REVIEW: Diagnosis by Lisa Sanders
As a Yale School of Medicine physician, the New York Times bestselling author of Every Patient Tells a Story, and an inspiration and adviser for the hit Fox TV drama House, M.D., Lisa Sanders has seen it all. And yet she is often confounded by the cases she describes in her column: unexpected collections of symptoms that she and other physicians struggle to diagnose.
A twenty-eight-year-old man, vacationing in the Bahamas for his birthday, tries some barracuda for dinner. Hours later, he collapses on the dance floor with crippling stomach pains. A middle-aged woman returns to her doctor, after visiting two days earlier with a mild rash on the back of her hands. Now the rash has turned purple and has spread across her entire body in whiplike streaks. A young elephant trainer in a traveling circus, once head-butted by a rogue zebra, is suddenly beset with splitting headaches, as if someone were “slamming a door inside his head.”
In each of these cases, the path to diagnosis—and treatment—is winding, sometimes frustratingly unclear. Dr. Sanders shows how making the right diagnosis requires expertise, painstaking procedure, and sometimes a little luck. Intricate, gripping, and full of twists and turns, Diagnosis puts readers in the doctor’s place. It lets them see what doctors see, feel the uncertainty they feel—and experience the thrill when the puzzle is finally solved.
Dear Dr. Sanders,
After I was approved to get the arc for this book, I went back and read your first book. That one extols the fading art of the physical examination in helping doctors to determine what is going on when a patient asks, “What’s wrong with me?” Here though the emphasis is on some baffling cases that can stump even the best clinicians. Often it takes time, willingness to listen to what the patient (or family members) has to say, dig through a chock-filled chart, and then put together the little clues and pieces that will crack the case.
Organized into chapters based on common symptoms – fever, headaches, abdominal pain, trouble breathing, rashes, and weakness – several cases are presented for each.These are laid out with background information of what brings the patient in and previous medical history (if any), then goes into the doctor’s thought process as she or he thinks, considers, and rules in or rules out what might be the issue. Sometimes colleagues are brought in or consulted or (yes, doctors do it, too) the internet is searched before that one clue is discovered and the “Aha!” moment arrives.
For some of these cases, I hope that they’re published in medical journals as a few of the doctors muse that not everyone can know everything. Sometimes valuable knowledge might have been set aside if older drugs get a new lease on life or strange things (like the reaction of lime juice on bare skin under sunlight or that raw or under-cooked shiitake mushrooms can cause a rash) aren’t widely known. Following along at home was fun. I’ve never watched “House” but I can’t wait until this new diagnostic series debuts on Netflix. B