Sep 15, 2009

Crazy Brain Doctors: Why Are Neurologists So Strange?

Doctor D recently got a fascinating question about Neurologists. Rather than make something up, Doctor D decided to use his other strategy for covering his ignorance: consult a specialist. Luckily he was able to beg the finest Neurologist in the blogsphere to answer your question. If you haven't yet discovered Dr. Grumpy and his wacky patients you are missing out!
Question: After many years of seeing neurologists I've come to the conclusion that all neurologists are either A) a tad crazy or B) an asshole. I only continue my Doctor-Patient relationships with the ones that are crazy as I prefer crazy folks to assholes. Why do you think they seem to fall in one of these two categories? I haven't noticed this polarizing break down in any other specialists I've seen.
"I freely admit that it seems more neurologists are 'different', though the degree can vary from slightly eclectic to downright scary. I read years ago that, as a percentage, more neurologists are left-handed than any other branch of medicine. I assume this means something, but I have no idea what. I'd like to think I'm at least on the more benign side of the whole thing, but I have no idea what they say about me outside of here.

I agree that the field seems oddly polarized at times, though not sure I've noticed the extremes you have. In my position, though I don't personally don't see how another doc treats his patients in the office. I wish I had an answer as to why it is so, but I don't.

I could also say the same about patients. The majority of them (who I'm not writing about) are decent people. I wouldn't be doing this if I didn't like them. But there are certainly those who I've had acrimonious relationships with from the first moment. I've had some get up and walk out of my office. The bottom line is that how we-see-you and you-see-us is highly subjective, based on the intangible nature of human chemistry. The same docs that you think are assholes likely have a share of loyal patients, and those you like certainly have other patients who think they're incompetent and/or scum.

And I agree with you on who you choose to see. If the docs are equally competent, then I'd rather see a benign eccentric than an ass."

-Dr. Grumpy

26 comments:

Doctor D said...

Doctor D did consider going into Neurology when he was a med student which may explain a lot about this blog.

One thing Doctor D has noticed: Neurologist wear more bow ties than any other medical specialty. Doctor D assumes that means something too, but he has no idea what.

Helen said...

I've never been to a neurologist, so I can't comment on the bow tie phenomenon.

I have, however, noticed that cardiologists as a group seem to be rather snappy dressers. I have one in particular - a great doctor - who is never without a full pinstripe suit, enormous silver cufflinks, buffed leather shoes and a whole pile of gel in his hair.

Grumpy, M.D. said...

I haven't worn a tie of ANY sort in 10 years, except at a wedding.

Grumpy, M.D. said...

Mary, by the way, says I didn't answer the question. So here it is: I have no idea why we are wierd.

Anonymous said...

Mary knows all.

Tex said...

Interesting about left-handedness and Neurologist. One of my favorite Docs is a left-handed Neurologist. He's not an ass, but I wouldn't call him weird, either.

Nurse K said...

Actual conversation:

Goofy Neurologist: Hey K, is that your patient?
Me: No, it's Dood Nurse's, but I know a little about him [blah blah blah].
Goofy Neurologist: I have another question. Between you and him, who's the better nurse? I mean, should I go in there and take him off the case now that I've been consulted...?

Goofy Neurologist wears a tie too, I shit you not...

Koren said...

Hey Nurse K, how does someone get an invite to your blog? (and sorry to post this here, but I can't figure it out what your email is to ask you to be invited)

queenofoptimism said...

Thanks for the great post Doctor D and thanks to you as well Dr. Grumpy. I have only seen female neurologists and they have been quite patronizing and more mean than weird.

I'm very curious as to why endocrinologists are so eccentric and from what I read, a specialist so many have a hard time building the doctor-patient relationship.

warmsocks said...

Hmmm... I've usually had pretty good luck with doctors, but this doesn't especially make me look forward to that neuro referral. I'd be okay with weird, but not with rude or patronizing.

Kim Kasch said...

I think the left-handed aspect has an impact. Let's do a little research about ”Left-handed professions”

ERP said...

I have a neurologist. He is not weird - maybe a little geeky but otherwise pretty normal.

Carrie said...

I'm a psych grad student and this is a topic that comes up a lot, especially when you teach undergraduate psychology courses. There have been several studies documenting a higher rate of psychological disorders in the psychological (and related, e.g., neurology) fields. It seems to be that people who have contact with a field are more likely to be aware of it and, therefore, are more likely to go into it. For example, if you have emotional problems and see a shrink, you're more likely to consider being a shrink when you grow up. While that sounds reasonable, I've personally always wondered if it isn't a case of "if you weren't crazy before the mad house, you'll be crazy after it".

John Woolman said...

Like Dr D, I contemplated neurology as a career; I even did a postgrad year in neurology. Much of the need for excessive intellectual ability in neurology has been removed by the incredible improvements in imaging over the last 30 years. it's still a speciality that attracts the very bright. And when you spend your day looking at nervous system dysfunction, if you didn't have a skewed view of humanity you will soon develop it. You will also see a higher proportion of skewed humanity in you patients than, say, an internist, but a lower proportion than a shrink or a pain specialist would see.

As to left handedness in neurologists, i agree with the observation and note also that specialist advocates amongst the legal profession also seem to have have a view of humanity similar to the neurologists and well as having a noticably high proprortion of left handers.

Anonymous said...

Once I'm asked what I do for a living during an office visit and I say I'm a social worker, I've had different neurologists show me their hunting knife collections which they keep in their office and next to their prescription pads, on the walls, in their desk drawers, and on top of prescription samples; tell me about times they think they were hallucinating on drugs; describe all their children's "social problems" in rapid fire speech( After I told them I don't work with children, they continued to tell me about this for another 10 minutes and then decided to do an examination); and describe in detail how they refused to go get their appendix removed even though they knew it was going to burst because they were afraid of surgery. (this was told to me unsolicited, after I answered a question he asked about if I take vitamins). And that's just the tip of the iceberg.

Queenofoptimism I share your experience: the mean ones are just patronizing.

In case anyone's interested, I still see Dr. HuntingKnife.

Jo said...

I work as a nurse on a neuroscience unit, and I have to say: our neurologists are weird, but charming. The neurosurgeons are weird, but funny. The endocrinologists? Weirder than a snake's suspenders, but very sweet.

When I first started on that unit, I was convinced I would never get along with any of those docs due to their oddnesses. Now, though? I'm just as weird. There's something about working with brains, spines, and glands that frees you to embrace your inner nerd.

Dragonfly said...

I've been told that the ID physicians are the ones that wear bow ties as well..

Dr. Alex said...

I've seen mostly the peds GI docs wearing their bow ties. Although, I've been known to wear one from time to time.

Grumpy, M.D. said...

I guess bow ties are less likely to be fomites, since they don't drag on the beds.

Anonymous said...

As a recently board certified young Neurologist (in an extra year of subspecializing fellowship currently), I find this a funny thread. But true. As a medical school student I originally wanted to do ENT and went to the annual meeting where everyone was dressed very well and seem to work out a bit. When I went to the American Academy of Neurology meeting, on the first day I noticed missmatched black socks, old brown suits from the 70s, off-kelter ties, men and women looking befuddled as they searched for their lecture room, more balding heads than I expected over heavy-weight glasses.... But these were usually the older generation. The younger ones (on average) seemed more like the ENT meeting folks, laughing and more superficially gregarious, dressed in more expensive attire, quick and witty with less flatly falling jokes... I think it represents the change in nature of neurology, from what it was: more of a cerebral game of localization/diagnosis/prognosis, to a more action game of treating the illness which you had to think less about to diagnosis because of modern imaging/labs/other diagnostic tools. So the selection bias for people going into this field is changing over time.

Ms Lynette said...

I call BULLCRAP! This as a person who has now been, as a caregiver or patient, to numerous neurologist over the last 27 months. From young to middle-age to old, from badly dressed to normally dressed to high fashion, from stupid to odd to just plain a-hole. Not one of you has answered the question or even come close.

The answer is this . . . many neurologist get caught up in the mystery and complication of all the things they treat. They have to be smart to do it. Smarter than the rest of the world. So they either get lost in all that mystery and might get a tad off their rocker, that's okay. Or, they get the big head and look down on the rest of the world. They know better than all the rest of the doctors, they know better than the patient how the patient feels, what the patient is feeling and when the patient is feeling it. They think they are hot-stuff walking and you better listen to them 'cause they are the ONLY ones who know what they are talking about.

Don't believe I know what I'm talking about? Read this post about neurologists. It's real and ever word gospel truth. Notice I don't identify the actual doctors. I do believe in not ruining a person the same as the professionals here protect the patients. And I wouldn't get sued if I did use the doctor's names.
http://lynettecares.blogspot.com/2010/09/neurologists.html

Marlena said...

my neurologist is weird, an ass and left handed

Anonymous said...

I have been to Mayo, KU Med, seen 6 other neurologist. I have only come to one conclusion. They are assholes with a holier than thou attitude with no common sense. All they say is, "lets just add another drug to the menu". Worst type of doctor to see. Just because they can remember lines out of a book for a med test doesn't give them common sense. Pompous assholes!

Anonymous said...

I would agree based on my limited experience that I have yet to be impressed with this specialty. Yes, they have lots of training and neurology is complex, but so are lots of other cases and parts of the body, to be honest. I've seen now three Neurologists or Neurosurgeons (female and male)--one told me my issue was anxiety, another "Fibromyalgia" and another that I shouldn't be in as much pain as I was in. ?? And he knows this because...?? I found my GP and Ortho specialists to be much more personable and willing to work with me in tandem as a cooperative health team. Oh, and I didn't agree with a recommended course of action and asked for another option; one Neuro stopped returning calls and labeled me as "non-compliant" in my casenotes. I ended up writing a letter a complaint and protest as that could affect later care for me. I will not go to a Neurologist again unless it's an emergency.

Anonymous said...

I've had nothing but problems with Neurologists. I have never had problems with any other doctors. The first guy I saw overcharged me by about $1000 and closed my case after 2 weeks without even knowing if the meds he prescribed for me had worked. That was a Dr. Battaglia from Buffalo Medical Group. Then, I went to Dent Neurology. They totally screwed up my script for Lyrica (which the first guy didn't even prescribe). When I called them on it (no screaming or cussing) they ended the relationship. Just recently, a Dr. Avino (formerly Dr. Pereira)did the same thing as Dent Neurology. I have been without Lyrica now for 3 weeks due to her foul up and have to find yet another Neurologist, just to get a new script for Lyrica.

Maybe 3 Neurologists isn't statistically significant, but it is interesting. Part of it might have something to do with the fact that I'm on Medicare and apparently it doesn't pay out like it used to. But Christ, the ones I've dealt with have been assholes, unprofessional and downright immoral.

Anonymous said...

I have seen 3 neurologists and they were all cold and uncaring in their remarks. They just seem to want to refer you to psychiatrists. They have no sense of humor either. Just dry and cold.

Post a Comment