Another reminder today of why I’m glad I’m graduating: the neurology program where I’m training seems to be dissolving. The chair of my department, Dr. J, is leaving. He stepped down as chair a year ago, but they’ve never been able to fill the position, so he’s been “acting chair.” Then several neurologists left: 3 of the child neurologists, 3 epilepsy doctors, 1 movement. In January, the dean of the medical school (who influences how the hospital and the clinics are paid and run in many, many different ways) was sacked on a Sunday night. While everybody is happy to see him gone (believe me, he had few supporters and is the root cause of most of the deserters), we currently don’t have a dean, which makes everybody nervous: big decisions get postponed, people don’t want to take positions here, money for research gets funnelled elsewhere, etc. And now Dr. J, who I adore and idolize and wish, someday, that I could be a quarter as brilliant and meticulous in my neurological exam and localization, is leaving.

I’ll admit that I’ve had many frustrations with the neurology department. When I started here, the program director (who was not the same one I interviewed with, nor was I told about a change in management before I started) was brand new – he had just finished fellowship. Unfortunately, Dr. W had been a resident in the program only two years before, and many of the attendings remembered him as a resident and had a hard time accepting him not only as an equal, but in an authoritative position. Within a year (with the combination of decreased financial compensation for teaching), most of the attendings stopped giving lectures, stopped doing teaching on rounds, stopped doing journal clubs. In essence, all of my education has come from my program director and I don’t like or respond to the way he lectures. Neurology was my favorite subject in medical school – I excelled at neuroanatomy. It’s been a different experience in residency. I don’t regret doing the combined residency (most of the time) and I have learned so much, but I do wonder if I would be close to a “mini Dr. J” if I had gone to another school. That’s not to say I don’t appreciate Dr. W – in many ways he has been an excellent program director. He has worked endless to try to improve our working conditions and he is always, always available for any question or concern or problem. He’s come over to my house when I was having flooding problems (he lives about a mile from me) and many, many times, he’s supplied the residents out of his own budget. I just don’t agree with his teaching styles or some of his management skills.

In any case, I’m kinda glad to leave behind this drama. Politics exist everywhere, but I hope to be blissfully unaware of my new department’s problems for at least 6-9 months.

Anyway, today’s poem is one that I apparently downloaded earlier this week. I have no recollection of doing so (eta, it apparently downloaded itself when I clicked on one of those websites that had automatic midi music and flashing gifs – the things I go through to find you poetry!), but it seemed appropriate. It is lovely read aloud though: hopefully by clicking on the link, you’ll only hear some random person’s gravelly voice and not tinny “harpiscords” http://www.eaglesweb.com/realaudio/yeats_to_a_friend_whose_work_has_come_to_nothing.ram

To a Friend Whose Work Has Come To Nothing
by William Butler Yeats

Now all the truth is out,
Be secret and take defeat
From any brazen throat,
For how can you compete,
Being honour bred, with one
Who, were it proved he lies,
Were neither shamed in his own
Nor in his neighbours’ eyes?
Bred to a harder thing
Than Triumph, turn away
And like a laughing string
Whereon mad fingers play
Amid a place of stone,
Be secret and exult,
Because of all things known
That is most difficult.