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consequence. The fibroelastoma that looked so ominous on her TEE somehow disappeared, or perhaps it wasn’t a fibroelastoma to begin with. Because of the blood thinner we gave her, she suffered no more strokes. Eventually she went to rehab, and from there she went home. She did not get the heart surgery. She would have to stay on the blood thinners for the rest of her life, and I may never be able to say what caused her problem, or whether it was still a problem, until she suffers the big stroke that wrecks her.
    Six months later, she came to the outpatient clinic, her speech much better, but still frustratingly limited. Her vision had not fully returned. She was making very slow improvement.
    “What’s your account of what’s going on?” I asked her.
    “I think it stinks.”
    “Are you optimistic you’re going to get better?”
    “Yup.”
    “Can you tell me what you think of your experiences in the hospital?”
    “I feel like I’ve never left here. Some days, I can wake up and say, ‘Oh, it’s going to be a very good day.’ Then, it sucks.”
    “What kind of person were you before all these strokes, and what kind of person are you now?”
    “I . . . I was always on the go. Four hours of sleep. Upbeat. Dancing . . . Yeah. I used to walk. Now I can’t see clear.”
    “That’s because you’re missing the right side of the world. You might not be aware of it, but your vision on the right is diminished because of one of the very early strokes. Are you a different person now?”
    “Once I’m home, I’m good. Like, I just . . .” She trailed off.
    “Are you very weepy?”
    “Kind of.”
    “I think this will settle down and there will be a new equilibrium where you’re better than you are now. And I hear you, that the dizziness is what’s driving you crazy. I know it’s frustrating, but your kind of case can’t be solved by a book, or it would have been solved by now.”
    “It’s not simple,” I tell Gilbert, the third-year medical student, “almost nothing is routine, but if at the right moment you can combine experience, logic, and leaps of imagination, you’ll get your patients where they need to go.”
    That’s the pitch. Gilbert has to decide on which specialty to choose by the end of the year, and that is the extent of the effort I will make to sell him on clinical neurology. Rounding on the ward will either appeal to him or it won’t. It’s not for everyone. Among the residents on the team, who have already chosen neurology, some will concentrate on research and try to find the causes and cures of Parkinson’s disease, Alzheimer’s, or multiple sclerosis. Some will go into pediatric neurology. Others will become epilepsy or stroke specialists, some will go into psychiatry. But a few special ones, like Hannah, will carry on the clinical tradition, one case at a time.
    Back on the ward, she comes up to me with the patient list. I am waiting at the nurses’ station with the rest of the team. “Elliott thought you ought to see this lady first before we make rounds,” she tells me. “Her name is Mrs. G, and she’s making me nervous.”
    “Why?”
    “She’s the lady with the hydrocephalus.” In other words, she has too much water in the cavities of her brain, a serious problem.
    “Lead on,” I reply. “I’m at your service.”

2
    Like a Hole in the Head

    Where baseball and neurology converge in a game-saving, over-the-shoulder catch
    On Tuesday, at Chief’s Rounds, a weekly ritual that takes place in the department library, Elliott handed me two tickets to the Red Sox–Mariners game, a 7:30 p.m. start. Like every home game, this one was sold out, but Elliott has season tickets. Although temperatures had already hit the 90s, by game time they would be in the low 80s, then back down into the 70s by the stretch. With clear skies and a crescent moon, it promised to be the kind of idyllic Boston evening that you dream about in mid-February, and feel entitled to by early