“It is natural law that all complex systems move from a state of order to disorder. Stars decay, mountains erode, ice melts. People get off no easier. We get old or injured and inevitably slide right back into the elements we were first made from. The organized masterpiece of conception, birth, and maturation is really only two steps forward before three steps back, at least in the physical world. Sometimes when Charlotte lost a patient she thought about that and found it comforting—a reminder that she hadn’t failed in what was ultimately an unwinnable game. But if she thought about it too long, she had to wonder if her entire medical career was an interminable battle against the will of the universe.”

Book Review:

Review by Jana L. Perskie (MAR 3, 2014)

Gemini is an intensely absorbing novel which I found difficult to put down. It is a very human tale which delves deeply into subjects like love in its many shapes and forms, and time – too little time, not enough time, counting time, too late. The author, Carol Cassella, uses time to move her storyline back and forth in years, seamlessly weaving together the characters and the events which impact them.

The novel is narrated by two characters in alternating chapters: Raney, (Renee Lee Remington), an adolescent when the story begins, unfolds her life over the years. She is an illegitimate child, abandoned by her mother and birth father. Raney lives with her extremely eccentric grandfather, who adores her, in the small town of Quentin, WA, near Olympic National Park. He goes so far as to build an underground bunker, fully supplied for TEOTWAWKI, (“The End Of The World As We Know It).” Raney shows artistic promise at an early age and paints on plywood with house paint because she cannot afford canvas and oils. This girl/woman tells of her teenage friendship with Bo, a rich, awkward and shy boy from Seattle who is visiting his aunt for the summer while his parents are off somewhere getting a divorce.

Dr. Charlotte Reese, is a physician who specializes in the care and treatment of patients in intensive care at Beacon Hospital near Puget Sound, WA. She is a committed doctor, who cares deeply about her patients. Charlotte is in a long term relationship with Eric Bryson, a science journalist, who loves her but has a hard time committing to marriage and, eventually, to having children.

There is an important 3rd character here, one without a voice. Jane Doe.

Charlotte is on duty when a horribly injured woman is admitted to the hospital. It is 3:00 A.M. when the woman, whisked in a medivac helicopter to Beacon’s intensive care unit, is given into Charlotte’s care. As the patient has no identification on her she is tagged with the moniker of Jane Doe, until someone comes to claim her and provide the necessary background information. On arrival she has “no fewer than five tubes: one down her throat, another in her neck, two in her left arm, and one looping from her bladder. She arrives with a splint on her right arm, a scaffold of hardware stabilizing her lower right leg, and so much edema that her skin is pocked with the medics handprints.” She is the apparent victim of a hit and run. Her body was discovered by a truck driver who found her in a ditch beside the highway. He immediately called 911.

In the beginning Charlotte’s only goal is to keep her patient alive. Charlotte becomes deeply involved in solving the mystery of “Jane’s” identity and in locating her family. But as days and weeks pass, Jane Doe remains in a medically induced coma to allow her brain to heal while her body tries to heal itself also. Because her coma is medically induced it is impossible to test for brain death as it would involve removing her life support. So, the test would, in fact, kill her.

“Earlier Charlotte had had a conversation with her boyfriend, Eric, who’d more than once watched her throw the weight of modern medicine along with her single-minded will against all natural forces to keep a patient alive, only to lose in the end. Eric had challenged her on it that day. ‘Should quantity of life always trump quality? Maybe you set your goals too high.’ ‘”

When no one comes forward to give information about Jane Doe, an ethical and medical dilemma occurs. Ought “the plug be pulled.” Jane is assigned a professional guardian ad litem – someone to act on her behalf as her next of kin.

Gemini is set in a time of incredible medical technology, (late 1980s), when bodies can be kept breathing even when other physical functions are shutting down. New research in DNA testing and genetics began to emerge in 1985. Researchers did not understand until then exactly how traits were passed to the next generation. Genetics plays an important role here.

Gemini is filled with mysteries, so much so that I was kept guessing until the end…which is not predictable, at least not to me. There are family secrets, medical mysteries, and ethical dilemmas. The author carefully ties the characters and various storylines together and the complicated puzzle that involves the lives of Jane Doe and Charlotte Reese is originally resolved.

The title “Gemini” refers to the heavenly constellation of the same name. The star configuration is related to a Greek myth about the twin brothers Castor and Pollux. Both were mothered by Leda, but they had different fathers: In one night, Leda was made pregnant both by Jupiter in the form of a swan and by her husband, the king Tyndarus of Sparta. The most common explanation for their presence in the heavens is that Pollux was overcome with sorrow when his mortal brother died, and begged Jupiter to allow him to share his immortality. Jupiter, acknowledging the heroism of both brothers, consented and reunited the pair in the heavens.

I found this book to be one of the best I have read in years. The narrative just flows. I identified with the characters and the complexities of their relationships. I wouldn’t recommend it as a light beach read, however. Although not necessarily a “downer,” I found myself feeling terribly sad and thoughtful at times. But Gemini is about real life, and real life isn’t always an “upper.”

AMAZON READER RATING:	from 65 readers
PUBLISHER:	Simon & Schuster (March 4, 2014)
REVIEWER:	Jana L. Perskie
AVAILABLE AS A KINDLE BOOK?	YES! Start Reading Now!
AUTHOR WEBSITE:	Carol Cassella
EXTRAS:	Reading Guide and Excerpt
MORE ON MOSTLYFICTION:	Read our review of: Healer Oxygen

Bibliography:

• Oxygen (2008)
• Healer (2010)
• Gemini (March 2014)

“There’s no way of knowing exactly how many of Henrietta’s cells are alive today. One scientist estimates that if you could pile all HeLa cells ever grown onto a scale, they’d weigh more than 50 million metric tons — an inconceivable number, given that an individual cell weighs almost nothing.  Another scientist calcuated that if you could lay all HeLa cells ever grown end-to-end, they’d wrap around the Earth at least three times, spanning more than 350 million feet.  In her prime, Henrietta herself stood only a bit over five feet tall.”

Book Review:

Review by Eleanor Bukowksy  (DEC 21, 2010)

Rebecca Skloot’s The Immortal Life of Henrietta Lacks is an enthralling look at the origin of HeLa cells that grew “with [such] mythological intensity,” that they “seemed unstoppable.” They were a “continuously dividing line of cells all descended from one original sample” acquired from Henrietta Lacks, a black woman who suffered from a particularly virulent form of cervical cancer complicated by syphilis. During the Jim Crow era, many hospitals refused to treat black patients. Therefore, Lacks traveled twenty miles to Johns Hopkins, where black people were segregated in “colored wards.” After enduring heavy doses of radiation that charred her skin, Henrietta, who was thirty-one and the mother of five, died in agony. Neither she nor her family had any idea that the cells obtained from her cervix in 1951 would eventually number in the trillions and become a vital part of medical research all over the world.

Henrietta, who was one of ten children, was born in Virginia in 1920. She grew up in a “home-house,” a four-room log cabin that formerly served as slave quarters. She later married her cousin, David (known as Day). Neither Henrietta nor Day had much education. They spent their childhood planting and harvesting tobacco, milking cows, and feeding farm animals. One of their children, Elsie, had an undiagnosed mental condition that left her unable to speak. She was eventually sent to an overcrowded, poorly staffed, and unsanitary institution named Crownsville, where patients lived under horrific conditions and were subject to dangerous experiments. Henrietta and Day had few resources to cope with life’s tragedies and were at the mercy of an exploitative society.

The author expertly depicts Henrietta, her extended family and acquaintances, as well as various scientists and physicians who either knew Henrietta or worked with her cells after her death. In addition, Skloot traces the incredible odyssey of HeLa cells that “went up in the first space missions” and contributed to “the polio vaccine, chemotherapy, cloning, gene mapping, [and] in vitro fertilization.” HeLa cells also were instrumental in the development of drugs to treat such conditions as hemophilia and Parkinson’s. Rebecca decided to track down the family and find out how they felt about what had happened to Henrietta. At first, the Lackses wanted no part of her. They were bitter and angry over the racism and condescension that they had endured over the years and had no reason to trust anyone outside of their immediate circle. In addition, they suffered from a variety of serious ailments such as diabetes and prostate cancer, but had spotty health insurance coverage and little money to pay doctor bills. They received no profit from their mother’s unwitting donation to medical science.

The Immortal Life of Henrietta Lacks touches on the history, sociology, science, and ethics of an era when the chasm between black and white, rich and poor, educated and unschooled, was very deep. Henrietta’s descendants express themselves eloquently. They are confused and incensed over what was taken from their mother without her knowledge or permission. Nor does Skloot skimp on the science; she explains how and why certain cells are more valuable than others. In addition, she discusses the legal and moral issues raised when someone takes tissue from a patient and then gives or sells it to researchers. Rebecca admits that “the Lackses challenged everything I thought I knew about faith, science, journalism, and race.”

AMAZON READER RATING:	from 413 readers
PUBLISHER:	Crown; First Edition edition (February 2, 2010)
REVIEWER:	Eleanor Bukowsky
AVAILABLE AS A KINDLE BOOK?	YES! Start Reading Now!
AUTHOR WEBSITE:	Rebecca Skloot
EXTRAS:	Reading Guide and Excerpt
MORE ON MOSTLYFICTION:	Another interesting book: Don’t Sleep There are Snakes by Daniel Everett

Bibliography:

• The Immortal Life of Henrietta Lacks (February 2010)

“It is possible that we are fatally conjoined to this ancient illness, forced to play its cat-and-mouse game for the foreseeable future of our species.”

Book Review:

Review by Eleanor Bukowksy  (NOV 25, 2010)

Siddhartha Mukherjee’s monumental The Emperor of All Maladies meticulously outlines the trajectory of cancer (derived from the Greek word “karkinos,” meaning crab) over thousands of years, starting in ancient Egypt. In 2010, seven million people around the world will die of cancer. Many have experienced the horrors of this disease through personal experience. The author provides us with a global view of this “shape-shifting entity [that is] imbued with such metaphorical and political potency that it is often described as the definitive plague of our generation.”

In The Emperor of All Maladies, we meet a variety of patients, doctors, scientists, and activists. We also hear the voices of such iconic figures as Susan Sontag, author of Illness as Metaphor, and Alexander Solzhenitsyn, whose Cancer Ward is a desolate and isolating “medical gulag.” Cancer is such a complex subject that it can only be understood by examining it in all of its facets: through myths, the anguish of its victims, and the untiring efforts of its adversaries, both past and present, some of whom were well-meaning but horribly misguided. Mukherjee says in his author’s note that he has made an effort to be “simple but not simplistic.” In this he has succeeded.

Ancient physicians thought that such invisible forces as “miasmas” and “bad humors” caused cancers. Many years of experimentation, studies of human anatomy, laboratory work, and clinical trials have shown cancer to be a “pathology of excess” that originates from the uncontrolled growth of a single cell. Cancer is “unleashed by mutations–changes in DNA that specifically affect genes that incite unlimited cell growth.” What treatment to use–surgery, radiation, chemotherapy, or a combination of these approaches–is rarely an easy decision. Equally significant are the efforts of public health officials, who seek to reduce cancer’s mortality through early detection (mammography and colonoscopy, among others, are screening methods in use today). In addition, cancer may be prevented by encouraging people to avoid environmental carcinogens such as cigarette smoke.

This elegant and heartrending narrative is far more than a biography of a terrible malady. It is also a story of paternalism, arrogance, and false hope, as well as inventiveness, determination, and inspiration. We meet Sidney Farber, who pioneered a chemotherapeutic approach to leukemia in children during the 1940’s and helped launch “the Jimmy Fund;” William Halstead who, in the nineteenth century, disfigured women with radical mastectomies that, in many cases, were not curative; Paul Ehrlich, who discovered a “magic bullet” to combat syphilis from a derivative of chemical dyes; Mary Lasker, a powerful businesswoman and socialite who zealously raised money and political awareness in what would become a national war on cancer; and George Papanicolaou, a Greek cytologist, whose Pap smear “changed the spectrum of cervical cancer.” Mukherjee constantly moves back and forth in time, showing how the past and the present are closely interconnected.

Throughout the book, Dr. Mukherjee’s keeps returning to one of his patients, thirty-six year old Carla Long. In 2004, she was diagnosed with acute lymphoblastic leukemia, a cancer of the white blood cells. Carla would have a long road ahead of her, one filled with pain, fear, and uncertainty. We look to the future with cautious optimism that even greater progress will be made in our never-ending battle against a treacherous and multi-pronged enemy. Mukherjee is a brilliant oncologist, gifted writer, scrupulous researcher, and spellbinding storyteller. The Emperor of All Maladies is a riveting, thought-provoking, and enlightening work that deserves to become an instant classic.

AMAZON READER RATING:	from 146 readers
PUBLISHER:	Scribner (November 16, 2010)
REVIEWER:	Eleanor Bukowsky
AVAILABLE AS A KINDLE BOOK?	YES! Start Reading Now!
AUTHOR WEBSITE:	Siddhartha Mukherjee Blog
EXTRAS:	Reading Guide
MORE ON MOSTLYFICTION:	More “doctor” books: How Doctors Think by Jerome Groopman Better by Atul Gwande

Bibliography:

• The Emperor of All Maladies (November 2010)

“Anne Miller. Wife, mother, nurse. Weeks of medication, available on a day’s notice. Suddenly Jamie grasps the truth. Anne Miller was different from the other critically ill penicillin patients he’d treated. Different from Edward Reese and Sophia Metaxas. Different for one reason only: Anne Miller would survive. The first human to be rescued from death by penicillin.”

Book Review:

Review by Bonnie Brody (JUN 15, 2010)

A Fierce Radiance by Lauren Belfer is a compelling novel. Comprised of several genres, this is a book to pick up and savor. I was kept riveted by a combination of history, romance and mystery. This mix makes for a thrilling ride that kept me enthralled throughout.

The era is 1941 through 1944. The book opens just after Japan has bombed Pearl Harbor. Our country has declared war and young men are being drafted or signing up for the military. Some of us can still picture this era. For those of you who are younger, let me give you a taste. Disease is rampant. There is no cure for polio, streptococcus infections, pneumonia, sepsis, cholera, tetanus or scarlet fever. There is a season for every illness and parents are frightened all the time that their children will die. Adults are frightened for their own lives. On top of that, our nation is at war and, other than sulfa drugs, which have limited curative ability, the United States has no medications to halt infection or disease for its own military.

Claire Shipley is a successful photographer for Life Magazine, the most popular news magazine in the nation. She has already lost one child to sepsis eight years ago. One day Emily fell on the sidewalk and cut her knee. A few days later she was dead. Her younger son, Charlie, is still living but Claire fears for his life at every turn. Claire is assigned to do a photo essay on penicillin, a new drug that is supposedly being developed. This miracle drug, developed from a green mold, is an antibiotic that supposedly has the power to stop gram positive infections in their tracks.

Dr. James Stanton is a physician who is at the forefront of penicillin’s so, in a sense, he holds the key to life and death. However, the supply of this drug is very limited and it is being produced in jars, bedpans and whatever other containers can be found. James meets Claire during the photo shoot and sparks fly. Theirs is a love at first sight but they don’t have much time because James is immediately sent to the war front. His job is to utilize the short supplies of penicillin on the injured servicemen.

Meanwhile, government agencies are becoming directly involved in the production of penicillin. Money is being allocated to institutes and scientists involved in its development. The pharmaceutical companies are ordered to cooperate rather than compete. The government declares that there is to be no patent on penicillin. Rather, it is to be developed by all private companies and utilized for wartime efforts.

James’ sister, Tia, is working on an alternative type of antibiotic, one that comes from the soil. The pharmaceutical companies get wind of this and start pouring their efforts into what they term “the cousins” to penicillin – alternative antibiotics that work on gram negative as well as gram positive infections. This is being done in secret. Claire gets wind of this and tries to get to the bottom of things. Now things get very interesting and the book becomes a real thriller.

I loved Lauren Belfer’s first novel, and A Fierce Radiance does not disappoint. She has done her research. I am usually not a great fan of historical novels, but this one is different than most others. It grabs you and may even rip your shirt in the process. I suggest that you buckle down for a satisfying read. You’ll be so riveted you may not be able to come up for air or find the time to sew the tear in your shirt.

AMAZON READER RATING:	from 39 readers
PUBLISHER:	Harper; 1 edition (June 15, 2010)
REVIEWER:	Bonnie Brody
AVAILABLE AS A KINDLE BOOK?	YES! Start Reading Now!
AUTHOR WEBSITE:	Lauren Belfer
EXTRAS:	Reading Guide and Excerpt
MORE ON MOSTLYFICTION:	More break through in medicine fiction: Wickett’s Remedy by Myla Goldberg

Bibliography:

• City of Light (1999)
• A Fierce Radiance (June 2010)

“Stipp slammed his hand against the wall. He had not wanted Mary by his side, and then he couldn’t have asked for anyone better. She had stayed calm. The only requisite that really mattered, but she had given more: intelligence and charity. When that boy had died, flailing, disoriented, shouting, reliving the battle, the blood arcing everywhere, Mary had thought to kneel by the boy’s side and sing. To sing! The boy had died to the unsteady voice of a tone-deaf, blood-covered angel.”

Book Review:

Review by Bonnie Brody (MAY 26, 2010)

Sometimes the reader is lucky enough to pick up a book that they can get lost in. Place and time disappear and all that is left is immersion in the written word. We become one with the book. My Name is Mary Sutter is such a book. From the time I started it until the very last page, all that existed for me was the story – the ebb and flow of events. I was transported.

The time is 1861 and the novel starts in Albany, New York. Mary Sutter is a determined woman, intelligent and headstrong. She is not like the average woman of her time. “She knew that it was said of her that she was odd and difficult, and this did not bother her, for she never thought about what people usually spent time thinking of. The idle talk of other people always perplexed her; her mind was usually occupied by things no one else thought of: the structure of the pelvis, the fast beat of a healthy fetus heart, or the slow meander of an unhealthy one, or a baby who had failed to breathe.” Mary is an accomplished midwife but she has dreams of becoming a surgeon. Never has a woman been admitted into medical school nor been accepted as an apprentice to a working surgeon. Mary writes letter after letter applying to the Albany School of Medicine and does not even receive the courtesy of a reply. Mary approaches an Albany surgeon, James Blevins, and inquires about apprenticing with him. He declines to take Mary on but they begin a friendship that endures time and hardship.

The Sutters are supportive and close. Mary has a twin, Jenny, who is as unlike Mary as any person can be. Still, they are close and loving. Amelia, Mary’s mother, is a midwife from whom Mary has learned her skills. The family comes from a long line of midwives. Christian is Mary’s beloved younger brother. The family is financially secure due to Mary’s father’s business. When the book opens, Mary’s father has recently died and the family is in mourning.

A new family moves in next door and Thomas Fall, an attractive young man, is drawn into the lives of the Sutter family. Mary is instantly attracted to him and feels like he is responsive to her feelings. However, he is more drawn to her sister Jenny and ends up marrying her. Mary is crushed. At the same time, the Civil War is beginning. Mary decides that she needs to leave Albany to mend her heart and help out in the war efforts. She hopes to find someone she can apprentice with in Washington and attain her dream of becoming a surgeon. At the same time, her brother Christian signs up to fight for the Union.

Nothing can prepare Mary for the horrific conditions in Washington. Though there is a war in progress, the Union government has not prepared for the medical necessities wrought by battle. The hospitals are not equipped with anything but the barest of necessities. Most of the surgeons who are manning the hospitals have never had to do an amputation, let alone take care of epidemics like typhoid or dysentery that are caused by close quarters and unsanitary conditions. Additionally, in 1861, treatments consisted primarily of whiskey, morphine, quinine, and bleeding the patient. Causes of most diseases were rarely understood.

It is in Washington that Mary meets a surgeon, William Stipp, who takes her under his wing and agrees to apprentice her. This is a dream come true for Mary. Mary ends up going to the battlefields, living in the trenches with the soldiers, providing medicine in the worst of conditions.

The book provides information about the Civil War at the same time that it tells Mary’s story. We learn about Lincoln’s travails, his health, tragedies and his difficulty finding good military leaders for the Union. I was especially fascinated to learn that Lincoln’s first choice to lead the Union army was Robert E. Lee but that Lee went with the Confederates when his home state of Virginia chose to secede.

We are privy to the stench and filth that is Washington. During the time this book takes place, from 1861 to 1863, Washington’s streets are amok with sewage, body parts, and smells so bad that it is difficult to breathe unless one covers their face. This book tells a fascinating story about a fascinating time. There is tragedy and there is hope. There is just enough history to provide context but not so much that it becomes boring. Not usually a fan of historical fiction myself, I can vouch for the fact that there is just the right balance of history and narrative to keep this book fascinating from page one until its end. Readers who enjoyed Cold Mountain by Charles Frazier will be drawn to this book.

AMAZON READER RATING:	from 86 readers
PUBLISHER:	Viking Adult; 1 edition (May 13, 2010)
REVIEWER:	Bonnie Brody
AVAILABLE AS A KINDLE BOOK?	YES! Start Reading Now!
AUTHOR WEBSITE:	Robin Oliveira
EXTRAS:	Reading Guide and Excerpt
MORE ON MOSTLYFICTION:	More Civil War novels: The Almagation Polka by Stephen Wright The March by E.L. Doctorow

Bibliography:

• My Name is Mary Sutter (May 2010)

“Tears [are] making tracks on his cheeks.  The cheeks I want to take between my hands and smother with kisses filled with love.  The kisses that will push away the hurt.  The cheeks I cannot touch, or he will have to do another round of compulsions.  The cheeks I love with all my heart, with every inch of me, because they are my darling son’s, and it is killing me to see him in such pain.””

Book Review:

Review by Eleanor Bukowsky (SEP 22, 2009)

Are your kids healthy and happy? If so, you are way ahead of the game. Just ask Beth Alison Maloney, whose son, Sammy, came down with a mysterious malady at the age of twelve. He started yelling at the treetops and the squirrels, refused to go into bed at night, could not enter or exit through the front door of his home, and did not allow anyone to touch him. Beth, who is a single parent with three brilliant and personable boys, had just moved to a new house in Kennebunkport, Maine. (The scenery is gorgeous, and Maloney eloquently describes the wondrous beauty of Maine throughout the seasons.) When Sammy changes so drastically, Beth assumes that the boy is distressed about the move or angry about his parents’ divorce. Perhaps, she thought, he is acting out as an expression of his displeasure.

Unfortunately, as time goes by, Sammy’s behavior becomes more extreme and compulsive (head banging, twitching, hopping, verbal tics, difficulty getting in and out of a van, among others). Beth’s life comes to a standstill and her other children, James and Josh, are adversely affected by Sammy’s constant need for attention. Since Sammy cannot attend school regularly, Beth is on duty 24/7, aghast at her child’s ever worsening condition and desperate to come up with a strategy to help him. Soon, Sammy is unable to sleep, eat normally, or even take a shower. Psychological counseling and a high dose of an anti-depressant do not help. When Beth tells Sammy to stop acting so bizarrely, he replies hysterically, “I can’t! It’s like a mental itch!” Beth finds it hard to accept that her son had become unhinged out of the blue and that he could stay this way for the rest of his life. Her pleasures (including socializing, kayaking on the beautiful waters of Maine, and even enjoying a restful night in bed) take a back seat to finding the answers that she needs.

Life might have continued in this vein indefinitely if someone had not tipped Beth off to the possibility that her son’s obsessive compulsive disorder and Tourette-like symptoms may stem from an undiagnosed strep infection. Beth embarks on a frustrating odyssey, visiting one doctor after another until she at last learns what is really wrong with Sammy. This is a heartbreaking and, ultimately, inspiring and hopeful book about a mother whose love for her child impels her to become his champion at school, in doctors’ offices, and wherever he needs an advocate. She accomplishes a great deal by networking, surfing the Internet, and finally, locating a developmental pediatrician in New Jersey and a child psychiatrist in Boston who proved to be godsends.

Maloney’s tenacity, selfless devotion, and intelligence shine through; readers will cheer for this courageous and loving mother. Beth made a vow and she has kept it. If Sammy were to get well, she promised, she would publicize his case so that other children who are suffering needlessly might also receive the help they need. Saving Sammy is a poignant story of a family in crisis, and it highlights how mysterious the world of medicine still is. Even with all of our technological advances, sometimes it all comes down to a great diagnostician who realizes that the most improbable answer can be the right one. Beth says, “There are some people who can do more for you in an hour than others can do in a lifetime.”

AMAZON READER RATING:	from 32 readers
PUBLISHER:	Crown; 1 edition (September 22, 2009)
REVIEWER:	Eleanor Bukowsky
AMAZON PAGE:	Saving Sammy: Curing the Boy Who Caught OCD
AUTHOR WEBSITE:	Beth Alison Maloney
EXTRAS:	Reading Guide and Excerpt
MORE ON MOSTLYFICTION:	More books like this one: Every Patient Tells a Story by Lisa Sanders Daniel Isn’t Talking by Marti Leimbach The Curious Incident of the Dog in the Night-Time by Mark Haddon

Bibliography:

• Saving Sammy: Curing the Boy Who Caught OCD (September 2009)

“Patients are worried. One survey showed that over one third of patients surveyed after visiting an emergency room had concerns about medical errors and by far the greatest concern was the possibility that they had been misdiagnosed. They are right to worry.”

Book Review:

Review by Eleanor Bukowsky (AUG 31, 2009)

Every Patient Tells a Story, by Dr. Lisa Sanders, an internist and teacher at the Yale University School of Medicine, is a mesmerizing look at the way sick people are treated and mistreated, often with the best of intentions, by their physicians. In her introduction, the author insists that every story she relates, however improbable, is real. The names of the patients and some of the doctors have been changed to protect confidentiality. Sanders is a technical advisor for the hit show, House, in which a brilliant but cranky diagnostician and his staff take about fifty-five minutes (including commercials) to save the patient of the week. Sanders also writes a monthly column about the art of diagnosis for the New York Times Magazine. In Every Patient Tells a Story, Dr. Sanders presents her well-thought out ideas about the obstacles doctors face when they attempt to make difficult diagnoses. In addition, she expresses strong opinions about the ways in which medical students can be trained to do a better job of finding out what’s really wrong with us.

This book is filled with tantalizing mysteries: a twenty-two year old woman is lying in the Intensive Care Unit near death for no apparent reason; a twenty-seven year old woman is brought to the ER by her fiancé after her heart starts beating wildly, her blood pressure climbs, and she starts to speak in “random phrases, meaningless sentences, [and] rapid, incoherent paragraphs;” a fifty-two year old former army man is reduced to tears by a recurring high fever, stiff neck, raw throat, and sore joints. In each of these cases, the doctors examine the patient, order a series of tests, and then try to figure out what is wrong. When, in spite of their best efforts, they cannot come up with an explanation, some practitioners turn to their colleagues for help. At times, the solution is so unexpected that even the physicians are stunned.

Sanders is a superb writer whose medical knowledge, storytelling ability, intelligence, and compassion make this book impossible to put down. She cites revealing studies to support her conclusions, and she expresses herself eloquently, using apt metaphors: “The experience of being ill can be like waking up in a foreign country.” It is the doctor’s job to provide “a road map that will help [patients] manage their new surroundings.” What happens, however, when there is no clear path and the medical practitioner is almost as lost as the person who came to him hoping for a cure? The answer is far from simple. Sanders insists that physicians can do a better job of listening to the patient, taking a thorough history, and conducting a proper physical exam. They should take advantage of the amazing technology available to them, while recognizing that even high-tech machines and sophisticated tests may be unhelpful or misleading. If the doctors are stumped even after taking all of these steps, then they should promptly consult an expert. It is crucial that physicians refrain from coming to premature conclusions to explain the inexplicable. Even if an incorrect diagnosis does not lead to the patient’s death, it can subject him to expensive and ineffective treatments and prolong his suffering. Every Patient Tells a Story is a must read for physicians and for anyone who may have to endure a potentially terrifying hospital stay for “medically unexplained symptoms.”

AMAZON READER RATING:	from 34 readers
PUBLISHER:	Broadway; 1 edition (August 11, 2009)
REVIEWER:	Eleanor Bukowsky
AMAZON PAGE:	Every Patient Tells a Story
AUTHOR WEBSITE:	Lisa Sanders, MD
EXTRAS:	The New York Times “Diagnosis” Column
MORE ON MOSTLYFICTION:	More Doctor books: How Doctors Think by Jerome Groopman Better by Atul Gawande Final Exam by Pauline Chen Direct Red by Gabriel Weston

Bibliography:

• Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis (First Release date)