Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

by Lisa Sanders

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Presents an unflinching look inside the detective story that marks nearly every illness-the diagnosis-revealing the combination of uncertainty and intrigue that doctors face when confronting patients who are sick or dying--from the challenges of the physical exam to the pitfalls of doctor-to-doctor communication, the vagaries of tests, and the near calamity of diagnostic errors.

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Contents:

Author's Note
Introduction: Every Patient's Nightmare

PART ONE: Every Patient Tells a Story

1. The Facts, and What Lies Beyond
2. The Stories They Tell

PART TWO: High Touch
3. A Vanishing Art
4. What Only the Exam Can Show
5. Seeing Is Believing
6. The Healing Touch
7. The Heart of the Matter

PART THREE: High Tech
8. Testing Troubles

PART FOUR: Limits of the Medical Mind
9. Sick Thinking
10. Digital Diagnosis
Afterword: The Final Diagnosis

Acknowledgments
Notes
Index
Dr. Lisa Sanders discusses the art and science of medical diagnosis, with lots of examples of puzzling medical problems and lots of analysis of how doctors figure out what's happening in a human body and why they sometimes get it wrong. Sanders is a technical advisor for the TV series House, and many of the medical stories she tells here would be right at home on an episode of the show, but in many ways Dr. Sanders is the exact opposite of Dr. House. She puts a lot of stress on the importance of clear communication between doctors and patients and on not losing sight of the patient's humanity. Most particularly, she emphasizes the importance of hands-on physical examinations, which she claims is something of a dying art thanks to the show more modern tendency to rely -- or over-rely -- on high-tech medical tests and to the fact that it's not taught effectively in medical schools.

The case studies she presents here are often fascinating in themselves, as medical detective stories, but what makes this book really worth reading is its eye-opening look at the difficulties of diagnosis, the all too many ways in which doctors can fail, and the potential ways in which doctors, patients and teachers can work to improve things.

It is, however, also mildly terrifying, especially for someone with occasional hypochondriac tendencies, to be so vividly reminded of all the strange, hard-to-figure-out things that can go badly wrong in the human body. And it may be very useful and important to be reminded that doctors are fallible human beings like the rest of us, but damn it, I still desperately want them to magically know what's wrong with me when I ask.
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I'm a huge fan of the TV-series House for which Dr. Sanders is technical advisor, so I was very excited to read her take on the "art of diagnosis." The cases described in this book are like reading an episode of Medical Mysteries and are scary, but also (obviously) absolutely fascinating. Sanders' main thesis in the book is that doctors need to listen to their patients more and learn how to conduct proper physical examinations rather than simply rely on tests. Basically, she seems to say that doctors need to be better doctors, which is a weird statement unless you are a person who believes that doctors are infallible, which is a highly inadvisable belief to hold. Actually, she is making a statement about how doctors are educated in the show more US, but I'm not sure this book is an efficient way of affecting that process.

Then, the book takes a strange turn when it starts to talk about Lyme disease - what begins as a standard description of a patient case unravels into what can only be described as a rant against doctors who champion the idea (seemingly mistakenly) about a condition called "chronic Lyme disease." I understand that Dr. Sanders feels strongly about the issue and I appreciate her passion, but it's rather misplaced in this particular book.

The last section of the book talks about something I find very interesting - the internet's role in future diagnosis! This part discusses the beginnings of medical databases and how the internet has made most of them obsolete - enlightening and really rather funny for anyone who has ever Googled a symptom!
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This review was written for LibraryThing Member Giveaways.
I like some odd genres: Books about Books...Books about People Who Move and Start Over...Books about Cooking...and the genre this book falls into, Books about Doctors.Don't ask me why.Books like this one fascinate me. I'm struck by the way doctors work on people's bodies using a clever combination of science and intuition. This is a particularly intriguing book to me as it deals with the art of diagnosis, using scientific knowledge along with experience and hunches, to figure out why things aren't right with a person. The author started out in television and ended up becoming a medical doctor. She seems to have just the right combination of knowledge about medicine and ability to write well to create this book. Very good book.
Less a book about "medical mysteries" and more a treatise on Sanders' philosophy of the patient experience. The main takeaway is value of the physical exam, which Sanders adamantly states cannot be replaced by diagnostic tests. None of this is negative: I thoroughly enjoyed Every Patient Tells a Story. Lisa Sanders is the real-life inspiration of Dr. House; while she shares his Sherlockian traits, she is highly patient-focused. A wonderful airplane read.
Interesting cases presented, but author also discusses US doctor training instead of staying with the medical puzzles. Would have been better to write two separate books.
House is one of my favorite shows on tv today so you can imagine how tickled I was to pick up Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis at the library. Lisa Sanders is a consultant for the show and apparently an inspiration ? as well. Sanders was a former tv reporter covering medical news who then went back to school to get her medical degree and she became interested in diagnostics, which is very much like playing detective:

“…what captured my imagination were the stories doctors told about their remarkable diagnoses – mysterious symptoms that were puzzled out and solved”.

In this book, Sanders shares the stories she has come across, whther personally or secondhand. Some of them are rather show more intriguing, and would definitely fit into an episode of House. She advocates the return of the physical exam, which was once the centre of a diagnosis, but has now been replaced with lab work or diagnostic imaging. She argues that medical students and practicing physicians have lost some skills as a result: learning to listen, learning to feel, learning how to see.

Sanders isn’t the most evocative of writers. While the cases are fascinating, a few days after reading this book, I couldn’t quite remember them anymore. Perhaps I had other things on my mind. Finishing my work for instance, the little one moving around inside of me (one month to go!). I obviously wouldn’t make it as a doctor – in one ear out the other is not a skill one would appreciate in a doctor. At any rate, this was an enjoyable read, which is perhaps odd to say, as this is a book full of sick and dying people. It’s obviously not a comforting read either, as this book makes it all too clear that doctors are human, that they make mistakes, plenty of mistakes, mistakes that could’ve been caught early on.

A good read if you’re interested in how a doctor thinks, and how diagnosis works. Or if you’re just a fan of House!
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Author Information

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Lisa Sanders, M.D., an internist on the faculty of the Yale University School of Medicine, writes the monthly column Diagnosis for the New York Times Magazine and serves as technical advisor on Fox TV's House, M.D. She lives in New Haven, Connecticut.

Common Knowledge

Canonical title
Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis
Alternate titles
Diagnosis: Dispatches from the Frontlines of Medical Mysteries
Original publication date
2009
Dedication
To Jack
First words
The stories I tell here are real. [Author's Note]
Barbara Lessing stared out the window at the snowy field behind the hospital. [Introduction]
The young woman was hunched over a large pink basin when Dr. Amy Hsia, a resident in her first year of training, entered the patient's cubicle in the Emergency Department. [Chapter One]
Last words
(Click to show. Warning: May contain spoilers.)They need to be heard, they need reassurance, explanations, encouragement, sympathy – the full range of emotional support that is a critical part of what we doctors try to do: heal. [Chapter Ten]
(Click to show. Warning: May contain spoilers.)And after medicine has finished doing all that it can, it is stories that we want, and finally, all that we have. [Afterword]
Blurbers
Gawande, Atul; Laurie, Hugh; Chen, Pauline W.
Original language
English
Disambiguation notice
Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis was also published in 2009 under the title Diagnosis: Dispatches from the Frontlines of Medical Mysteries. This work should not be combined... (show all) with Sanders' 2019 book with a similar title, Diagnosis: Solving the Most Baffling Medical Mysteries, as it is a separate and distinct work.

Contents:

Author's Note
Introduction: Every Patient's Nightmare

PART ONE: Every Patient Tells a Story

1. The Facts, and What Lies Beyond
2. The Stories They Tell

PART TWO: High Touch
3. A Vanishing Art
4. What Only the Exam Can Show
5. Seeing Is Believing
6. The Healing Touch
7. The Heart of the Matter

PART THREE: High Tech
8. Testing Troubles

PART FOUR: Limits of the Medical Mind
9. Sick Thinking
10. Digital Diagnosis
Afterword: The Final Diagnosis

Acknowledgments
Notes
Index

Classifications

Genres
General Nonfiction, Nonfiction
DDC/MDS
616.075Applied Science & TechnologyMedicine & healthDiseases, Allergies, Skin ConditionsPathology; Diseases; TreatmentPathology
LCC
RC71 .S186MedicineInternal medicineInternal medicineExamination. Diagnosis
BISAC

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ISBNs
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