Clinical Cluedo
1
In Context 242 www.thelancet.com/neurology Vol 9 March 2010 The fundamental rules of medicine—take a thorough history and, if unsure, always phone a friend—are well illustrated in this collection of unusual medical cases. The Deadly Dinner Party presents cases that all required a certain level of detective work and lateral thinking to reach the eventual diagnosis. Each scenario is unravelled in an almost forensic fashion to finally untangle why the patient became infected or afflicted with a particular illness in the first place. Jonathan A Edlow is a physician and an author. He is the vice chairman of emergency medicine at the Beth Israel Deaconess Medical Center, MA, USA, and also an associate professor of medicine at Harvard Medical School, MA, USA. He has collected these true stories over the years—some date back a decade or so—and he relates his interest in unusual cases back to his childhood, when he was a fan of Sherlock Holmes. Written as a series of short stories, but with a theme to each section, the book flows well and is easy to read; Edlow writes in a journalistic style, giving the sense of an unfolding mystery as each doctor and patient in turn recalls the events. I could imagine the physician sitting at a desk in his or her office, staring into the distance as they take the reader with them back to the time when they and their colleagues were literally working as detectives, trying to reach and then explain the diagnosis. The author refers to a wide range of literature to support each case, from 19th century editions of The Lancet, to the recent tales of Harry Potter, with an extensive source index at the back of the book. He also delves into a fair amount of medical history, from the evolution of thyroid surgery to early reports of Guillain-Barré syndrome. Take the case of “Little Luisa’s blinding headache”, the story of a 5-year-old girl who develops a headache associated with clumsiness and loss of vision. After a series of consultations and investigations, she is finally diagnosed with pseudotumour cerebri. The physicians have no idea why she has developed this disorder, and it is only after extensive questioning that we discover the culprit—her grandmother’s belief in the power of a daily dose of fish oils, leading to vitamin A toxicity. The Deadly Dinner Party is aimed at anyone who has an interest in medicine and epidemiology. As a doctor, I enjoyed trying to decode the mysteries myself as I read about the evolving symptoms and history, yet a lay person could easily understand the text. The author’s explanations of anatomy and physiology, from cranial nerves to the metabolism of vitamin D, are clearly depicted, without being patronising or dull to the clinical reader. I wholeheartedly recommend this book and hope that it inspires the hidden detective in all of us. Emma Hill [email protected] Books Clinical Cluedo The Deadly Dinner Party and Other Medical Detective Stories by Jonathan A Edlow Yale University Press, 2009. Pp 256. £20.00. ISBN 978-0-300-12558-0 Neurology going global International Neurology: A Clinical Approach offers a wide ranging and exhaustive view of neurological pathology around the world. This book deals with the diversity that now characterises the approaches to and management of neurological disorders in terms of geography, racial and ethnic groups, economic aspects, environmental matters, and pathological features. Wherever they practise, neurologists face the usual diseases found in their region, but they are also facing more and more aetiological patterns imported from abroad. This trend is occurring in all directions south, north, east, and west; a natural effect of globalisation. This book contains 22 sections and 173 chapters from 244 experienced authors from all continents. So- called classic subjects, such as neurovascular disorders, epilepsy, dementia, movement disorders, and peripheral neuropathies, benefit from a simple but pertinent approach. With useful introductions, epidemiological, pathophysiological, clinical, and therapeutic aspects are then covered in a synthetic and clear manner, making information easily accessible, even for non-neurologists. The text is enriched with additional components including illustrations, graphics, tables, algorithms, neuroradiological images, pictures of patients, and neuropathological images (macroscopy and microscopy). Each chapter ends with a brief but relevant bibliography of further reading. Many examples of the effect of geography, genetics, and the environment on neurological disorders and their management are given in several chapters. For example, the importance of neurogenetics is emphasised for disorders such as epilepsy, the dementias, Parkinson’s disease (with a practical treatment algorithm included as an appendix at the end of the book), myopathy, and encephalopathy. The clinicogeographical variations of vascular disorders in different regions of the world are described, as are those for multiple sclerosis, a disorder that is common in northern parts of the globe but is less often diagnosed in tropical regions. Different clinical International Neurology: A Clinical Approach Edited by Robert P Lisak, Daniel D Truong, William M Carroll, and Roongroj Bhidayasiri Wiley-Blackwell, 2009. Pp 728. £124.99. ISBN 978-1-4051-5738-4
Transcript of Clinical Cluedo
In Context
242 www.thelancet.com/neurology Vol 9 March 2010
The fundamental rules of medicine—take a thorough history and, if unsure, always phone a friend—are well illustrated in this collection of unusual medical cases. The Deadly Dinner Party presents cases that all required a certain level of detective work and lateral thinking to reach the eventual diagnosis. Each scenario is unravelled in an almost forensic fashion to fi nally untangle why the patient became infected or affl icted with a particular illness in the fi rst place.
Jonathan A Edlow is a physician and an author. He is the vice chairman of emergency medicine at the Beth Israel Deaconess Medical Center, MA, USA, and also an associate professor of medicine at Harvard Medical School, MA, USA. He has collected these true stories over the years—some date back a decade or so—and he relates his interest in unusual cases back to his childhood, when he was a fan of Sherlock Holmes.
Written as a series of short stories, but with a theme to each section, the book fl ows well and is easy to read; Edlow writes in a journalistic style, giving the sense of an unfolding mystery as each doctor and patient in turn recalls the events. I could imagine the physician sitting at a desk in his or her offi ce, staring into the distance as they take the reader with them back to the time when they and their colleagues were literally working as detectives, trying to reach and then explain the diagnosis. The author refers to a wide range of literature to support each case,
from 19th century editions of The Lancet, to the recent tales of Harry Potter, with an extensive source index at the back of the book. He also delves into a fair amount of medical history, from the evolution of thyroid surgery to early reports of Guillain-Barré syndrome.
Take the case of “Little Luisa’s blinding headache”, the story of a 5-year-old girl who develops a headache associated with clumsiness and loss of vision. After a series of consultations and investigations, she is fi nally diagnosed with pseudotumour cerebri. The physicians have no idea why she has developed this disorder, and it is only after extensive questioning that we discover the culprit—her grandmother’s belief in the power of a daily dose of fi sh oils, leading to vitamin A toxicity.
The Deadly Dinner Party is aimed at anyone who has an interest in medicine and epidemiology. As a doctor, I enjoyed trying to decode the mysteries myself as I read about the evolving symptoms and history, yet a lay person could easily understand the text. The author’s explanations of anatomy and physiology, from cranial nerves to the metabolism of vitamin D, are clearly depicted, without being patronising or dull to the clinical reader. I wholeheartedly recommend this book and hope that it inspires the hidden detective in all of us.
Emma [email protected]
BooksClinical Cluedo
The Deadly Dinner Party and Other Medical Detective Stories
by Jonathan A EdlowYale University Press, 2009.
Pp 256. £20.00.ISBN 978-0-300-12558-0
Neurology going globalInternational Neurology: A Clinical Approach off ers a wide ranging and exhaustive view of neurological pathology around the world. This book deals with the diversity that now characterises the approaches to and management of neurological disorders in terms of geography, racial and ethnic groups, economic aspects, environmental matters, and pathological features. Wherever they practise, neurologists face the usual diseases found in their region, but they are also facing more and more aetiological patterns imported from abroad. This trend is occurring in all directions south, north, east, and west; a natural eff ect of globalisation.
This book contains 22 sections and 173 chapters from 244 experienced authors from all continents. So-called classic subjects, such as neurovascular disorders, epilepsy, dementia, movement disorders, and peripheral neuropathies, benefi t from a simple but pertinent approach. With useful introductions, epidemiological, pathophysiological, clinical, and therapeutic aspects are
then covered in a synthetic and clear manner, making information easily accessible, even for non-neurologists.
The text is enriched with additional components including illustrations, graphics, tables, algorithms, neuroradiological images, pictures of patients, and neuropathological images (macroscopy and microscopy). Each chapter ends with a brief but relevant bibliography of further reading.
Many examples of the eff ect of geography, genetics, and the environment on neurological disorders and their management are given in several chapters. For example, the importance of neurogenetics is emphasised for disorders such as epilepsy, the dementias, Parkinson’s disease (with a practical treatment algorithm included as an appendix at the end of the book), myopathy, and encephalopathy. The clinicogeographical variations of vascular disorders in diff erent regions of the world are described, as are those for multiple sclerosis, a disorder that is common in northern parts of the globe but is less often diagnosed in tropical regions. Diff erent clinical
International Neurology: A Clinical Approach
Edited by Robert P Lisak, Daniel D Truong,
William M Carroll, and Roongroj Bhidayasiri
Wiley-Blackwell, 2009. Pp 728. £124.99.
ISBN 978-1-4051-5738-4
