الْفَقِيهُ كُلُّ الْفَقِيهِ مَنْ لَمْ يُقَنِّطِ النَّاسَ مِنْ رَحْمَةِ اللهِ، وَلَمْ يُؤْيِسْهُمْ مِنْ رَوْحِ اللهِ وَلَمْ يُؤْمِنْهُمْ مِنْ مَكْرِ اللهِ

- علي بن أبي طالب (ع)

THE NEUROLOGIC EXAM as a diagnostic tool gained mythical proportions in the pre-CT/MRI era, when great clinicians could pinpoint a lesion in the nervous system with often astounding accuracy. Decisions for surgery and other interventions were frequently made entirely on the basis of the neurologic history and physical findings. Today, with the availability of modern imaging techniques, the neurologic exam takes on a new and equally important role in diagnosis and management. Rather than serving as an end in and of itself, the neurologic exam today is a critical way station in the clinical decision-making process. Does the patient who just collapsed on the street have cardiac disease or an intracranial bleed? Is the patient with leg weakness and numbness suffering from degenerative joint disease or from impending spinal cord compression? Does the patient with nausea and vomiting need a gastroenterology consult, a head CT, or emergency interventions to lower dangerously elevated intracranial pressure? These—and many similar questions that frequently arise for health care providers in all subspecialties—can quickly be answered by a carefully performed neurologic exam.

cranial nerve testing can raise “red flags” that suggest specific neurologic dysfunction rather than a systemic disorder. For example, many medical conditions cause lethargy, unsteadiness, headaches, or dizziness. However, any of these symptoms together with cranial nerve abnormalities strongly suggests brainstem dysfunction as the cause.

Albert Camus,
By Henri Cartier-Bresson

Camus, having a staring contest with the absurd

*me, after 4 seasons of Better call Saul*:

Vince Gilligan is Dostoevsky but for TV

Also I loved the way he wrote Charles Mcgill. It's just brilliant.
Chuck represents the greatest danger of intelligence: Rationalization. Because if you're smart enough, you can come up with a rational explanation for almost anything, and twist reality however you like. And people are gonna believe it too (just remember how ppl used to turn off lights and hand out their phones whenever Chuck is around, and indulge in his imaginary "disease").

A Philosopher Lecturing on the Orrery,
By Joseph Wright of Derby

An Experiment on a Bird in the Air Pump,
By Joseph Wright of Derby

Irwin Braverman:

Once upon a time in a distant med school...

Urinalysis, done traditionally

The brilliant neuro exam

That shy doctor

So, if the physical exam was developed because the good ol' doctors didn't have the same advanced tools and technologies that we have now, then what's the point of teaching the physical exam today?