Doctor Who S1e7
Giacometta Fritchman
Shaun notices the EMS bring in a young patient, Liam, who keeps trying to fend them off which is mistaken as him being psychotic. However, Shaun approaches them, stating that the staff are scaring Liam who doesn't like people touching him and is actually autistic. Shaun cleans him up, while Liam realizes that Shaun is the same as him. When his parents arrive, all he can say to them is "wrong stop!". When they ask what happened, Shaun says Liam had a laceration to his head, probably a fall, and has cleaned it. Liam says he "got lost!" and his mother is shocked that Shaun was his doctor. His father says the bright lights make him anxious and asks if they can take him home, to which Shaun says he is jaundice and tender when touching his and shouldn't go home. When Glen regains consciousness, Jared explains how he got there, while also stating that he is 28 and that a pacemaker is being flown in later this afternoon and they will prep Glen for surgery then. Shaun explains to Neil what is going on with Liam, while Neil tells Shaun to do an ERCP to clear Liam after that, a few weeks of broad-spectrum antibiotics. However, Shaun appears to disagree. Claire is at the Nurses' Station doing work and checks out a psych questionnaire when Shaun interrupts her, asking if she will help him with the ERCP saying she is good with autistic people.
Jared finds Glen, who reveals he broke his pacemaker on purpose because he wants to die. He knows he will just keep getting worse and has no family that will nag him into what Jared wants him to do. He says he is in pain all the time, announcing he knows his rights, can refuse treatment if he wants and the minute he catches his breath he'll leave. He tells Jared to leave, but Jared decides to sit and wait for Glen since he's got all day. Neil informs Liam's parents they cannot treat him until they know the underlying cause; they sign the papers for surgery as there is no other option. Meanwhile, Jessica sits with Glassman, talking about how Shaun is getting a 70" TV. She wants to know why he is so worried about Shaun and reveals that Shaun has been late for work, he called him at 2 in the morning because he couldn't find a screwdriver and Armen wants to kick him out of the building. She reminds him how hard he fought for Shaun to be a resident at the hospital because he know Shaun can learn, but is he willing to let him learn? Claire finds Shaun watching TV in one of the waiting rooms in the hospital; he exclaims that he can see the pixelation and that is not great because an eye with 20/20 vision cannot detect the pixels. She turns off the TV and wants to know why he left after the MRI. He said that he failed, but she says it's not that; she thinks there is something more going on and questions how he doesn't like Liam because he has the same condition Shaun has, while also stating she thinks Liam likes him and looks up to him and Shaun probably understands Liam more than she does.
Jared is waiting for Glen to pass out, so he can get him upstairs before he dies. Glen says he has already lived, married and loved for 20 years, but he is now alone, with no roof over his head and is in severe pain, so it feels like the end of the story. He scoffs that Jared claims to understand and calls him an ass because he suffered because he was rich and only saw his parents at Christmas. He talks about boarding school and when he became a man and ready to tell them he was done with them. However, he found that they were gone, when he went to their home after they had sold the house and hadn't told him. Claire tries to calm Liam down while his mother holds down his flailing arms and Shaun begins to talk to him. He says it is okay to make mistake and should make more of them. He notices Liam's red eyes and asks about herbal supplements. Shaun discovers that the supplements caused the scarring in his bowels and they now have to go in surgically and remove the pieces to fix it. Liam's mother thanks Shaun for diagnosing their son, but there is no way he is allowed to be involved in the surgery.
Jared tells Glen his pacemaker has arrived and will return when he is ready to put it in. Glen admits his wife didn't die; she left him, for which he gave her good reason. Meanwhile, Jared didn't get what he deserved like good parents who loved him, but they were lucky to have him. Jared smiles and holds his hand briefly. Claire seems remarkably well adjusted, which concerns Dr. Mohan. She doesn't reach the requirement to be grounded from work, saying she is a strong woman but is she has suppressed feelings about this incident, she will need to share them with someone or they will eat her up. Jared returns to Glen's room with the gurney for surgery only to find his bed empty again. He goes on the hunt for him again while Shaun arrives in Liam's room. However, as he says he is glad to be participating, Liam's pressure is bottoming out and he is going into septic shock. In the OR, Neil quizzes the team, and they are told to do a full-length middle incision of the bowel to find where it is perforated. Neil offers the scalpel to Shaun who takes it, remembering when Steve gave him his toy scalpel. He does the incision and gives the time.
Jared sits with Glen, who has signed a DNR and shuts off the temporary pacemaker. Jared sits and asks Glen if he feels any anxiety, to which he says no but feels a little pain. Jared gives him some morphine to offset it, while Glen puts his hand on Jared's shoulder and thanks him as he takes his last breath and Jared tears up. In the locker room, Jared walks in and tells Claire about Glen not wanting the pacer and that he was a good guy. Claire finally admits to him about Jenna dying and agrees to talk to him about it, while resting her head on his shoulder. Liam soon wakes up with his parents by his side, while Shaun says his surgery went well and will be able to walk around in two weeks when the antibiotics have cleared his infection. His father quickly wants to dim the lights but suddenly stops and asks Liam if the lights are okay and he says they are. Shaun smiles as he sees Liam and his parents together. Glassman and Shaun are watching football, while Glassman is trying to teach Shaun about online banking and budgeting. They are cheering for the game when suddenly Shaun wants to go to the Superbowl. Glassman says that is something he needs to remember when he is budgeting, then says they should both go. Suddenly, the salesperson from the store informs them that is it almost closing time and they need to go. Shaun says he would like to buy the TV, to which the salesperson says they could stay as long as they want, while Shaun and Glassman recline in their chairs and chill out.
Our guest on this episode is Dr. Madeline Fields. She is a Neurologist and Epileptologist. She works at Mount Sinai Hospital in New York City. She received her Bachelor of Science degree at SUNY Binghamton and went on to Terrell College to get a Master Science degree in Biological Sciences. She also got her MD degree at Technion Israel Institute of Technology. After that, she did her postdoctoral training at Albert Einstein College of Medicine for internship. She went on to Mount Sinai School of Medicine for her Neurology residency and completed her training at NYU where she did a Fellowship in Neurophysiology. She is Board Certified in Neurology, Clinical Neurophysiology and Epilepsy. During her training and career, she has earned many awards.
Correct, which is not always the case for other types of medical fields. For example, a pain doctor, someone who takes care of people who have a lot of physical pain can be an anesthesiologist, can be a neurologist, can be a physiatrist or rehab doctor that specializes in those things. Specifically to be an epileptologist and a lot of the subspecialties and not all but most in neurology you have to be a neurologist first.
As a neurologist, you can choose to go into other specialties as well besides epileptology? What are those other options for people that are thinking about neurology but want to go into something else besides being a seizure expert?
You could also become a strokologist, a stroke doctor. Even off of that there is a subspecialty called interventional neurology where people will do some training in stroke and then they learn to become an interventionalist which is procedure-based doing that from anesthesia. Being in the OR they can retrieve clots from stroke, do angiograms and they do a lot more invasive procedures. Neurointensivist is another subspecialty. People who work in the ICU but specifically neuro ICU and who come out of surgery for various brain issues, the neurointensivist deal with all the ventilators and all the complications and recovery from surgery or complications from neurology.
Is your work life balance as a neurologist and epileptologist good? Does your job require you a lot of sleepless nights? What is your work life balance for people that might be interested in this career? How would you describe it?
Not a neurologist, just as a doctor. I did like science. My father was a dentist and he had been a big fan of medical careers growing up. He was a proponent of keeping your options open. I appreciate that but not everybody has that. I changed my mind 50 times when I was in college but I did. The neurology part came in medical school. I had a teacher who could draw the brain and the spinal cord. He was ambidextrous with both his right and left hand at the same time.
There is at Mount Sinai though once a year a Brain Fair that is run by The Friedman Brain Institute, the FBI, which is part of Sinai. They have a wonderful Brain Fair where they have a real live brain that you can walkthrough. The neurosurgeons bring out their 3D printer and they get the brains that you can hold. We do an EEG on some of the students as they come by. That is geared toward high school students.
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