Special Expertise: Epilepsy
Hospitals: Orange Regional Medical Center; St. Luke’s Cornwall Hospital
Diagnosing epilepsy for patients requires Olga Fishman, MD, to gather clues from video clips, MRIs, EEGs, even suicide scars. “Not every seizure is caused by epilepsy, and not every epileptic episode resembles the seizures on TV,” she says. “It can be as subtle as staring, blinking, chewing, or lip-smacking; or as dramatic as dropping to the ground.” Her aim is to draw distinctions between patients who have epilepsy and those who have been misdiagnosed, so that both groups can enjoy better quality of life. “I love the human aspect of my job,” she says.
Why did you decide to specialize in epilepsy?
I always knew I would attend medical school because I was a curious child. My grandfather was a doctor; and by indulging my curiosity, he got to be entertained and I got to learn. My father got diagnosed with Parkinson’s when I was in college, which sparked my interest in neurology. Then I did a rotation in medical school, learning to interpret EEGs, the tests that detect brain activity; and where other people just saw wavy lines, the tests somehow spoke to me. My field also speaks to the cerebral part of me because it overlaps with psychiatry.
How do you prove or disprove a case of epilepsy?
I use tools like EEG and MRI, and consider other causes of seizure-like events: sleep apnea, cardiac issues, or even psychological issues such as conversion disorder. I treated a lovely young lady who carried a diagnosis of epilepsy for several years. It turned out that she had cardiac arrhythmia, which deprived the brain of oxygen so it seized. This has changed the way I practice because I’m more diligent in excluding other causes of seizures — conditions where meds may not help.
How do you connect with your patients?
I smile; I pay attention to their kids. I also pay attention to details. Tattoos always have a back story. Suicide scars may have an underlying story that’s worth exploring. You get clues that steer the conversation in the right direction so that you can ask the right questions.
What do you do outside of work?
I like doing things with my hands. Knitting and crocheting indulge my creative side. I also play piano; and buying a baby grand was one of the first purchases I made upon coming to Crystal Run.