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


Lisa Sanders - 2009
    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.

Better: A Surgeon's Notes on Performance


Atul Gawande - 2007
    But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable. Gawande's gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable. At once unflinching and compassionate, Better is an exhilarating journey narrated by arguably the best nonfiction doctor-writer around (Salon). Gawande's investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.

How We Die: Reflections of Life's Final Chapter


Sherwin B. Nuland - 1994
    This new edition includes an all-embracing and incisive afterword that examines the current state of health care and our relationship with life as it approaches its terminus. It also discusses how we can take control of our own final days and those of our loved ones.Shewin Nuland's masterful How We Die is even more relevant than when it was first published.

The Shift: One Nurse, Twelve Hours, Four Patients' Lives


Theresa Brown - 2015
    In the span of twelve hours, lives can be lost, life-altering medical treatment decisions made, and dreams fulfilled or irrevocably stolen. In Brown’s skilled hands--as both a dedicated nurse and an insightful chronicler of events--we are given an unprecedented view into the individual struggles as well as the larger truths about medicine in this country, and by shift’s end, we have witnessed something profound about hope and healing and humanity. Every day, Theresa Brown holds patients' lives in her hands. On this day there are four. There is Mr. Hampton, a patient with lymphoma to whom Brown is charged with administering a powerful drug that could cure him--or kill him; Sheila, who may have been dangerously misdiagnosed; Candace, a returning patient who arrives (perhaps advisedly) with her own disinfectant wipes, cleansing rituals, and demands; and Dorothy, who after six weeks in the hospital may finally go home. Prioritizing and ministering to their needs takes the kind of skill, sensitivity, and, yes, humor that enable a nurse to be a patient’s most ardent advocate in a medical system marked by heartbreaking dysfunction as well as miraculous success.

Do No Harm: Stories of Life, Death and Brain Surgery


Henry Marsh - 2014
    Operations on the brain carry grave risks. Every day, leading neurosurgeon Henry Marsh must make agonizing decisions, often in the face of great urgency and uncertainty.If you believe that brain surgery is a precise and exquisite craft, practiced by calm and detached doctors, this gripping, brutally honest account will make you think again. With astonishing compassion and candor, Marsh reveals the fierce joy of operating, the profoundly moving triumphs, the harrowing disasters, the haunting regrets, and the moments of black humor that characterize a brain surgeon's life.Do No Harm provides unforgettable insight into the countless human dramas that take place in a busy modern hospital. Above all, it is a lesson in the need for hope when faced with life's most difficult decisions.

When Death Becomes Life: Notes from a Transplant Surgeon


Joshua D. Mezrich - 2019
    Joshua Mezrich creates life from loss, transplanting organs from one body to another. In this intimate, profoundly moving work, he illuminates the extraordinary field of transplantation that enables this kind of miracle to happen every day.When Death Becomes Life is a thrilling look at how science advances on a grand scale to improve human lives. Mezrich examines more than one hundred years of remarkable medical breakthroughs, connecting this fascinating history with the inspiring and heartbreaking stories of his transplant patients. Combining gentle sensitivity with scientific clarity, Mezrich reflects on his calling as a doctor and introduces the modern pioneers who made transplantation a reality—maverick surgeons whose feats of imagination, bold vision, and daring risk taking generated techniques and practices that save millions of lives around the world.Mezrich takes us inside the operating room and unlocks the wondrous process of transplant surgery, a delicate, intense ballet requiring precise timing, breathtaking skill, and at times, creative improvisation. In illuminating this work, Mezrich touches the essence of existence and what it means to be alive. Most physicians fight death, but in transplantation, doctors take from death. Mezrich shares his gratitude and awe for the privilege of being part of this transformative exchange as the dead give their last breath of life to the living. After all, the donors are his patients, too.When Death Becomes Life also engages in fascinating ethical and philosophical debates: How much risk should a healthy person be allowed to take to save someone she loves? Should a patient suffering from alcoholism receive a healthy liver? What defines death, and what role did organ transplantation play in that definition? The human story behind the most exceptional medicine of our time, Mezrich’s riveting book is a beautiful, poignant reminder that a life lost can also offer the hope of a new beginning.

When the Air Hits Your Brain: Tales of Neurosurgery


Frank T. Vertosick Jr. - 1996
    In other words, by all of us."--Dr. Bernie Siegel, author of Love, Medicine and MiraclesRule One for the neurologist in residence: "You ain't never the same when the air hits your brain." In this fascinating book, Dr. Frank Vertosick brings that fact to life through intimate portraits of patients and unsparing yet gripping descriptions of brain surgery.With insight, humor, and poignancy, Dr. Vertosick chronicles his remarkable evolution from naive young intern to world-class neurosurgeon, where he faced, among other challenges, a six week-old infant with a tumor in her brain, a young man struck down in his prime by paraplegia, and a minister with a .22 caliber bullet lodged in his skull. In candid detail, WHEN THE AIR HITS YOUR BRAIN illuminates both the mysteries of the mind and the realities of the operating room."Riveting."--Publishers Weekly

Hot Lights, Cold Steel: Life, Death and Sleepless Nights in a Surgeon's First Years


Michael J. Collins - 2005
    A natural overachiever, Collins' success, in college and medical school led to a surgical residency at one of the most respected medical centers in the world, the famed Mayo Clinic. But compared to his fellow residents Collins feels inadequate and unprepared. All too soon, the euphoria of beginning his career as an orthopedic resident gives way to the feeling he is a counterfeit, an imposter who has infiltrated a society of brilliant surgeons.This story of Collins' four-year surgical residency traces his rise from an eager but clueless first-year resident to accomplished Chief Resident in his final year. With unparalleled humor, he recounts the disparity between people's perceptions of a doctor's glamorous life and the real thing: a succession of run down cars that are towed to the junk yard, long weekends moonlighting at rural hospitals, a family that grows larger every year, and a laughable income.Collins' good nature helps him over some of the rough spots but cannot spare him the harsh reality of a doctor's life. Every day he is confronted with decisions that will change people's lives-or end them-forever. A young boy's leg is mangled by a tractor: risk the boy's life to save his leg, or amputate immediately? A woman diagnosed with bone cancer injures her hip: go through a painful hip operation even though she has only months to live? Like a jolt to the system, he is faced with the reality of suffering and death as he struggles to reconcile his idealism and aspiration to heal with the recognition of his own limitations and imperfections.Unflinching and deeply engaging, Hot Lights, Cold Steel is a humane and passionate reminder that doctors are people too. This is a gripping memoir, at times devastating, others triumphant, but always compulsively readable.

The Real Doctor Will See You Shortly: A Physician's First Year


Matt McCarthy - 2015
    But when a new admission to the critical care unit almost died his first night on call, he found himself scrambling. Visions of mastery quickly gave way to hopes of simply surviving hospital life, where confidence was hard to come by and no amount of med school training could dispel the terror of facing actual patients.This funny, candid memoir of McCarthy’s intern year at a New York hospital provides a scorchingly frank look at how doctors are made, taking readers into patients’ rooms and doctors’ conferences to witness a physician's journey from ineptitude to competence. McCarthy's one stroke of luck paired him with a brilliant second-year adviser he called “Baio” (owing to his resemblance to the Charles in Charge star), who proved to be a remarkable teacher with a wicked sense of humor. McCarthy would learn even more from the people he cared for, including a man named Benny, who was living in the hospital for months at a time awaiting a heart transplant. But no teacher could help McCarthy when an accident put his own health at risk, and showed him all too painfully the thin line between doctor and patient.The Real Doctor Will See You Shortly offers a window on to hospital life that dispenses with sanctimony and self-seriousness while emphasizing the black-comic paradox of becoming a doctor: How do you learn to save lives in a job where there is no practice?

The House of God


Samuel Shem - 1978
    Six eager interns—they saw themselves as modern saviors-to-be.   They came from the top of their medical school class  to the bottom of the hospital staff to serve a  year in the time-honored tradition, racing to answer  the flash of on-duty call lights and nubile  nurses. But only the Fat Man—the Clam, all-knowing resident—could sustain them in their struggle to survive, to stay sane, to love and even to be doctors when their harrowing year was done.

Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients


Ben Goldacre - 2012
    We like to imagine that it’s based on evidence and the results of fair tests. In reality, those tests are often profoundly flawed. We like to imagine that doctors are familiar with the research literature surrounding a drug, when in reality much of the research is hidden from them by drug companies. We like to imagine that doctors are impartially educated, when in reality much of their education is funded by industry. We like to imagine that regulators let only effective drugs onto the market, when in reality they approve hopeless drugs, with data on side effects casually withheld from doctors and patients.All these problems have been protected from public scrutiny because they’re too complex to capture in a sound bite. But Dr. Ben Goldacre shows that the true scale of this murderous disaster fully reveals itself only when the details are untangled. He believes we should all be able to understand precisely how data manipulation works and how research misconduct on a global scale affects us. In his own words, “the tricks and distortions documented in these pages are beautiful, intricate, and fascinating in their details.” With Goldacre’s characteristic flair and a forensic attention to detail, Bad Pharma reveals a shockingly broken system and calls for something to be done. This is the pharmaceutical industry as it has never been seen before.

What Doctors Feel: How Emotions Affect the Practice of Medicine


Danielle Ofri - 2013
    But doctors’ emotional responses to the life-and-death dramas of everyday practice have a profound impact on medical care. And while much has been written about the minds and methods of the medical professionals who save our lives, precious little has been said about their emotions. In What Doctors Feel, Dr. Danielle Ofri has taken on the task of dissecting the hidden emotional responses of doctors, and how these directly influence patients.How do the stresses of medical life—from paperwork to grueling hours to lawsuits to facing death—affect the medical care that doctors can offer their patients? Digging deep into the lives of doctors, Ofri examines the daunting range of emotions—shame, anger, empathy, frustration, hope, pride, occasionally despair, and sometimes even love—that permeate the contemporary doctor-patient connection. Drawing on scientific studies, including some surprising research, Dr. Danielle Ofri offers up an unflinching look at the impact of emotions on health care.With her renowned eye for dramatic detail, Dr. Ofri takes us into the swirling heart of patient care, telling stories of caregivers caught up and occasionally torn down by the whirlwind life of doctoring. She admits to the humiliation of an error that nearly killed one of her patients and her forever fear of making another. She mourns when a beloved patient is denied a heart transplant. She tells the riveting stories of an intern traumatized when she is forced to let a newborn die in her arms, and of a doctor whose daily glass of wine to handle the frustrations of the ER escalates into a destructive addiction. But doctors don’t only feel fear, grief, and frustration. Ofri also reveals that doctors tell bad jokes about “toxic sock syndrome,” cope through gallows humor, find hope in impossible situations, and surrender to ecstatic happiness when they triumph over illness.  The stories here reveal the undeniable truth that emotions have a distinct effect on how doctors care for their patients. For both clinicians and patients, understanding what doctors feel can make all the difference in giving and getting the best medical care.

Final Exam: A Surgeon's Reflections on Mortality


Pauline W. Chen - 2006
    What she did not count on was how much death would be a part of her work. Almost immediately, Chen found herself wrestling with medicine’s most profound paradox, that a profession premised on caring for the ill also systematically depersonalizes dying. Final Exam follows Chen over the course of her education, training, and practice as she grapples at strikingly close range with the problem of mortality, and struggles to reconcile the lessons of her training with her innate knowledge of shared humanity, and to separate her ideas about healing from her fierce desire to cure.From her first dissection of a cadaver in gross anatomy to the moment she first puts a scalpel to a living person; from the first time she witnesses someone flatlining in the emergency room to the first time she pronounces a patient dead, Chen is struck by her own mortal fears: there was a dying friend she could not call; a young patient’s tortured death she could not forget; even the sense of shared kinship with a corpse she could not cast aside when asked to saw its pelvis in two. Gradually, as she confronts the ways in which her fears have incapacitated her, she begins to reject what she has been taught about suppressing her feelings for her patients, and she begins to carve out a new role for herself as a physician and as human being. Chen’s transfixing and beautiful rumination on how doctors negotiate the ineluctable fact of death becomes, in the end, a brilliant questioning of how we should live.Moving and provocative, motored equally by clinical expertise and extraordinary personal grace, this is a piercing and compassionate journey into the heart of a world that is hidden and yet touches all of our lives. A superb addition to the best medical literature of our time.

Bellevue: Three Centuries of Medicine and Mayhem at America's Most Storied Hospital


David M. Oshinsky - 2016
    From its origins in 1738 as an almshouse and pesthouse, Bellevue today is a revered public hospital bringing first-class care to anyone in need. With its diverse, ailing, and unprotesting patient population, the hospital was a natural laboratory for the nation's first clinical research. It treated tens of thousands of Civil War soldiers, launched the first civilian ambulance corps and the first nursing school for women, pioneered medical photography and psychiatric treatment, and spurred New York City to establish the country's first official Board of Health. As medical technology advanced, "voluntary" hospitals began to seek out patients willing to pay for their care. For charity cases, it was left to Bellevue to fill the void. The latter decades of the twentieth century brought rampant crime, drug addiction, and homelessness to the nation's struggling cities problems that called a public hospital's very survival into question. It took the AIDS crisis to cement Bellevue's enduring place as New York's ultimate safety net, the iconic hospital of last resort.

Overdiagnosed: Making People Sick in the Pursuit of Health


H. Gilbert Welch - 2011
    Gilbert WelchRead Overdiagnosed: Making People Sick in the Pursuit of Health PDF from Beacon Press,H. Gilbert WelchDownload H. Gilbert Welch's PDF E-book Overdiagnosed: Making People Sick in the Pursuit of Health