Diagnosis: Solving the Most Baffling Medical Mysteries

Great read. Highly recommend. Read it through audible

Dr. Sanders gives readers 53 brief medical stories involving rare medical conditions, and efforts to make an accurate diagnosis. Each story is only a few pages long, but provides a good summary. I suspect that readers who are not medical professionals will be amazed at the difficulties various doctors had solving each medical "mystery". I gave this book 4 instead of 5 stars because I wanted to see more overall analysis from the author about the problems with doctors' decision-making processes when trying to make a diagnosis.

I’ve been a fan of Dr Sanders’ Diagnosis columns in the New York Times where she tackles medical mysteries and seeks out the wisdom of the crowd (AKA crowd-sourcing). There is a similar column in the Washington Post called “Medical Mysteries” which similarly discusses those cases that doctors call zebras (from the dictum that if you hear hoof beats behind you think a horse and not the more unusual zebra) and on occasion, also does a crowd-source. But back to Dr Sanders book. Besides the writing, what I most enjoyed about the book that each patient’s story was short and to the point, not a lot of meaningless fluff. And the book also made a nice companion to the (late 2019) series on Netflix series “Diagnosis.” I enjoyed this book just as much as I enjoyed her previous book (not reviewed since it was a hardcover and I read it long ago — probably worth a re-read), Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis. She was a medical consultant for the late great TV show House and, as I recall, when I read that book, I was rather reminded of House as I was reading the book. The bottom line is, if you love medical mysteries as I do, especially zebras and other exotic disease presentations, then this is definitely the book for you. I gave it five enthusiastic stars and really can’t wait to re-read it.

The author, herself a physician, presents cases with unusually diagnoses, in language lay person like myself can understand. She discusses the patients' symptoms and the effects they have, detrimentally, on the patients. The reader of her book is absorbed with the patients as people and and with their medical and lifestyle problems. There is the story of a patient with symptoms doctors can't explain. Many diseases are ruled out, even Lyme's disease. But it turns out patient does indeed have a tick-borne disease, one that is not susceptible to the medication that treats Lyme's disease, which medication she had been put on. In fact, the patient had Rocky Mountain Spotted Fever, from a different species of tick. Another patient with a myriad of symptoms that baffled doctors for a while turned out to have Schnitzler syndrome, wherein macrophages go wild and tell the body to act like it's infected. An expensive drug was available to treat it, but the patient's insurance company wouldn't pay for it. The doctor appealed to the drug manufacturer, which thereupon provided the drug to the patient for free. The patient then became symptom free. Another patient wound up having Lemierre's syndrome. It's a rare infection that was very fatal before antibiotics. Even now, with antibiotics, it's 18 percent fatal. It's caused by a strep throat going awry. It took month, but this patient recovered completely. There's a message from this case : take strep throat seriously. There can be serious side effects from prescribed medications. One patient was on allopurinol for gout. She developed an allergic reaction that affected the kidneys. She was on dialysis for weeks. The gout medication was stopped. The patient then rapidly improved. Another patient turned out to have a disease from flying squirrels. It was endemic typhus, a rare bacterial disease. Once diagnosed and treated, the patient recovered. A patient with mystifying symptoms was determined to have hereditary angioedema, a genetic anomaly . She was treated with steroids to prevent the swelling caused by the disease. Another patient developed symptoms that included tingling, numbness and an irregular heart beat. Turns out the patient had cinguatera poisoning from a barracuda fish he ate. The toxin therefrom came from organisms that grow on reef algae in some tropical waters. Cooking doesn't destroy the toxin. The symptoms can persist for months, even years. I only eat fish from cold water, fish such as cod,haddock, flounder, sole. In another case, s young woman with a medical problem that defied diagnosis, died. Her organs were donated. The recipient of her liver died within days of receiving the liver transplant. Turns out the dead donor had a rare genetic defect and was missing an enzyme that breaks down proteins and thereby allows ammonia to build up with fatal conclusions. A patient presented with pain,fever, and inflammation. She had familial Mediterranean fever, which caused malformed proteins. White blood cells overreacted. The patient was put on the medication colchicine,which prevents most attacks. The patient takes this medication regularly. I assume for life. Another baffling set of symptoms in another patient turned out to be Whipple's disease, caused by a bacterium. The patient was on antibiotics for more than a year. The patient was able to stop using a wheelchair, then able to put aside a walker, and even be able to walk without a cane -- but not far. And so it goes, one medical mystery after another in this compendium of interesting and challenging medical cases. I was enthrall despite my lack of a medical background. I love good detective stories, including medical ones. I recommend this book.

During the time I was reading this book, I was hospitalized and had an opportunity to talk to others about the book and various chapters. It was very interesting and I also enjoyed the Netflix series.

Written by a practicing physician, this book is filled with short chapters (4-5 pages, generally) that originally appeared as columns in The New York Times Magazine. These cover the roughly 5% of diagnoses that are difficult for doctors to make, simply because they are rare or have unusual presentations. For a person with no understanding of medical terminology, this book would be quite interesting because the author defines terms clearly. If the reader does have some knowledge of medical terminology, the explanations become redundant. Would not recommend for people in the medical field. The book would be enjoyed by people who enjoy medical shows on TV.

I thoroughly enjoyed this book and didn't want it to end. It contained two-three page accounts of symptoms and diagnoses of uncommon ailments. It was presented in an unfolding manner which led your thinking logically so you could try to participate in the diagnoses. Many of these cases stumped the first doctors on a case and required referrals, and in some cases a serendipitous previous experience of a doctor solved the puzzle. Its format resembles that of 'Minute Mysteries' that were popular years ago.

Livro excelente!

If you like medical mysteries this is for you. The style of the writing carries you along and I had cut short one afternoon so that I could get back to carry on reading. I only wish it was much, much longer. I read it on Kindle so I can't estimate how many pages it had. All the medical mysteries were explained as the medics got to grips with the various tests, without being overly complicated for the lay person. I will have to seek out any other titles from this author.

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Me gustó

The content of the book was fascinating and explored a wide array of uncommon diagnoses. The book was well written and researched. The cases were quite short with some detail which is great for the average reader however I would have liked a little more detail on the mechanism of each illness. All in all this was a fantastic read.