How Can You Be Two Places At Once When You’re Not Anywhere At All?

摘要

This title is a quote from the FiresignTheater, a comedy group in the 60’s thatappealed to the drug culture of babyboomers. It came to mind when I revieweda couple of evaluations of patients I hadseen, who had gone, at my suggestion,to another center for another opinion,from people who subspecialized withinmy own field of movement disorders.The notes on both patients seemed tohave missed the mark. The neurologicalexam in movement disorders, as is true inmuch of neurology, is the crucial bedrockon which all else depends. Unlike otherareas of medicine, or even in much ofneurology, the history is less importantthan the exam. Like dermatology, whatyou see is what you get. After all, dizziness,clumsiness, imbalance are words soimprecise that they should not be used inmedical presentations except when quotingthe patient.