The Neurological Identity

Coffee, Reflex Hammer, and a Friendly Knock on the Head

I’m sitting at my London desk, the coffee has thickened to the consistency of contrast agent, and my reflex hammer is parked diagonally across my notepad – a small provocation to neurological order. As I ponder a freshly read paper on the core identity of the neurologist by Joseph E. Safdieh and Mathew Stuart Robbins, I can almost feel the friendly knock on the head: We all too easily get lost in our cozy niches – me, a devoted MS tracker leading the way – and forget what truly defines us: history taking, examination, localization, clear thinking. Subspecialties are welcome, but only as an extension of this fundamental attitude, never as a replacement. Otherwise, our neurological care unravels: patients wander through silo labyrinths, titles cause confusion, and diagnostic breadth evaporates during training.

Cases That Tell More Than Diagnoses

I leaf through my own cases: the patient who started with dizziness in the vestibular clinic, then moved to the headache specialist, and finally landed with me; the referral letter with the diagnosis in capital letters, while reality lurks in the fine print; the consultation where I learned more from the history than from thirty pages of previous findings. That’s exactly the point: I’m not the man of the big machine, I’m the guy with the map in his head. History, examination, localization, pathophysiology – that’s my mother tongue. Everything else is dialect.

First Neurologist, Then Specialist

The paper says: first neurologist, then specialist. I nod, take a daring sip of coffee, and decide to dust off my name tag: plain “Neurologist” on top, small print underneath: “with a soft spot for myelin puzzles.” For me, training means more morning reports where we truly localize, and symptom-driven clinics so the gray matter in our heads doesn’t become mere decoration. In the hospital, it means less relay racing between silos, more hypotheses with target coordinates. And for me personally, it means not wielding the reflex hammer like a scepter, but as a reminder: you’re a diagnostician, think first, then press “imaging.”

Hunting MS – But With Perspective

I will keep hunting MS – of course – but not as an island state, rather as part of the continent Neurology. Act subspecialized, think neurologically: that is my compass. And when I next ask myself who I am, I answer in one sentence, without frills: I am SherlockMS, neurologist; my niche is my hobby, my craft is my profession.

Until the next case,

Your Sherlock MS