Neurology has a lot of tools to do the physical exam. We will debate each other on doing the fundoscopic exam every time (requires ophthalmoscope), reflexes (requires a hammer, not the edge of your stethoscope), or a full peripheral sensory exam (pins, tuning fork, etc.). As a result, there’s a of stuf to carry around from room to room. And carrying things…requires a bag.
Enter the Neuro Bag. There are a lot of different approaches, from the humble fanny pack that has unfortunately made a major resurgence, to the Norman Rockwell physician bag (as most recently acquired by the inimitable GrandBig Sib Dr. Jennifer Yang, neuroimmunology fellow).
As a medical student, I somehow managed to fit my entire Welch Allyn Starter Pack into the ample pockets of my short coat. This “utility coat” probably weighed about ten pounds, something that hardly registered on shoulders already weighed down by impending doom (both likely contributed to my loss of about two centimeters of height).
As an intern, I tried keeping everything in my scrub pockets, “cargo shorts” style, a technique that works decently well for basic supplies but has a more difficult time accomidating heavy metal instruments. There’s also the problem of adjusting/repacking one’s “loadout” every time one wants to put on a clean set of scrubs.
Once PGY-3 started and I became a “real neuro resident,” I decided that I really needed to keep up with my peers and get a bag. During the brief window of “healthcare heroes” I picked up a very nice shoulder bag from The North Face, one with all the functionality of a fanny pack but with a far more stylish positioning (they’ve since stopped making it, although this one adapts to a similar cross-body position).
I proceeded to stuff that bag to the brim with tools and “just in case” supplies. And yes, I have needed to use the spare spinal needles and vitals of 1% lidocaine. Now, in PGY-4Post-graduate year. While a normal person might think this has to do with graduation from college, it’s actually counting the years of training that take place after medical school. After completing residency, any fellowships, and becoming an attending physician, they thankfully stop counting. That would get sad very quickly. More, I started needing to add toys to attract the attention of the pre-ambulatory set, and I ran out of available volume.
My latest Neuro Bag incarnation comes from Topo Designs, also the maker of my non-work shoulder bag. While still compact overall (the whole thing fits nicely inside my backpack), it has more room for the larger instruments. My favorite items are probably the Panoptic ophthalmoscope, array of spinal needles, and zebra finger puppet. There are a few valuable items that I do not keep in the bag, namely my stethoscope and Trömner reflex hammer; however, safety pins, surgical marking pens, and spare batteries are all included among the vast treasures contained within.