Sunday, April 25, 2010

Every Patient Tells a Story -- Book Review

Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis
by Lisa Sanders, M.D.

Rating: 5 out of 5

The author, Dr. Lisa Sanders, is a professor at Yale Medical School.  She is also a technical advisor to the TV show, "House, M.D." and a columnist for the New York Times Magazine.  This is one of the most compelling books about medicine I have read in a long time; the only book that even comes close to it is Complications by Atul Gawande.  That book had a different focus than this book, however.  Sanders writes about the medical profession much more generally than Gawande, and from an internal medicine aspect.  At one point she describes internal medicine as the most difficult specialty (I imagine that most specialists feel that way about their own specialties) because the cause of the patient's problems cannot be observed directly, making the art of diagnosis that much more important -- hence the subtitle of the book.

Here's where this book essentially scares the crap out of me (in a good way, however).  It's Sanders' contention that doctors are no longer being trained adequately in the art of the physical exam, and those older doctors that were trained in it are no longer taking advantage of it and using it to its full extent.  The entire book is a series of case studies that present a variety of patients in dire straits, simply because many of them were misdiagnosed by some doctor.  These are the cases that no one really discusses or thinks much about -- and yet, people die every day because of these issues.  It's at this point that the reader suddenly sits up and thinks, that could be me!

Sanders' writing style is tremendously engaging, and she doesn't hesitate to describe episodes in her own training and medical practice that show her in a less-than-favorable light.  She is definitely adept at showing the human side of the medical profession, and the tremendous, almost superhuman challenges they face in their training and practices.

While I devoured this book, it really made me want to be a doctor.  Immediately.  White coat and everything.  But then, the reality kicked in -- age, four years of constant studying, blood -- and I calmed back down.  However, for those people already headed for medical school in some form or fashion, this is an excellent, inspiring book that provokes thought.  It should be read by everyone, but especially every pre-med student, medical student, resident, and patient.

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