Why a Neurologist Needs So Many Files
Thursday, 04 October 2012
From 1900 to 2000
Medico-Chirurgical Hall
Professor Chris Levi - Neurologist, John Hunter Hospital, Newcastle, New South Wales
Notes
The Society met in the Medico-Chirurgical Hall on Thursday 4th October 2012
The President Dr Ken McHardy was in the Chair.
At the first meeting of the new session Professor Chris Levi, Neurologist and Director of Acute Stroke Services at John Hunter Hospital, Newcastle, New South Wales, spoke on Why a Neurologist needs so many Flies. He drew analogies between fishing and the practice of medicine, particularly in making timely decisions often with either inadequate information or an overload of information. He stressed the importance of experience in making such decisions, both for fishermen and clinicians. He also spoke of the need for better communication across clinical disciplines. Poor communication has often hampered good practice in his own field of stroke medicine.
He went on to speak of his main clinical and research interests: acute stroke therapy and the genetics of stroke disease. One of the most debated issues in stroke medicine is the benefit and risks of 'clot-buster' drugs such as tissue plasminogen activator (tPA). Although the debate continues the evidence is mounting that, given early enough and after exclusion of haemorrhage, the net overall benefit outweighs the potential for harm. In future years it may be possible to profile patients more accurately and appropriately target treatments. As far as stroke is concerned the need for rapid treatment has resulted in a shift in neurological philosophy from being a contemplative to an action man discipline. Not all neurologists are comfortable with this and many, particularly in the USA, have left responsibility to emergency room physicians.
He then spoke of the complex genetics of stroke. Despite media hype and profiteering organisations offering personal genetic analysis, it is not yet possible to determine inpidual risk profiles but in the future genetic studies may allow the development of diagnostic markers, new drug therapies and new approaches to risk modelling.
After many questions the Vote of Thanks was proposed by this year's President, Dr. McHardy, who presented Professor Levi with a copy of The Heritage of the Med-Chi.
C John Scott
Acting Honorary Secretary