Neurology is an exciting and challenging field. It encompasses all disorders of the brain and nervous system, parts of the body about which our knowledge is growing but still limited. The qualities of a neurologist can be summed up by the three C's: curious, compassionate and committed.
Charles Flippen II, MD, a neurologist and director of the Neurology Residency Program at the David Geffen School of Medicine at UCLA, describes how these qualities are at the core of every neurologist's work.
"It's rare for a problem to unfold in front of you; you have to do detective work," he explains. "You have to be curious about the patients' stories. We don't have cures for many disorders, so you have to be compassionate and provide the best care for as long as you can. Finally, you must be committed. There's never a time when you say there's nothing you can do."
Developing patient relationships
Neurologists spend a lot of time with each patient, as much as 45 minutes for a new patient visit.
"You have to want to hear patients' stories and listen intently," Dr. Flippen says. Diagnosing patients is a lot like solving puzzles. Neurologists have to hear all the tiny details to narrow down where in the nervous system the problem originates and then narrow down possible diagnoses.
Dr. Flippen also adds "disciplined" to his list of the most important qualities of a neurologist. Disciplined in schooling, listening and follow-up.
"It takes time to narrow down possible diagnoses — you can't just rush in," he says. "It becomes automatic over time, but early on, you have to be patient."
Specialties for all personalities
After medical school, neurologists complete a one-year internship, followed by a neurology residency and then a fellowship to further specialize.
Dr. Flippen specializes in headache medicine, but there are subspecialties to suit every personality. For those who prefer a faster-paced environment, stroke may be the best fit. People with a greater interest in procedures may want to consider neurocritical care. Alzheimer's or behavioral neurology may be a better option for doctors who are less interested in procedures and who find long-term, complex puzzles satisfying.
There are opportunities to work in community practice, research, academic medicine, tertiary care centers and county hospitals, giving physicians access to a wide array of patients. The field continues to grow with advances in scientists' understanding of how the nervous system works and advances in treatment options, making it an exciting time to study, practice and research neurology.
Why study neurology?
The primary draw is the relationship with patients. Few physicians get the time with patients that neurologists do. Midway through medical school, Dr. Flippen watched a neurologist interact with patients during rounds, and began to consider changing his specialty from pediatrics to neurology.
"The doctor carefully listened to and examined each patient with care," he remembers. "The patients' problems were intriguing, and that doctor-patient relationship aligned with what I always imagined being a doctor was all about."
He went on to realize how much mystery still surrounds headaches, and what a difference it makes in people's lives when you can offer them help.
"There's an emotional payoff to working with people who have chronic painful conditions," he says.
Dr. Flippen encourages all medical students to pay attention to how neuroscience plays a part in each field they study. Every organ is connected to the brain, and understanding how the brain works is crucial to understanding how the body works as a whole. Students can seek out a neurologist to observe to find out if neurology may be a good fit.
"Neurology is intellectually satisfying, and the connections we make with patients keep us interested and excited in our work," he explains. "The patient is always at the center of everything we do."
By Patricia Chaney