Neurology Exam by Howard F. Stein

Neurology Exam

My neurologist asks me many questions
To make sense of my brain:
What day of the week is it?
Where are you now?
What is your home address?

(What if I am homeless?)
What state are you in?
Where were you born?
What did you eat this morning?
How many fingers am I holding up?

I answer them all
With confidence and precision.
Perfect score – far better than in
Other realms of my life.

I break the brief silence
With hesitant questions of my own:
Tell me, doctor, with all
Your education and medical experience,
So what even if all my answers are correct?
Today, Thursday, March 10,
Is neither more nor less than
Tuesday, August 23
Or any other date of the year.
Our Earth is merely at different
Points in its orbit around the sun.

Despairing, I press her further:
As you search for what
My answers can tell you
About the workings of my brain,
Your questions are not wrong –
Only beside the point
In the face of my urgency.

Tell me, why do you live?
Why do you wish to awaken
The next day?

What is or is not inside my skull
And nervous system
Cannot answer questions
Like these.
I do not live for the sake
Of how much white matter
Remains in my brain.

Only loving and being loved
Can calm the unrest
My questions float upon.
Without their balm,
I do not care
When or where I am,
What I ate earlier today,
Or whether I can tell you
How many fingers
You hold up before my face.

Howard F. Stein, Ph.D. Professor Emeritus, Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK USA.

Author’s Note: Distinction between white and gray matter of the brain:
The white matter of your brain and spinal cord is composed of bundles of axons. These axons are coated with myelin, a mixture of proteins and lipids, that helps conduct nerve signals and protect the axons. White matter’s job is to conduct, process, and send nerve signals up and down the spinal cord.
       Gray matter, named for its pinkish-gray color, is home to neural cell bodies, axon terminals, and dendrites, as well as all nerve synapses. This brain tissue is abundant in the cerebellum, cerebrum, and brain stem. It also forms a butterfly-shaped portion of the central spinal cord.
The back portion of this butterfly shape is known as the posterior, sometimes called the dorsal gray horn. This region passes sensory information via ascending nerve signals to the brain. The front part, which is sometimes called the ventral gray horn, sends descending nerve signals governing motor activities to your autonomic nerves.

Image Credit: Neuron cluster [associated with, image source unknown]

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