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

FOR REFERENCE:

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. show less

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! show less

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! show less

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.

"What the patient brings to the (diagnostic) process is unique: the particular & private facts of his life & illness. And what the physician brings is the knowledge & understanding that will help him order that story so that it makes sense to both the doctor - who uses it to make a diagnosis & the patient - who must then incorporate that subplot to the larger story of his life."

This stood out for me. From bring a healthcare service provider to to the recent experience of being ill, this line aptly sums up the whole experience & has been my guiding personal principle that I adopt in my work.

Leaving the personal front aside, this books makes for light reading, filled with stories of about the diagnostic processes that goes on by doctors. show more Like detectives, they have to figure out the ills on a patient's body based on clues & guesswork at times.

It brings to mind about the systemic & the intuitive processes that we adopt in out everyday lives.

Really ideal for a light tea or bedtime read. Nothing too mind draining if you are an academic looking for depth though show less

This book is a great insight into how doctors think and how they diagnose -- or rather, how they are supposed to do those two things. It's compelling yet terrifying reading -- compelling because of the author's subject matter and her incredibly accessible writing style; terrifying because one of her main points is that doctors are no longer being trained in the art of the physical diagnosis, and that can lead to horrendous misdiagnoses that can happen to any patient anywhere. Nevertheless, this book is absolutely required reading.