mental status exam

What an ordeal. Eight hours of testing, of picture stories, verbal stories, word pairs, numerical recall, shapes, what's missing, what shouldn't be here and on and on and on. My head hurt after the first four hours. Another four hours later I was wiped out.

My tester was an older woman, a retired school teacher who'd had to go back to work when her husband lost his job. She was very teacher-ish but also kind and charming. We had fun together and she enjoyed spending a day with me as a different experience from her usual assignments of profoundly mentally ill individuals.

Sample question for you. Joyce said "I am going to read you a string of numbers and letters. I want you to put them in order, A, B, C, and in numerical order, 1, 2, 3." I would nod my understanding and say okay, and then here comes the string:

9, W, 3, H, 5, C, 1, M, 4, T

I was supposed to say "1 3 4 5 9 C H M T W."

The initial questions were always easy enough to lend a false sense of security. And then would come the questions which simply made my head hurt. It was very odd, because the strings of unrelated words and digits always increased in number. I would do fine up to a certain point, say 8 or 9 digits, and then would come the extra and that would be the end. It wasn't even that I could not remember the last digit or letter or word, but that the addition of that last one made all of the others vanish as well. Kind of like my brain said "you've got to be kidding me" and shut down.

I expect that's normal, not a sign of looming dementedness, but it's interesting and wonderful to pay such direct attention to how my own brain works in my head in response to this kind of testing. It gave me an odd sense of my brain as a separate thing, efficiently working inside of my skull like a computer humming busily in the next room while I lounge on the sofa reading.

I don't know how I did. I do know I can no longer do long division with the little V-bar thingie like I learned in 3d grade. I can do it with up to two decimals, but dividing 67.364 by 33.72? Not a chance. My algebraic skills, too, have vanished, the little bit I had. If the square root of 7ax is 6, I know in some magical world, 7ax = 36, but I don't know what the hell "a" is and I never will.

The only spelling question I missed was boutonnierre (I stuck a u before the first n) and I could kick myself, because I know how to spell it. She did say I was her first person ever to spell mnemonic correctly. Yay! A star from my teacher. Hoping my brain will get an all clear and a star too. Off to Dallas. 'Bye.

here's what i like about george bush . . .

"He doesn't think too much. He just gets up in the morning, puts on his jeans and t-shirt and kicks terrorist ass. That's what I like about Bush. We don't need a president who thinks too much."

That statement courtesy of my new neurologist. We had a rousing political debate lasting about 35 minutes and as we were discussing our opposing views on the relative merits of presidents past and present, congress, bureaucracy, wire tapping, habeas corpus, torture, what is entailed in sound fiscal policy, why the rich need more tax cuts v. why they do not, it dawned on me "this is diagnostic; he's doing this on purpose to see if I can put two thoughts together."

It was interesting, this first step in getting evaluated for early onset of dementia. The next step is an MRI and then a neuropsych exam. The mind I have left makes note of the fact that there are Rethugs everywhere, even masquerading as a friendly doctor freshly missing a ponytail and with a suspicious puncture in the earlobe. It's so disconcerting to come across Rethugs in Dem clothing, but a good reminder to be ever vigilant. I kid. Sort of.