I had decided that i wanted to do general surgery; so I did a neurosurgery rotation as a 4th year medical student. Neurosurgery residents and faculty are a different breed for sure. Maybe I should say they are not all warm and fuzzy like some other specialties and hard to shock. Anyway, we were rounding with the chief as we did daily. On neuro, the mental status exam involves not just answering queries of tell me your name, what day is it, tell me where you are, who is the president; it also involves showing motor ability and following commands.
we rounded on this gentleman who had been mugged on his way off the riverboat. He had had an epidural hematoma that had to be evacuated. He was doing well. His family reported that he was mild mannered. However, it seems that his personality was more aggressive after the incident. Anyway, when the chief had him go through the exam; he begrudgingly answered appropriately. When the chief asked him to show him two fingers; he smiled and flipped him the bird from both hands. Chief never missed a beat; said he did good.
