Physical Foundations

Most of my blog topics come from patients. A question asked across the exam room in my resident clinic, a family navigating something I had not written about yet, a clinical moment that stays with me on the drive home. This week was different. One of my favorite attendings — an epileptologist whose clinical instincts I deeply respect — mentioned a term in passing during a conversation: epilepsy-related dementia. I nodded, but when I got home I realized I had never given this

There is a question I ask every new patient in my neurology resident clinic, and I ask it regardless of what brought them in. "Have you ever had a significant head injury?" The answers surprise people. Not the question — the answers. Because once I ask it and give them a moment to think, the stories come out. A car accident in their thirties that put them in the ER overnight. A fall from a ladder that left them with a headache for two weeks. Years of playing football or ho

I know what happens when I bring up exercise in the clinic during appointments with my patients. There is a particular look. A slight shift in the chair. Sometimes a polite nod that communicates, clearly, that this conversation has been had before and that it did not result in a gym membership. I understand it. The word "exercise" carries decades of cultural baggage — images of early mornings, discomfort, athletic ability that was never there to begin with, and a time commit

I want to tell you about a conversation I have frequently in my resident clinic. A patient comes in concerned about memory. They're forgetting names, losing their train of thought mid-sentence, feeling mentally foggy in a way that wasn't there a few years ago. We go through the workup. And somewhere in the history, frequently as an afterthought, they mention that they haven't been sleeping well for years. They wake up at 3 am and can't get back down. Or they're in bed for ei

In the high-stakes world of neurology, we often get caught up in the "glamour" of $5,000 PET scans and the latest monoclonal antibody infusions like Leqembi and Kisunla . But as a resident clinician, the most important ten minutes of my day aren’t spent looking at a computer screen—they are spent sitting across from a patient with a single sheet of paper and a pen. That single sheet of paper is the Montreal Cognitive Assessment (MoCA) . I recently became officially accredi

The landscape of modern healthcare is shifting toward shared accountability. We see it in the explosion of wearable fitness trackers and the availability of at-home kits for everything from cholesterol to colon cancer screening. It was only a matter of time before this trend reached the world of memory care. Today, the "Black Box" of neurology is opening. Patients no longer have to wait for a specialist appointment to begin investigating their cognitive health. However, as a