Every Patient Tells a Story

Lisa Sanders, MD writes the monthly column Diagnosis for the New York Times Magazine and is a consultant for the television series House, MD. Dr. Sanders was a broadcast journalist specializing in medical stories before deciding to become a doctor as her second career. She now teaches at the Yale School of Medicine as well as being a practicing internist. She collects stories of interesting diagnoses and writes about them in her NYT column and now has a book out, Every Patient Tells a Story, medical mysteries and the art of diagnosis (2009) which recounts not only the stories of patients whose illnesses were hard to diagnose, but also discusses the diagnostic process and the importance of the physical exam, a fast-disappearing art apparently as high-tech tests replace that skill in many cases.

In the introduction, the case of a young woman so jaundiced that she is "highlighter yellow" (p. xii) but does not have hepatitis, is solved by an internist who takes her history again, examines her, rereads her chart and test results and has an "aha" moment where he puts together all the clues to come up with a rare disease which he then verifies by a trip to the library and a close look at her irises to see if there is a golden ring around the outer edge. If you have watched the TV show House, you may recognize this disease from one episode.

I suspect that my friends, family and colleagues will be glad that I have finished the book so that I will no longer regale them with alarming stories of medical near-misses while they are dining. Librarians who took their lunch in the staff room this week provided a captive audience for my chapter by chapter synopses of this book. I will check it in and now it goes to the patron who saw it on my desk and asked to be put on hold for it. Enjoy, but don't come down with every symptom you read about. That's "Intern's Disease" a manifestation of the power of suggestion.

Every Patient Tells a Story is non-fiction that will appeal to fans of medical novels by Patricia Cornwell, Robin Cook, Michael Crichton, Michael Palmer, Abraham Verghese or Tess Gerritson.
Also of interest: The Medical Science of House