Summary:

In this collection of "clinical tales," to use Oliver Sacks' term, Sue Hall, an experienced neonatologist who spent some years as a social worker before medical school, tells a remarkable range of stories about newborns in the NICU and their parents.  As memoir, the stories record moments in a life full of other people's traumas, disappointments, anxieties, and hard-won triumphs where her job has been to hold steady, find a balance point between professionalism and empathy as young parents go through one of the hardest kinds of loss.  Each story is told with clarity and grace, sketching the characters deftly and offering useful medical information along the way on the assumption that many who read the book will do so because they are facing similar challenges and decisions.  Each story is followed by a two- to three-page "Note" giving more precise medical background and offering further resources for those who have particular interest in the kind of case it was. 

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This book is exactly what it claims to be in the title. Dr. Ofri gives us fifteen clinical tales, each of which describes a lesson she has learned from a patient or from her own experience as a patient. It is an extension of her first book, Singular Intimacies: On Becoming a Doctor at Bellevue (see this database) and relates to her experiences after she completes residency training at Bellevue Hospital in New York City, to which she eventually returns as a staff physician. Three of the stories are examples of how a physician experiences the patient role, including one in which she relates an early personal experience to that of a patient she cares for ("Common Ground").

Since Ofri served as several locum-tenens, some of the stories take her to rural communities and small towns but most concern experiences with patients at Bellevue in clinics or in the hospital. She also discusses the challenges and limitations of teaching the next generation of doctors at Bellevue ("Terminal Thoughts").

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In this study of a small group of children followed by an HIV clinic at an unidentified institution, the author describes in detail her experience with the children, their caregivers--sometimes biological family members, sometimes foster providers--and the medical staff responsible for the management of their viral infection. The writer, a humanities professor at a medical school, acknowledges the privilege she felt at having been in a position to develop a close personal contact over several years with the people about whom she writes.

The frame of the study is case-oriented. Each child is described and the medical and social histories of a total of nine are outlined and then fleshed out with personal interviews and home visits made by the writer. In addition to the histories, Hawkins includes a glossary of contemporary medical terms and common acronyms relevant to HIV, a bibliography, and a list of resources for those interested in looking further into this infection as it presents in children.

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This is a collection of two dozen case studies, written for non-medical readers, of patients with right-brain disorders. The chapters are divided into four groups: "Losses," dealing with loss of memory, cognition, and proprioceptive sense; "Excesses," with tics and other cases of overabundance; "Transports," with seizures and various "dreamy states," and "The World of the Simple," concerning mental retardation. In every case, Sacks focuses on the interior or existential world of the patient as the foundation of diagnosis and treatment. Sacks argues that this approach is appropriate for the right hemisphere, which compared to the left is less dedicated to specific skills and more dedicated to a "neurology of identity."

Sacks openly proposes these studies as a corrective to the field of neurology, which has tended to focus on the left hemisphere and therefore, he argues, has wound up treating patients solely in terms of specific deficits, often to their detriment. In "the higher reaches of neurology," and in psychology, Sacks argues, disease and identity must be studied together, and thus he recommends that neurologists "restore the human subject at the centre" of the case study. Sacks warmly recommends music, story-telling, and prayer as therapies that work by ignoring physiological defects and speaking to the patient's spirit or soul.

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This book contains six medical case studies in which hope, or lack of it, played a role in the outcome. Five stories are of Groopman's cancer patients, the sixth the story of his own recovery from severe chronic lower back pain. The book concludes with an account of Groopman's search for scientific answers to the questions that inspired the book: How is the cognitive-emotional complex of hope formed in the mind? How might that complex affect the chemistry of the brain? And how might that, in turn, affect the physiology of the body in a way that would be relevant to healing?

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Crossing Over presents "extended, richly detailed, multiperspectival case narratives" of 20 dying patients served by the Hospice of Lancaster County in Pennsylvania and the Palliative Care Service of Royal Victoria Hospital in Montreal. These complex narratives (each written by a single author) reveal the patient’s story from many points of view, including those of family members and professional caregivers.

The authors explain how this project differs from recent books of clinical narratives by Timothy Quill (A Midwife Through the Dying Process, 1996), Ira Byock (Dying Well: The Prospect of Growth at the End of Life, 1997), and Michael Kearney (Mortally Wounded. Stories of Soul Pain, Death and Healing, 1996 [see entry in this database]). Barnard et al. point out that Quill, Byock, and Kearney are "passionate advocates for their own styles of care . . . Yet these very characteristics--advocacy and close personal involvement--limit their books in important respects." (p. 5) Basically, these authors select cases that illustrate the efficacy of their models and present the patients’ stories from their own point of view.

Crossing Over draws on a standard qualitative methodology that includes tape-recorded interviews of patients, families, and health care professionals; chart reviews; and participant observation. After the introduction, the narratives occupy 374 pages of text (almost 19 pages per patient). Part II of the book, entitled "Working with the Narratives," includes a short chapter on research methods and 29 pages of "Authors’ Comments and Questions for Discussion." The latter is designed to be used as a teaching guide.

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Second Opinions, Jerome Groopman's second collection of clinical stories, illuminates the mysteries, fears, and uncertainties that serious illness evokes in both patients and doctors. The book is divided into 8 chapters, each a clinical story involving a patient with a life-threatening illness, plus a prologue and epilogue written by Groopman. The stories focus on people who face myelofibrosis, acute leukemia, hairy cell leukemia, breast cancer, and marrow failure of unknown cause. Two chapters are Groopman's personal accounts of his firstborn son's near fatal misdiagnosis, and of his grandfather's Alzheimer's dementia.

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This posthumously published collection of essays by Dr. Klawans, an eminent neurologist and writer, explores the interactions between patient, family and neurologist and the implications of specific neurologic diseases. Klawans's special interest in neurology is movement disorders, such as Huntington's chorea and Parkinson's disease, but his outside interests range from evolutionary biology to classical music. His essays, therefore, focus on single patients or families, but the author weaves thoughts about his other interests into each "case."

The book is divided into two sections, "The Ascent of Cognitive Function" and "The Brain's Soft Spots: Programmed Cell Death, Prions, and Pain." In a brief preface, Klawans declares that this book is "more than just a set of clinical tales about interesting and at times downright peculiar patients" from his 35 years of practice, but rather it "humbly grapples with the 'whys' of our brain, not the 'hows.'" (pp. 9-10) In the preface, as well as in one essay, Klawans acknowledges the work and impact of fellow neurologist-writer Oliver Sacks ("Oliver is truly the father of us all." p 12).

The title essay concerns a six-year-old girl who was found, locked and completely speech-deprived, in a closet. Because she is still within the window of opportunity for language acquisition, "Lacey" quickly learns to speak, unlike Victor, the Wild Boy of Aveyron, whose story was immortalized in the François Truffaut film, L'enfant Sauvage. Klawans uses these stories as a launch pad to discuss the evolution of language, including a proposal that the cavewoman, not the man, was responsible for development of the human species as she taught her offspring language.

Other chapters focus on patients with epilepsy, Parkinson's disease, localized and hemispheric stroke, "painful-foot-and-toe syndrome, " and Creutzfeldt-Jakob disease. Two particularly memorable chapters concern Huntington's chorea and Refsum's disease. The chapter, "Anticipation," explores the profound ethical concerns of genetic testing for Huntington's chorea as applied to three generations of one particular family. In the chapter, "The Hermit of Thief River Falls," Klawans recollects his first year as a neurology resident, and his care of a reclusive patient with a rare eponymous illness, Refsum's disease--just in time for a visit by Refsum himself, a famous Norwegian neurologist.

The book concludes with a speculative "afterthought" about genetics, evolution, and the importance of extended "juvenilization" --the protracted post-natal development of Homo sapiens. This essay intertwines some of the threads regarding speech development and evolutionary biology, particularly brain development, that were introduced earlier in the text.

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This book, which is subtitled "Seven Paradoxical Tales," contains seven of Oliver Sacks' clinical stories of persons whose unusual neurological deficits teach us something about the way the brain (and, therefore, the mind) works. In "The Case of the Colorblind Painter" an artist learns to adapt to a completely black-and-white world after sustaining trauma to his occipital lobe.

"The Last Hippie" portrays a man whose ability to form new memories was destroyed by a massive midline brain tumor; he still "lives" in the 1960's. "A Surgeon's Life" depicts a Canadian surgeon with Gilles de la Tourette Syndrome, showing how he is able to live as a respected member of the community and practice surgery despite this disabling condition. "To See and Not See" tells the tale of a man in his 50's who is suddenly able to see after being blind since early childhood.

In "The Landscape of His Dreams" Sacks introduces a painter who, after a serious illness in the 1960's, apparently developed extraordinary and persistent "waking visions" of Pontito, his hometown in Italy. For many years he has obsessively painted remarkably accurate scenes of Pontito. "Prodogies" and "An Anthropologist on Mars" both deal with autism. The first tells of an autistic boy from England who has remarkable skill in visual memory and drawing; the second is about an autistic woman with a Ph.D. in animal science, who teaches at Colorado State University.

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In Book I Oliver Sacks describes his visit to Pingelap and Pohnpei in the Caroline Islands (now a part of the Federated States of Micronesia). On Pingelap (population 700) 5-10% of the people are completely colorblind; i.e. they have a rare hereditary condition called achromatopsia in which the retina has no functional cone cells. Rod cells, which normally provide peripheral and night vision, are their only source of vision. While partial colorblindness is common, achromatopsia is normally very rare. Sacks and Knut Nordby, a Norwegian scientist who is himself achromatopic, examined dozens of achromatopes on Pingelap and in a village of Pingelapese people on the larger Pohnpei.

In Book II Sacks takes the reader to Guam where he investigates (with his friend John Steele, a neurologist who lives on the island) the neurological disease called "lytico-bodig." The "lytico" form of this disease is a progressive paralysis similar to amyotropic lateral sclerosis, while the "bodig" form resembles parkinsonism. Both appeared in Guam after the Second World Way and now seem to be dying out. However, no one has ever determined their cause.

Sacks tells the story of his visit, while also discussing various hypotheses that have been considered and discarded over forty years of study. The last section of the book describes a trip to Rota, a small island north of Guam, where Sacks visits a forest of cycad trees and discusses his life-long fascination with these primitive plants.

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