When I first picked up Every Patient Tells a Story in the library, I expected a rather one-dimensional anthology of medical cases told from the patient’s perspective. The book certainly offered medical cases, but was also an incredibly balanced and engaging read that left me wanting more. Published in 2009, this book was written by Dr. Lisa Sanders, MD, author of “Diagnosis,” a popular weekly column in the New York Times that inspired the hit TV show House MD.
I knew I was in for a treat when the book jumped right into things with the story of a patient suffering from severe nausea only relieved by hot showers. The rest of the book, for the most part, presented case after case of medical mysteries ranging from the mundane to the very bizarre. These exciting stories, at times told from the patient’s perspective, at other times recounted from the physician’s, read like my childhood-favourite Encyclopedia Brown. To elaborate, the author teasingly presents clue after clue, subtly offering the reader a chance to figure out the diagnosis for him/herself, before revealing the answer a few short pages later (for those wondering what causes this unusual nausea, by the way, the final diagnosis was marijuana overdose).
While one might think a book that inspired House MD would be full of rare diseases, the cases themselves were not esoteric in the slightest. I knew most of the diagnoses and was able to follow the stories without much effort, even as a first year medical student. In fact, the author also went the extra mile to explain medical jargon in lay terms. One explanation that comes to mind is a comparison of the thyroid gland to a carburetor, controlling how fast the body’s “engine” runs. Therefore, I would feel comfortable giving this book to anybody to read, knowing that very little would go over their heads.
It is hard to believe that this collection of cases is actually a tool used to illustrate the author’s main concept: how diagnostic error occurs. The book carefully breaks down the diagnostic process and illustrates how deficiencies at each stage can lead to physician error. Structured as an elegant balance between informative narrative and illustrative stories, the book taught me about traps to be cognizant of as I continue my journey through medicine. Furthermore, the author didn’t stop at identifying problems, but also presented thoughtful solutions to faults in diagnostic thinking and practices.
No analysis of present issues is complete without a look to the past, and that is the final piece of the book. Informative but not overwhelming, Dr. Sanders walks the reader through the evolution of diagnostics from subjectivity to objectivity, focusing on key breakthroughs such as the invention of the stethoscope, to bring the current state of affairs into context. She finishes off by discussing physician interaction with the digital age, and briefly explores the future of diagnostics.
Extraordinarily well written and balanced, Every Patient Tells A Story was a very pleasant surprise for me. The language is easily understandable without being condescending, informative but not didactic. As a medical student learning about the physical exam, this book could not have come at a better time to reinforce the importance of what I have been learning. I would recommend this book to anybody with an interest in medicine: the lay person curious about how doctors think; the medical student just entering the world of medicine; even residents and physicians looking to practice medical thinking. All have something to take away from this book. Happy reading!