EVERY PATIENT TELLS A STORY
Medical Mysteries and the Art of Diagnosis
by Lisa Sanders, M.D.
FROM DR. LISA SANDERS, NEW YORK TIMES MAGAZINE’S “DIAGNOSIS” COLUMNIST AND TECHNICAL ADVISOR TO THE HIT TV SERIES HOUSE, M.D., COMES A RIVETING EXPLORATION OF THE GREATEST CHALLENGE IN MEDICINE—THE ART AND SCIENCE OF MAKING A DIAGNOSIS.
The experience of becoming suddenly, and surprisingly, ill can be deeply unnerving. Transported to an unfamiliar world, forced to put her former life on hold, the patient inevitably has a burning question for her doctor: What is wrong with me?
“Besides her own inborn capacity for problem-solving, Sanders’ experience as internist, writer, and consultant to House serves her well here, for absorbing anecdotes generously pepper the exposition.”—Booklist
“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
“If you need to be reminded that there are still diseases that can’t be cured in an hour—including commercial breaks—then this book is for you. Fantastic stuff.”—Hugh Laurie
“A doctor’s insightful reflections on the disconnect between how physicians should practice and how they actually practice… Fans of Jerome Groopman and Atul Gawande will appreciate this first collection by another astute observer of the medical profession.”—Kirkus Reviews
“Readers who enjoy dramatic stories of doctors fighting disease will get their fill, and they will also encounter thoughtful essays on how doctors think and go about their work, and how they might do it better.”—Publishers Weekly
Fortunately, in most cases where an illness presents itself, making a diagnosis is straightforward. The patient’s story and the physical exam suggest a likely suspect, and the technology of diagnosis rapidly confirms the hunch. But there are other cases where—despite all the information, training, and high-tech tools that doctors have at their disposal today—the diagnosis remains elusive: patients with complicated stories or medical histories, or cases where the symptoms are less suggestive, the physical exam unrevealing, the test results misleading.
In those instances, the patient is faced with her worst nightmare—being sick, possibly even dying, and having doctor after doctor fail to figure out why. The doctor, for her part, is confronted with what Lisa Sanders, M.D., an internist on the faculty of Yale University School of Medicine, describes as “the most difficult and most important component of what physicians do.” Donning her detective cap, the doctor must embark on a quest for a diagnosis—a journey that can be messy, filled with red herrings, false leads, and dead ends, one in which the possibility of error is often ever-present, even as the patient’s life hangs in the balance.
In Dr. Sanders’s illuminating new book, EVERY PATIENT TELLS A STORY: Medical Mysteries and the Art of Diagnosis (Broadway Books; On-sale August 11th, 2009; ISBN: 978-0-7679-2246-3; $25.00), she puts readers on the front lines of medicine, offering an unflinching look at the combination of uncertainty and intrigue that doctors experience when confronting patients who are sick or dying. Through a series of fascinating real-life medical cases, she sheds new light on the intricate series of interactions between doctor and patient that constitute the diagnostic process, revealing how a small misstep by either one can lead to an incorrect or incomplete diagnosis.
The cases in EVERY PATIENT TELLS A STORY run the gamut of perplexing medical mysteries, including a healthy young man who suddenly loses his memory—making him unable to remember the events of each passing hour; to two patients diagnosed with Lyme disease who improve after antibiotic treatment—only to have their symptoms return; to a young teacher—healthy and active—who collapses at school after a pulmonary embolus, but without a sign of a blood clot to help diagnose the source; to a young woman dying in the ICU—bleeding, jaundiced, incoherent—with her doctors baffled by what is killing her.
Sanders explores why one doctor is able to make a diagnosis when previous doctors couldn’t, where errors were made in the diagnostic process, and what we can learn from those missteps. She also explores the implications of the demise of the physical exam in modern medicine and candidly discusses her own triumphs and shortcomings, retracing the diagnosis of past patients, and even exploring the diagnosis of her sister’s death. Throughout, she asks tough questions of both doctors and patients: What does a doctor do when the patient profile says one thing and tests say another? What should a patient do when she thinks her doctor has given her a wrong diagnosis?
A modern-day Sherlock Holmes, Sanders not only asks the questions, she gives readers tools to answer them. From Googling symptoms, to navigating a doctor’s office visit, to knowing one’s medical history, she gives patients insightful advice on improving their chances of obtaining—and understanding—a diagnosis. As the title of her book suggests, every patient has a unique story, and Sanders accurately chronicles the real-life drama of piecing together clues to provide firsthand accounts of the expertise and intuition required to save lives.
“I try to share a face of medicine that is both exciting and important,” she writes. “Exciting because the process of unraveling the mystery of a patient’s illness is a wonderful piece of detective work—complicated yet satisfying. Important because any one of us might someday be that patient. The more you know about the process, the better you will be prepared to assist and understand.” EVERY PATIENT TELLS A STORY is the first work of medical narrative to focus specifically on the fascinating topic of diagnosis.
ABOUT THE AUTHOR
LISA SANDERS, M.D., an internist on the faculty of the Yale University School of Medicine, writes the monthly column “Diagnosis” in the New York Times Magazine and is a technical advisor for the TV series House, M.D. She lives in New Haven, Connecticut.
ABOUT THE BOOK
EVERY PATIENT TELLS A STORY:
Medical Mysteries and the Art of Diagnosis
By Lisa Sanders, M.D.
Published by Broadway Books, an imprint of the Crown Publishing Group, a division of Random House, Inc.
August 11th, 2009/Hardcover; $25.00; 304 pages
For more information about EVERY PATIENT TELLS A STORY or to schedule an interview with Dr. Lisa Sanders, please contact Rachel Rokicki at 212-782-8455 or rrokicki [at] randomhouse.com.
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