Current Mailing Address

Paul Schnafield

85 Otis Lane

St. Paul, MN 55104

 

Email: pschanfield@comcast.net

 

Present Activity Status: Working

 

Tell us about your community activities:  Volunteer at United Jewish fund council, J.C.C. Maccab, Games of St, Paul, Bridge Club, Bike Group, Book club, Maimondes St. Paul Chairman

 

Family Status: Married with 2 children

 

What path has your career taken since your residency?  Include military service, private practice, academic career, teaching and research accomplishments.

 

Private Practice in St. Paul and east metro area

Teaching Family Practice residence St. John’s NE Hospital

Teaching UMN medical students

Mentoring of Premedical Students

Stroke Director St Johns NE

 

We are interested in anecdotes and experiences from your residency years.  Include interactions among fellow residents and teaching staff. 

Residency War story: A fellow resident paged me stat to help him. He was trying to do a funduscopic exam on a mentally and physically handicapped seizure patient, when her eye (a real eye) slipped out of the orbit and was hanging there by the neurovascular bundle. We were able to replace the eyeball back in the socket and her vision returned shortly thereafter!

A.B. Baker story: He was quizzing the medical students as to why testing for proprioception is not a reliable localizing sign longitudinally in the spinal cord. Many neurophysiological answers were given by the students a couple even were quite accurate (in my humble opinion), although none were acceptable to the Master Neurologist, Dr. Baker.... His answer: Proprioception is a poor longitudinal cord localizing sign because WE tell you to check it only at the big toe. If it were more valuable, we would tell you to also check it in the hand.

A.B. Baker story: He was rounding with Ms. Clipper and the chief resident when they noted a lot of noise coming a patient room. Shortly thereafter, a junior neurology resident came out of the room. Dr. Baker glares at the resident and inquires about the situation. The junior resident, somewhat nonchalantly and confidently announced that the patient was in the throes of a pseudoseizure a hysterical generalized seizure, and she would be fine. The professorial stare intensified. The silence became rather deafening. After a time, Dr. Baker announced that in his entire career he had only diagnosed hysterical generalized seizures correctly in one person. You know what that person died of eventually, doctor? The junior resident, sweating and stuttering, of course, indicated that he did not know... I tell you son, she died of status epilepticus! Now get back into the patient room and tend to her until her spell has passed.

Dr. George Flora charming, clever and a gifted clinical neurologist and a most exceptional teacher.. . .but when it came time to publishing and doing research, well....

Dr. Joe Resch everyones (especially mine) favorite person and neurologist. He was the glue that held the Department of Neurology together. He was second in command and seemed quite willing to remain in the background, while ghost writing articles, papers and books. He was a clean desk type of a person. He gave everyone a chance to succeed, a wonderful mentor. Born to be a grandfather, and a lovable one at that. Easy to underestimate despite being so smart, wise and savvy, as he was soft .

Residency war story: We had admitted a schizophrenic, institutionalized patient to the neurology ward to see if her were complex partial seizures. She was a large, rather mean looking woman who would suddenly go into a trance-like state and start wandering about the hospital. The nurses observed that if you stepped in front of her, she would turn away and keep walking. With this knowledge, we were able to guide her back to her room untouched, where she sat down and continued to stare trance-like, straight ahead. She began to rock. A junior neurology resident (me) tried unsuccessfully to engage her in conversation. So, I gently placed a pillow on her lap and asked if she needed anything else... She suddenly leaped to her feet, threw the pillow aside, grabbed me, pulled off my glasses, twisted them until the lenses popped out, returned my damaged spectacles, sat down, and announced that, one should interrupt me when I rocking. That said, she resumed rocking and staring straight ahead.

Dr. Milton Alter: The chief of the Minneapolis Veterans Administration Hospital. While A.B. Baker clinical neurology training stressed listening to the patient and analyzing the history, Dr. Alter seemed to emphasize a physician power of observation. It is very fair to say, I believe, that Milton Alter had keen powers of observation. He was always looking for a nuance that might lead off in a new direction of study and research. Dr. Alter was a man of extremely high energy and curiosity, leading him to be a prolific writer, researcher and traveler. As his chief resident at the V.A., I was motivated, stimulated and educated to the by a man who lived and worked full speed ahead all of the time.

Share your thoughts regarding the changes in medicine since your residency.  In your opinion, is Neurology positioned well for the future?

Neurology as the world turns: As a University of Minnesota neurology resident in the middle 1970s, I was blessed with a wonderful training program - centered at the University, but most importantly, allowing each resident to train also at two county hospitals and an outstanding Veterans Hospital. As neurologists, we seem to be more useful in the practice of medicine than I had ever imagined. Our job is a broad one. We must diagnose with accuracy. We must guide the patients, their families and the other health care providers in evaluation and treatment of many long term problems. We are often there at the end of life, and therefore faced with significant ethical issues and grieving families Today new challenge in the training of residents, I believe, is to educate them in sub-specialization skills required by the rapidly advancing neurological sciences, while maintaining their interpersonal skills of listening to patients and families and with them as people. How our training programs will guide us in this difficult challenge will determine the future of clinical neurology. I believe that clinical neurology was developed here in the Midwest, in Iowa, Michigan, Wisconsin and Minnesota. With the demands of sub-specialization, we must somehow keep this Midwestern patient oriented practice of medicine alive, or our next generation of neurologists will be of the puzzle and not part of the solution, will be procedure-ists (is that a word?) and not clinicians, and will augment the fragmentation of the practice of medicine.