Something is seriously wrong with me: I can’t stop training. Perhaps more accurately, I keep attempting to wrest my medical trajectory closer to the engineering career I should have pursued all along.
Enter epilepsy. On my first day of dedicated EEGElectroencephalogram. It turns out that if you put a bunch of electrodes on the scalp, you can (somewhat crudely) measure brain activity. This allows us to get an idea of what is going on in different areas of the brain and guide further studies or treatments. More training we talked about differential amplifiers, and it was as though some long-forgotten area of my brain woke up, motes of dust flying up into a ray of sunlight. “I love this stuff!” I thought, and proceeded to be absolutely horrible at reading EEGs for the rest of the month. I wanted to get good at them, though, and the idea of doing an epilepsy fellowship began to take root.
I didn’t want to do a fellowship. By the end of child neuro residency I’ll have been at this for thirteen years, eighteen if you count undergrad and the year I spent working afterward. I wanted to be done, to stop trading more years of my life for levels.
I got more information. If you want to run an epilepsy monitoring unit (EMUEpilepsy Monitoring Unit. Not to be confused with the Australian bird, this is an area of the hospital dedicated to treating seizures. Often, we want the patient to have a seizure in this controlled environment as it will help us decide what to do next. More), you need to do the fellowship. If you want to work with fancy invasive electrode setups and surgical planning and treatment-resistant seizures, you need to add that “Epileptologist” specialization to the character sheet. In 2021, I spent two months at the beginning of 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 on the EMUEpilepsy Monitoring Unit. Not to be confused with the Australian bird, this is an area of the hospital dedicated to treating seizures. Often, we want the patient to have a seizure in this controlled environment as it will help us decide what to do next. More trying to convince myself I didn’t like epilepsy. It was about as effective as my cat-proofing strategies: I loved it.
Unfortunately, epilepsy fellowships were somehow competitive enough that positions filled a full eighteen months in advance, in a wild free-for-all of deadlines, dates, interviews, and offers (they’ve since moved to a Match, which trades this for an algorithmic selection process like residency). When the dust settled, I emerged to find I had a position at Stanford University.
Technically, only one year of fellowship is needed to become an Epileptologist, but with my dreams of research in EEGElectroencephalogram. It turns out that if you put a bunch of electrodes on the scalp, you can (somewhat crudely) measure brain activity. This allows us to get an idea of what is going on in different areas of the brain and guide further studies or treatments. More analysis and desire to lead presurgical workups, I am planning on two years. That’ll bring me to a nice twenty years since high school in some form or another of advanced education or training. Plus, with an extra two years of practice, I might finally become as proficient at reading EEGs as an average neurology resident!