Last July while helping with the orientation clerkship for third year students, I experienced two first time seizures. I don’t remember much from the day, but I do remember the confusion I felt when I woke up in the hospital’s emergency department, a mere five minute walk from the classrooms in which I spent so many hours learning.
It all went down on July 2nd. I had heard all of the familiar jokes about avoiding the hospital and any major surgeries in July when all of the interns began their training, so it was almost humorous that I, a young and generally healthy student, found myself in the emergency department at that very time of year. I felt like a classic textbook Step 1 board exam question, like:
A 24 year old female presents to the emergency room with first time seizures. As per her physician’s instructions, four days prior, she increased her dose to the maximum dose of a medication that is known to lower the seizure threshold. In addition, she is training for an Ironman triathlon and swam 2.5 miles the night before. What is the mechanism of action of the best treatment for this patient?
After being discharged after a night in the hospital, my med school friends, fresh off of taking Step 1 only a couple weeks prior, were eager to ask me about what had happened: What kind of seizure did you have? What treatment are you on right now? Wait, First Aid doesn’t say that seizures are a side effect of that medication! (Psst…I checked; it does).
Months later, I sat in several lectures exploring the pathophysiology of seizures and the pharmacology of the drugs used to treat epilepsy. I couldn’t help but remember and recall my own experience that summer and try to diagnose myself based on what a friend had told me had happened. The dense lectures were much more interesting because of their relevance to my life, and you can bet that I didn’t miss any questions on seizures on my neurology mid-term and final exams because of my personal connection to it!
Because there is so much information to cram in our heads in such a short amount of time, sometimes we spend only a couple minutes discussing diseases that are rare or that we don’t know much about. The fact of the matter is that there just isn’t enough time to cover all of the nitty gritty details of every disease process. But it’s important to keep in mind that these illnesses are affecting and could potentially be hindering the lives of real patients. If anything, my experience has been even more motivation for me to learn as much as I can this year for my future patients’ sake.
