Specialty
My special interest? People. If someone comes in with sore throat or earache, I'm interested in it. If someone has arthritis or carpal tunnel, I'm interested. I have an easier time saying what I'm not interested in, because that list is smaller. And even then, it's a difficult answer. For instance, I'm not as interested in gynecology and male health, but mainly because I'm not set up to do the exams. I was very interested in the patient about whom I wrote my thesis--a case of severe dysmenorrhea (cramps) post tubal ligation. However, even after the many hours spent on this case, I wouldn't say that gynecology or even women's medicine is my special interest. I was more interested in the patient's quality of life. Treating a female disorder was just a part of that.
Modalities. What are my favorites: homeopathy, IV therapy? Although many students at school complained about having to learn so many modalities (read many class hours) and being a "jack of all trades", I think this is the strength of our medicine. Where M.D.s have mainly two tools: drugs and surgery, we have many more. Instead of feeling embarrassed when listing herbal medicine, supplements, diet, lifestyle, homeopathy, flower essences, and various forms of physical medicine as my favorite modalities, I should feel proud. The more modalities I can employ, the better for the patient because I can tailor the treatment to their problem, their level of dedication to health, and their pocketbook. Sometimes I clearly see a homeopathic constitution, and sometimes I don't. Sometimes a problem is clearly emotionally related or there is an emotional component where a flower essence can help. Other times a blend of vitamins and herbs will greatly help their symptoms as they change their diet and lifestyle to support new-found health. Many times specialization in one modality is done for the financial benefit of the doctor--not the health benefit of the patient. This type of medicine works well if the doctor is part of a team of doctors, all of whom have a specialty, but not when you are primary care.
Even if one has a specialty, how do we see that specialty in the light of holistic medicine--where we are to see the patient as a "whole"? How can you specialize in neurology, for instance, when the treatment may be in healing the gut (gastroenterology) so that inflammation (immunology) doesn't attack the neurons and the brain? Or what if you have to treat a blood sugar dysregulation or a thyroid disorder (endocrinology) that is affecting neurotransmitter levels in the brain? But wait, the thyroid problem is autoimmune (immunology) that stems from a gluten intolerance (gastroenterology)! I'm sorry, but I can't disect the body in such a way as to say that I'm not interested in any part of it. Luckily, I was trained to treat the whole thing!
So what is my primary interest? I've decided. And my special area of interest is...drumroll please......the brain! Why? Well, we already know that endocrinology affects the brain, gastroenterology affects the brain, neurology IS the brain, immunology definitely affects the brain, environmental medicine is at the forefront of brain health research...even cardiology and gerontology now focus on brain health. And of course, everyone wants smart kids, so there's your pediatrics. And if I say that I'm the "brain doctor" then people may refer to me all those hard to treat cases they fear, like depression or autism. Now I won't have to give up anything to say I have a specialty--except maybe dermatology, which I'm not really that intersted in. (I'll leave proctology to the specialists as well.)
