Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis Hardcover – Aug 11 2009
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"Lisa Sanders is a paragon of the modern medical detective storyteller. The tales here crackle with suspense. But what sets her apart is her Holmes-like eye for the clues–and her un-Holmes-like compassion for those who suffer."
—Atul Gawande, author of Better: A Surgeon’s Notes on Performance and Complications: A Surgeon’s Notes on an Imperfect Science
"Dr. Lisa Sanders is the most acute observer of health care in America. In this compelling book, she opens the black box of diagnosis and lets us look inside."
—Ian Ayers, author of Super Crunchers: Why Thinking-by-Numbers Is the New Way to Be Smart
"Not ‘whodunit’ so much as ‘whatdunit,’ Lisa Sanders’s book brilliantly conveys the sleuthing that lies at the heart of medical diagnosis. But this is more than a set of suspenseful tales unfolded by a skilled storyteller. Amid all the flash and dazzle of the modern doctor’s high-tech armamentarium, Dr. Sanders finds that all too often it is the ancient skills, of touch and of attentive listening, that serve the physician, and her patients, best of all. Enlightening for patients, essential for practitioners, this book should be read by every doctor. I’m praying that mine will."
—Geraldine Brooks, author of March, People of the Book, and Nine Parts of Desire
"Lisa Sanders has written a beautiful, thought-provoking book about the sine qua non of medical care–diagnosis. She tells stories about great diagnostic triumphs and explains both the pitfalls and successes of diagnosis. Her patient stories captivate the reader as we try to solve the unfolding mystery. Through these stories we understand and remember the importance of accurate diagnosis."
—Robert Centor, MedRants.com
"Every Patient Tells a Story is a must-read for anyone who has ever been a patient or is a doctor. Written by a physician I respect and a writer I love, the book is filled with intriguing diagnostic dilemmas that will draw you in, and with human stories that will linger in your mind–and heart–long after you are done."
—Pauline W. Chen, author of Final Exam
About the Author
Lisa Sanders, M.D. is an Assistant Clinical Professor at the Yale University School of Medicine and a clinician educator in Yale’s Primary Care Internal Medicine Residency program. Dr. Sanders writes the popular “Diagnosis” column, which appears monthly in The New York Times Magazine.
Her column was the inspiration for the acclaimed Fox television show “House M.D.,” and she currently serves as technical advisor for the show. Although teaching about clinical reasoning and diagnostic error is her first love, much of her research and practice focus on the treatment of overweight and obese patients She is the author of The Perfect Fit Diet: How to Lose Weight, Keep it Off And Still Eat the Foods You Love.
Before entering medical school, Sanders was an Emmy Award-winning producer at CBS News, where she covered medicine and health and she also worked as a producer at ABC and NBC News. She lives in New Haven, Connecticut.
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Top Customer Reviews
Lisa Sanders, M.D.
New York: Broadway Books, 2009, $29.95, 276 pgs.
Lisa Sanders' book is a riveting exploration of the most difficult and most
important thing that doctors do: diagnose the disease of a patient. As Sanders
explains through her book, diagnosis is not so much based on a scientific
formula as it is an art that takes many years to develop. Even experienced
physicians and specialists sometimes have a difficult time effectively and
accurately diagnosing patients. A patient's experience of being ill is also mired
with complexity and turbulence. And it is no wonder since the experience of
being ill is unique to each patient. The patient may have a really difficult time
to come to terms with his/her illness. When a patient becomes ill, life as (s)he
knew it is on hold. And this is really scary for most patients.
This is especially the case if patients become ill suddenly. Patients struggle
to come to terms with their illness. Doctors have a difficult time to sometimes
diagnose the disease effectively. Yet, never in the history of the medical
profession have doctors had the knowledge, and the skills that they have today
to effectively diagnose illness. And yet mistakes are made, diagnoses missed,
and symptoms or tests are sometimes misunderstood. In this high-tech world
of modern medicine, Sanders shows that knowledge, while essential, is not
sufficient to unravel the complexities of illness. She presents a look inside the
story that marks every illness.Read more ›
Most Helpful Customer Reviews on Amazon.com (beta)
It turns out that the things we patients secretly crave from our doctors--eye contact, focused conversation, LISTENING, the reassuring touch of the physician's educated hands on our painful abdomens or dislocated shoulders--are also the most vital tools of a truly great diagnostician. Of course we're grateful for medical technology, but as Dr. Sanders so brilliantly argues, these technical advancements work best when physicians' own powers of observation--and yes, intuition--are also fully engaged.
The last chapter is a dramatic departure from the rest of the book. Here Dr. Sanders tells us a very personal diagnosis story, one involving the untimely death of her younger sister. The gift of such an intimate conclusion reminds the reader of the humane impulse that so clearly motivated its author on every preceding page.
This book may be a disappointment to those led by the title and blurbs on the covers to expect a book just about diagnostic stories, something akin to a compendium of the monthly "Vital Signs" column in Discover magazine. For those concerned about health care issues, though, it provides a thorough background into an area of medicine and insight into the debate over the growing use of expensive tests. The worrisome aspect of this book comes because once you understand the importance of a careful exam, you realize that not only is it being abandoned wholesale by the profession even when it should be retained, you have no way to know whether your doctor is any good at it.
One positive sign related in this book is the renewed interest among medical faculty of the importance of careful physical exams. Doctors must now show proficiency in order to be licensed. Even practicing doctors are seeking out additional training, as Dr. Sanders does when she attends a class on heart sounds. Even this seems incomplete to me; after the training the doctors test much better than before, but do they keep that improvement 6 months or 6 years later? I wonder why they don't leave the class with a program that has hundreds of versions of the sounds they've learned on it so that they can test/refresh their skill once a month or so.
The last takeaway from this book, and it's useful reminder, is that medicine is an art. Not only are doctors imperfect, so is knowledge and diagnosis of disease. People get things, debilitating things, and nobody can figure out what they have. This book serves to point out that a skilled doctor taking a careful look may be able to solve some of the mysteries.
Thus, this book is both about medical diagnoses, but it also raises important questions about medical practices that are of interest generally, but i believe would be of interest to and resonate with doctors as well.
The book is very well written. It is clear, concise, and personal.
It also gives a nice depth for how I will look at House when the new season begins. (Perhaps with more medicine and less drama, I hope).
My biggest complaint about the book? Sequel isn't ready yet. Finished it in a day, and would like to read more.
Altogether, a great read. Get it.
The subtitle promises that the book is full of medical mysteries, and indeed, the stories in the book about people with strange collections of symptoms whose illnesses proved very hard to figure out are as compelling as I expected.
The problem is that these stories are not quite what the book is about. It's as if the author started to write a book about medical mysteries and then got sidetracked. The digressions are about interesting and important issues (why the physical exam is something of a lost art and what this might mean for the practice of medicine, for example). However, they don't fit into the book as it's designed and as it presents itself. It's as if you went to see what you expected to be a romantic comedy film and found yourself faced with something that started out sort of like "When Harry Met Sally", where the middle portion of the movie was more like "Midnight Express", with a few scenes pulled from "The Sound of Music", and then the ending of Harry and Sally, followed by a fragment from a lecture on Plato.
It's not that all the parts aren't worthy themselves. It's that they by no means make a coherent narrative. Worse, imagine that the director, writer, and actors in the mish-mosh movie insisted that it was simply a romantic comedy. That the detective stories are the best parts of the book makes it worse, in some ways.
I've loved books about being a doctor since I read Intern and The Making of a Surgeon more than 35 years ago. I wanted to love this book, too. I think maybe the worst part of the experiences was that the good bits were so very good.
I wish that this author had written two books, one about the medical mysteries of diagnosis and one about the evolving state of the practice of medicine. I expect that both books would be better than this one, and a good deal more satisfying to read.
All that said, it IS a well-written and interesting book, and far from a total waste of time.
This book is an important book that should be read by practicing physicians. Dr. Sanders, through case studies, explores the idea that every patient has a story to tell and if a physician is truly listening, the diagnosis will uncover itself.
Her book and Dr. Jerome Groopman's book, How Doctors Think should be on every physician's MUST READ list. Without a doubt these books explore the communication process that is necessary when practicing medicine.
I loved reading Dr. Sander's book. She writes with great compassion and discloses to her readers her own family's medical mystery that doesn't have a happy ending. I appreciate her candor in disclosing her family's heartache. I hope it will help other families have a happier ending.