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.


Writing for a wide audience in non-technical language, Groopman offers these stories to enlarge for readers the lived experience of patienthood and doctoring. The angle of vision he provides comes from conflicting diagnoses and human error, the bureaucracies of clinical trials and managed care, chance, faith, an unyielding attention to detail, and invariably, hope. Groopman chooses these particular stories as the "critical moments that have forever shaped my thinking and practice--not only for my patients but for my family and myself."

They include, he writes in the prologue, cases "when my opinions and actions proved right and when I seriously erred." Groopman clearly inserts himself as a major character in each of these stories, sharing his patients' crises with the firm belief that every doctor needs "deep knowledge of his patient and his disease and ready access to first-rate technology."

While this pledge is obviously something most people would desire in their own physicians, Groopman inhabits an astonishingly elite world, one he openly acknowledges: "I did occupy a privileged position in the world of modern American medicine . . . If I saw one person or ten in the clinic, it made no difference. If I wanted to spend an hour rather than fifteen minutes to examine and talk with a patient, I could. No one imposed 'cost effective' clinical algorithms to stay my hand from pursuing a more intensive evaluation." (p. 81)

In addition, most of the patients in the book were well-educated, assertive, and often economically privileged; if they weren't, they had Groopman working on their behalf. Thus, while the book is a well-written account of 8 unique patients and their determined doctor, it represents one small segment of a much larger health care conversation.


Dr. Groopman is the Recanati Professor of Medicine at Harvard Medical School.



Place Published

New York



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