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A riveting exploration of the most difficult and important part of what doctors do, by Yale School of Medicine physician Dr. Lisa Sanders, author of the monthly New York Times Magazine column "Diagnosis," the inspiration for the hit Fox TV series House, M.D.
"The experience of being ill can be like waking up in a foreign country. Life, as you formerly knew it, is on hold while you travel through this other world as unknown as it is unexpected. When I see patients in the hospital or in my office who are suddenly, surprisingly ill, what they really want to know is, ‘What is wrong with me?’ They want a road map that will help them manage their new surroundings. The ability to give this unnerving and unfamiliar place a name, to know it–on some level–restores a measure of control, independent of whether or not that diagnosis comes attached to a cure. Because, even today, a diagnosis is frequently all a good doctor has to offer."
A healthy young man suddenly loses his memory–making him unable to remember the events of each passing hour. Two patients diagnosed with Lyme disease improve after antibiotic treatment–only to have their symptoms mysteriously return. A young woman lies dying in the ICU–bleeding, jaundiced, incoherent–and none of her doctors know what is killing her. In Every Patient Tells a Story, Dr. Lisa Sanders takes us bedside to witness the process of solving these and other diagnostic dilemmas, providing a firsthand account of the expertise and intuition that lead a doctor to make the right diagnosis.
Never in human history have doctors had the knowledge, the tools, and the skills that they have today to diagnose illness and disease. And yet mistakes are made, diagnoses missed, symptoms or tests misunderstood. In this high-tech world of modern medicine, Sanders shows us that knowledge, while essential, is not sufficient to unravel the complexities of illness. She 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. Through dramatic stories of patients with baffling symptoms, Sanders portrays the absolute necessity and surprising difficulties of getting the patient’s story, the challenges of the physical exam, the pitfalls of doctor-to-doctor communication, the vagaries of tests, and the near calamity of diagnostic errors. In Every Patient Tells a Story, Dr. Sanders chronicles the real-life drama of doctors solving these difficult medical mysteries that not only illustrate the art and science of diagnosis, but often save the patients’ lives.
From the Hardcover edition.
"The experience of being ill can be like waking up in a foreign country. Life, as you formerly knew it, is on hold while you travel through this other world as unknown as it is unexpected. When I see patients in the hospital or in my office who are suddenly, surprisingly ill, what they really want to know is, ‘What is wrong with me?’ They want a road map that will help them manage their new surroundings. The ability to give this unnerving and unfamiliar place a name, to know it–on some level–restores a measure of control, independent of whether or not that diagnosis comes attached to a cure. Because, even today, a diagnosis is frequently all a good doctor has to offer."
A healthy young man suddenly loses his memory–making him unable to remember the events of each passing hour. Two patients diagnosed with Lyme disease improve after antibiotic treatment–only to have their symptoms mysteriously return. A young woman lies dying in the ICU–bleeding, jaundiced, incoherent–and none of her doctors know what is killing her. In Every Patient Tells a Story, Dr. Lisa Sanders takes us bedside to witness the process of solving these and other diagnostic dilemmas, providing a firsthand account of the expertise and intuition that lead a doctor to make the right diagnosis.
Never in human history have doctors had the knowledge, the tools, and the skills that they have today to diagnose illness and disease. And yet mistakes are made, diagnoses missed, symptoms or tests misunderstood. In this high-tech world of modern medicine, Sanders shows us that knowledge, while essential, is not sufficient to unravel the complexities of illness. She 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. Through dramatic stories of patients with baffling symptoms, Sanders portrays the absolute necessity and surprising difficulties of getting the patient’s story, the challenges of the physical exam, the pitfalls of doctor-to-doctor communication, the vagaries of tests, and the near calamity of diagnostic errors. In Every Patient Tells a Story, Dr. Sanders chronicles the real-life drama of doctors solving these difficult medical mysteries that not only illustrate the art and science of diagnosis, but often save the patients’ lives.
From the Hardcover edition.
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Most Helpful Customer Reviews
10 of 10 people found the following review helpful
Format:Hardcover
A engrossing read this one, and not one just for medical professionals. Detailing the thought processes and techniques of diagnosing peculiar or unusal symptoms, this is a good book for learning how to work through problems in your working life. Basically: never assume, never assume you're not making assumptions, check and check again, trust your instincts, and the basics are there for a reason. And then if all else fails use google!
There are a few surprising revelations here: working as I do as an Engineer, where checklists and standard work procedures are indispensable (and also save lives - leaving a spanner in a jet engine makes a bit of mess), I was astounded to read that surgical procedures are planned and executed with no checks. Surgical instruments are 'uncontrolled', and the reluctance and arrogance on the part of surgeons was also a surprise to me too, with one surgeon saying "these are a surgeon's hands, not a typist's" when asked to use a computer-based diagnosis tool.There are lessons here for my own profession too - the use of lectures in techniques for finding a diagnoses, and seminars where doctors were informally challenged to diagnose a particular set of symptoms sounded a lot of fun. I found the tendency for doctors to leap straight for the high-tech solution instead of old-fashioned physical examinations very revealing - when you've got a hammer every problem looks like a nail.
Very nicely written, the author has managed to convey complicated medical terminology into layman's language, with a minimum of jargon, this is a fascinating glimpse 'behind-the-scenes' of medical professionalism.
There are a few surprising revelations here: working as I do as an Engineer, where checklists and standard work procedures are indispensable (and also save lives - leaving a spanner in a jet engine makes a bit of mess), I was astounded to read that surgical procedures are planned and executed with no checks. Surgical instruments are 'uncontrolled', and the reluctance and arrogance on the part of surgeons was also a surprise to me too, with one surgeon saying "these are a surgeon's hands, not a typist's" when asked to use a computer-based diagnosis tool.There are lessons here for my own profession too - the use of lectures in techniques for finding a diagnoses, and seminars where doctors were informally challenged to diagnose a particular set of symptoms sounded a lot of fun. I found the tendency for doctors to leap straight for the high-tech solution instead of old-fashioned physical examinations very revealing - when you've got a hammer every problem looks like a nail.
Very nicely written, the author has managed to convey complicated medical terminology into layman's language, with a minimum of jargon, this is a fascinating glimpse 'behind-the-scenes' of medical professionalism.
6 of 6 people found the following review helpful
Format:Hardcover|Amazon Vine™ Review
(What's this?)
I chose this book for two reasons. Firstly, I am a big fan of House and have been missing it since it went to Sky, and secondly it is not the type of book I would normally read, so it gave me a good excuse to go outside my usual read zone.
Not only does author Lisa Sanders give a fascinating insight into the world of medicine and the diagnostic process, she does so in a way that is just as interesting and accessible to someone with no medical background as it must be for those who study and work in the field of medicine.
Don't expect medical mysteries to leap off every page, but every chapter is nevertheless compelling. It could even help you should you be on the receiving end of a GP who asks but doesn't listen. Sometimes with GPs you have to take charge of the conversation because - as pointed out in the book - they do tend to ask questions and not let you answer them. They want a simple yes or no, and if you asked they would probably think they have an excellent manner with people, little realising that their patients could feel like they've been treated like objects on a conveyor belt. This "not-really-listening" approach could lead to something crucial being missed, more so for those who are admitted to hospital and faced with barrages of tests carried out by different people, with scarcely the chance to have a real conversation with a doctor who will genuinely listen and examine them as well as relying on tests.
Doctor Sanders is a strong advocate for treating the patient like a human being and not a set of symptoms or an interesting case file, and for that should be applauded. She uses "she" when talking about the generic doctor and "he" when talking about the generic patient, which could also be seen as something to be applauded - though I generally prefer it when authors randomise it so it's sometimes "she" and sometimes "he" - it would have made the writing more natural. That's not to say she doesn't have a very open and honest writing style, and I doubt that many people who perhaps thought this book was more about the cases than the diagnostic process would put it back down again, as it's a very interesting and readable book.
"Interesting," is the key word however, and for a book that doesn't "entertain" in the traditional sense, "interesting" may only take you so far in before you begin to slow down and lose the initial impetus to read on. I think it's well worth getting to the end of this book, but then I can't ever leave a good book unfinished - there are others who may not share this view.
Not only does author Lisa Sanders give a fascinating insight into the world of medicine and the diagnostic process, she does so in a way that is just as interesting and accessible to someone with no medical background as it must be for those who study and work in the field of medicine.
Don't expect medical mysteries to leap off every page, but every chapter is nevertheless compelling. It could even help you should you be on the receiving end of a GP who asks but doesn't listen. Sometimes with GPs you have to take charge of the conversation because - as pointed out in the book - they do tend to ask questions and not let you answer them. They want a simple yes or no, and if you asked they would probably think they have an excellent manner with people, little realising that their patients could feel like they've been treated like objects on a conveyor belt. This "not-really-listening" approach could lead to something crucial being missed, more so for those who are admitted to hospital and faced with barrages of tests carried out by different people, with scarcely the chance to have a real conversation with a doctor who will genuinely listen and examine them as well as relying on tests.
Doctor Sanders is a strong advocate for treating the patient like a human being and not a set of symptoms or an interesting case file, and for that should be applauded. She uses "she" when talking about the generic doctor and "he" when talking about the generic patient, which could also be seen as something to be applauded - though I generally prefer it when authors randomise it so it's sometimes "she" and sometimes "he" - it would have made the writing more natural. That's not to say she doesn't have a very open and honest writing style, and I doubt that many people who perhaps thought this book was more about the cases than the diagnostic process would put it back down again, as it's a very interesting and readable book.
"Interesting," is the key word however, and for a book that doesn't "entertain" in the traditional sense, "interesting" may only take you so far in before you begin to slow down and lose the initial impetus to read on. I think it's well worth getting to the end of this book, but then I can't ever leave a good book unfinished - there are others who may not share this view.
5 of 5 people found the following review helpful
Format:Hardcover|Amazon Vine™ Review
(What's this?)
Lisa Sanders was a journalist before becoming a doctor, and has a real gift for crafting a story. Based around many unusual case histories, she examines how doctors make their diagnoses and analyses many of the difficulties and deficiencies in this process.
It's perhaps easy to become a little despondent in realising the limits of doctors' knowledge; on the other hand it's pleasing to know that (in the US at least, and hopefully the UK will follow) many of the issues with the methods of the doctors themselves are being addressed in their training. So for example, too often the medics have been relying on The Machine That Goes 'Ping', and not relying enough on their own senses, seeing, listening, touching. And we've all had the experience in the GP's surgery of not really being listened to and being interrupted before we've had our say. A survey quoted in the book found that it was an average of 16 seconds before being interrupted, and in the worst case the patient only spoke for 3 seconds before the GP barged in.
This is compulsive reading for everyone, for medics to help take a good look at themselves and also for the rest of us who may be one of these patients defying diagnosis one day.
It's perhaps easy to become a little despondent in realising the limits of doctors' knowledge; on the other hand it's pleasing to know that (in the US at least, and hopefully the UK will follow) many of the issues with the methods of the doctors themselves are being addressed in their training. So for example, too often the medics have been relying on The Machine That Goes 'Ping', and not relying enough on their own senses, seeing, listening, touching. And we've all had the experience in the GP's surgery of not really being listened to and being interrupted before we've had our say. A survey quoted in the book found that it was an average of 16 seconds before being interrupted, and in the worst case the patient only spoke for 3 seconds before the GP barged in.
This is compulsive reading for everyone, for medics to help take a good look at themselves and also for the rest of us who may be one of these patients defying diagnosis one day.
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Most Recent Customer Reviews
Same book, different title
This is the same book as Diagnosis: Dispatches from the Frontlines of Medical Mysteries by the same author, just published under a different title.
Published 13 months ago by JD Morris
Very useful book
Lisa Sanders is the technical advisor to the brilliant TV series, 'House'.
This book is excellent, enlivened with anecdotes and obersvations. Read more
This book is excellent, enlivened with anecdotes and obersvations. Read more
Published 14 months ago by William Podmore
Great! a must read for medical students
It is fascinating and very interesting. It approaches many topics of bioethics and the critical thinking needed for differential diagnosis. Read more
Published 15 months ago by Alex
Interesting gift
I bought this book for my nephew and his girl friend who are both training to be doctors.
I read a bit and liked it--easy to read for none medical people. Read more
I read a bit and liked it--easy to read for none medical people. Read more
Published 17 months ago by Minnie
Not quite house but not far off
The book provides a brief overview of some of the unusual problems that can face medical practitioners and real life stories of their diagnosis (and misdiagnosis). Read more
Published 21 months ago by Toast
Doesn't quite know what it is
This book is confused. Part of it wants to be a "aren't medics amazing?" type of tribute to medics and their diagnostic skills; part of it wants to be a "We had this patient with... Read more
Published 23 months ago by Dr. Rich Boden
not that interesting
I see that this is coming out in paperback in June 2010 so it would be worth holding out given the difference in price. Read more
Published on 8 May 2010 by Ms. Billygoatgruff
Medical students and process geeks will love it
The marketing department at the publisher's have let this one down by pushing the author's connection to "House". Read more
Published on 18 Feb 2010 by Paul Robinson
Slightly misleading cover, but very good book
Diagnosis is a very interesting read, though for different reasons than I first expected. The front cover mentions that the author is technical advisor to the tv series "House",... Read more
Published on 20 Dec 2009 by J. S. Hardman
A fascinating read
I really enjoyed reading this book. It's written by Lisa Sanders who was apparently technical advisor to the TV show 'House', which starred Hugh Laurie. Read more
Published on 17 Dec 2009 by P. Potter
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