D5PI

One of the most difficult things about neurology is the fact that it is never an exact science. As someone who is just beginning to practice it, I've come to realize that I am venturing into a field of uncertainties--of rules of thumb; of anecdotal evidence; of learning by experience.

For example, when faced with a patient who has suffered a stroke, neurologists attempt to establish a pattern of predictability based on the time when the disease started to manifest. By doing so, we are able to determine the best course of action and at the same time, anticipate the events that are likely to happen as the disease unfolds. This rather crude way of thinking gives us clinicians some form of security as we face the unknown. Truth be told, I think we take comfort in relying on these patterns because deep down, we're scared of the future. We're scared that things might not go the way we want them to. We're scared that we might fail. And in the absence of complete reassurance, we hold on to these patterns and hope that things pan out for the good. It's our best weapon inasmuch as it is our best defense.

Today would be the fifth day that we're apart. In neurologic parlance, today marks day 5 post-ictus. If I were to make use of this analogy for how things are with us, today would be one of the most critical time points in our course--the point of maximal damage. It's the period where we would do our best, observe, and pray to God that the injury would not be massive enough to tip the scale towards death. To a neurologist, this is the patient's tipping point--the point where the neurologist would do everything in his power, and hope that the patient would be strong enough to make it through. And as frustrating as it is, the only thing the neurologist can do once he has laid out all his cards, is wait.

You would know.

Today would be the fifth day. I have done everything I can, and I have laid out all my cards. All I can do right now is wait.