Dr. Jakov, SERS Neurologist – 2008

Re-Evaluation – 2008:

Dr. Jakov, SERS Neurologist

Dr. Jakov walked into the exam room. Turning to Angela, he asked, “So why are you here today?”

“SERS sent me to you for my medical re-evaluation,” said Angela.

“But why did they send you to me?” he queried.

Confused by his question, Angela responded, “Well, I thought because there was additional medical information from my neurologist and balance disorder specialist since the last time I saw you. Did you get those records from the school retirement system?”

“The only thing I’ve received are case notes from your psychiatrist,” said Jakov.

“I don’t understand,” said Angela. “Why wouldn’t they send you all the other information?” She didn’t really expect him to answer that question.

Estelle stepped in and said, “Dr. Jakov, I can fax Angela’s other medical records to you when I get back to my office. We did bring a disk showing the MRI which shows evidence of Angela’s brain injury.”

“Okay, I’ll go look at that now,” he said as he took the computer disk and walked out of the room. He returned a few minutes later saying, “I couldn’t get the file to open. But if what this shows are dilated perivascular spaces as is written on this disk, that doesn’t prove anything. Everyone has dilated perivascular spaces; that’s nothing special.”

“But the report says the pattern is consistent with brain damage from whiplash,” replied Angela. Perhaps it sounded like she knew too much. When you’ve had so many doctors discount that there is anything wrong with you, you pay attention to the doctors who are highly specialized and what their reports say.

“Dr. Jakov, Angela’s doctors say that she has a blocked vertebrobasilar artery leading to something called vertebrobasilar insufficiency,” said Estelle as she showed him some excerpts from the doctors’ depositions explaining their diagnoses.

“Twenty percent of the population has blocked vertebrobasilar arteries and they don’t have these kinds of symptoms,” scoffed Jakov. As he skimmed over a few pages of the depositions, he shook his head and waved his hand back and forth in the air, saying, “No, no, I don’t agree with any of this.”

Estelle asked, “Doctor, Angela’s been having so many problems and I’d really like to know what you think could be causing all of these symptoms and what we can do to help.”

He faced Estelle, as if Angela weren’t even there, shaking his head disgustedly. “It’s all psychological.”

Estelle tried again. “Dr. Jakov, in a newsletter I got from one of the local hospitals, they had this article on ministrokes or TIAs and listed some symptoms to watch out for. All of these symptoms are the things Angela has when she gets over does it.” Estelle pulled out the newsletter and started reading some of the symptoms: “Weakness on one side of body, confusion, trouble speaking, blurry vision…”

Jakov interrupted before she finished. “Those checklists are like the ones they have for attention deficit disorder. Anyone filling it out would think they have ADD.”

“But doctor, if it’s all psychological, how could that be?” questioned Estelle.

“Well, you know the mind does strange things. I just saw a woman in the hospital last week that can’t move at all. Just sits there and stares,” said Jakov.

“She was catatonic?” Estelle said.

“Yes,” he replied as he looked in Angela’s direction. “Let me see you walk.”

Angela stood up from her wheelchair and walked across the office. Her gait was wide-based and she had a kind of limp. “See that,” said Jakoff disgustedly. “There’s nothing that explains that. All I can say is if you can’t connect the dots, it’s psychological. You get a lot of strange things that can’t be explained – it’s not organic damage, it’s all psychological.”

Angela was seething. This arrogant jerk was so incompetent. Off course she wouldn’t have known incompetence had she not seen a top-notch balance disorder specialist. Did he even bother to ask her why she walked that way? Did it matter that she had fallen while going upstairs several years ago and injured her kneecap?

Angela couldn’t hold back. “What about some of the objective medical tests that were run?”

Jakov replied, “There are no objective medical tests to explain any of this!”

“The Frenzel goggle test? The VEMP? The ABR?” retorted Angela as the doctor headed for the door. While she could not remember what the letters stood for, or how they explained some of her difficulties, she knew they were connected to some of the problems she was having and that these were objective tests that a person could not fake.

Estelle interrupted. “Dr. Jakov, I’ve really appreciated the time you’ve taken with us. I will fax you those other medical records.”

© Angela Cramer, 2008

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