Have you ever wondered what cerebral spinal fluid (CSF) is and what looks like or what it does? It is a fluid that flows in the ventricles of the brain and bathes the brain and spinal cord to provide cushioning and protection of the Central Nervous System among many other functions. I had the opportunity to see it at the Neurology Department at Fes University Hospital. Half of this week (July 22- 24), I shadowed physicians in Neurology.
Above is a patient who had a stroke recently and now has hydrocephalus because of which he is unable to walk long distances and uses a walking cane. Dr. Salma Laasila, a second year resident, performed a lumbar puncture to remove 30 milliliters of CSF and will observe the patient after 48 hours to see if there is any improvement in his gait. *All photos were taken with the permission of the patient and doctors*
I spent the first three days of the week in Neurology where I shadowed Dr. Laassila, a second year neurology resident. She did an excellent job showing me the department and introducing other residents and supervising physicians. The day started by taking part in morning reports where all the residents and two attending physicians discuss interesting cases from the previous days. A resident will present the case and the supervising doctors would ask questions and have a moment of teaching.
After the morning report, one of the supervising doctors and Dr. Laasila would stay back to answer any questions my colleagues or I had. After morning report, I shadowed her the entire day. In the three days, I observed her do biopsies of secondary salivary glands to send to the lab for analysis and help make a clinical diagnosis. I also watched lumbar punctures to extract CSF to be taken to the lab for analysis as well. Many of the patients we saw in Neurology either has Multiple Sclerosis (MS) or a stroke.
Dr. Sara Zejli and Dr. Laasila performs secondary salivary gland biopsy on this patient to rule out other clinical diagnosis to be certain she has MS because her MRI suggests she has MS.
Dr. Laasila comparing an old MRI and a recent MRI and explaining the differences she sees.
It has been a rewarding experience shadowing physicians in Morocco. However, there are a few challenges I faced at CHU. I do not speak French nor the Arabic Darija dialect. Therefore, communicating with physicians and Moroccans in general has been a challenge. Luckily, the hospital has been pairing us with English speaking physicians. I am making an effort to learn as much Arabic as I can -including Darija. Dr. Laasila did a spectacular job translating morning reports and informing of the patients history, symptoms, and complaints. I am forever thankful to CHU for this opportunity.
From left to right is me, Alexis, Dr. Salma Laasila, and Michael.