My Neurologist and Me

I went to see my neurologist yesterday for my three-month follow up. I am still not used to saying I have a neurologist. It’s like when you first get married and it feels wildly foreign to refer out loud to your “husband.” But the strangeness comes with a hint of pride. I would rather have a neurologist than, say, a proctologist or a chiropodist. It somehow feels more glamorous, more high brow, more befitting of me. The corporeal mutiny of age inches forward—an extra chin here, an autoimmune attack there—but that one vestige of youth, my vanity, remains.

My check up was more of a check in. In fact, my neurologist would make a great shrink. He has mastered the therapist’s technique whereby the patient poses a burning question and the therapist manages to get the patient to answer it for herself through a deft combination of silence and answering a question with another question. The burning question of the appointment was what to do next: nothing or scan again. The latter option means I would be actively searching for evidence of new “activity” in the brain despite a lack of symptoms (the doctor dismissed the lazy arm that cause me a spasm of panic earlier in the month within the first two minutes of our appointment; it’s not a MS symptom). If the scan reveals symptom-free activity it is enough to get you an MS diagnosis, which is the trigger to start on meds. American doctors are generally pro-medicine of all kinds, so odds are if I was in the US a doctor would advocate a scan. Brits on the other hand opt for the wait and see approach at this stage. And in this matter I’ve decided to side with the country of which I’ve most recently become a citizen. I shall stick my head in the sand and enjoy the symptom-free life I’m experiencing now for as long as it lasts, hopefully for the next sixty years or so.

I pretty much knew this was my decision before I walked into the doctor’s office, but that didn’t stop me from subjecting him to a thirty minute interrogation. I was desperate for my symptom-free three months to mean something of statistical significance about reducing my chances of developing MS. It doesn’t. It means what it means which is that I’ve gone three months without any symptoms. And that is a good thing in and of itself. And that’s all. I was hoping there would at least be some sort of ceremony to present me with my “three months symptom-free” Alcoholics Anonymous style token, something I could carry around in my pocket and finger inconspicuously when I was feeling insecure. Something to hold onto.

The one bit of new information I did glean from my questioning was that more instances of MS occur the farther away from the equator you go in either direction. My neurologist slipped it into a response to a question I had about treatment in the US versus the UK, citing “the equator effect” in explanation for why he couldn’t give me an accurate answer.

“I’m sorry, I don’t know what you mean,” I asked, concerned that this man in front of me was actually a quack witch doctor masquerading as a neurologist. This would not be good for my frail ego — which as I’ve mentioned is dependent on having a neurologist—nevermind my health. Next he’s going to tell me cats can suck the air out of babies’ mouths. But instead he went on to explain the epidemiological phenomenon of MS and the equator, which I later confirmed on the Internet (a validation process which I am sure sends shudders up the spine of every doctor in the land). Unfortunately the relationship is not causal, which means I won’t be changing the name of this blog to An American in Quito anytime soon.

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