone smarter, more patient or more thoughtful than I, met this cardiology clinic patient subsequently and directed her to a neurologist. I like to think that I was willing enough to look at my own oops moments, and turn a loss into a long-term gain.