Bull's Eye: Unraveling the Medical Mystery of Lyme Disease [Paperback]

Dr. Jonathan A. Edlow M.D. (Author)

Book Description

ISBN-10: 0300103700 | ISBN-13: 978-0300103700 | Publication Date: April 10, 2004 | Edition: 2

In this riveting account of medical sleuthing, Dr. Jonathan A. Edlow tells the history of the discovery of Lyme disease over centuries and continents. He also provides the latest information about the disease and its treatment, explaining the recent widespread outbreaks and examining the controversies that have swirled over the diagnosis, vaccine, treatment, and even definition of Lyme disease. In a new preface, Dr. Edlow updates recent developments and controversies in Lyme disease research, discusses reactions from the two "camps" of the Lyme disease community, and writes about some of the reactions of patients to the book. "A valuable guide for dealing with emerging diseases. . . . The best thing of all about Bull's-Eye is that it lays out the unknowns along with the knowns, the mainstream view along with alternative readings, and thus reveals science for what it is: a perpetual, and admirable, work in progress."-Andrew C. Revkin, New York Times Book Review "Bull's-eye is a compelling mystery and a riveting account of science in action."-Robert B. Parker "The story of an emerging infection and its history. . . . Beautifully written. . . . Anyone who is curious about Lyme disease or medical discovery in general will find this book interesting reading."-Raymond Dattwyler, New England Journal of Medicine

Editorial Reviews

From The New England Journal of Medicine

Jonathan Edlow's book, Bull's-Eye: Unraveling the Medical Mystery of Lyme Disease, was published at a particularly fitting time. This year marks the 20th anniversary of the discovery by Burgdorfer, Benach, and Barbour of the causative agent of Lyme disease, a spirochete we now know as Borrelia burgdorferi. That discovery pulled together many of the diverse scientific and historic aspects of Lyme disease and set the stage for further research into this spirochete and the diseases it causes. Edlow's book allows the reader to develop a better understanding of this complex illness. However, his book is not just about Lyme disease, and it is not a medical textbook; rather, it is the story of an emerging infection and its history. To quote the author, "This is a tale about scientific inquiry, as it exists in a cultural context." The title is somewhat misleading, however, because the book, which is beautifully written, is not just about the discovery of Lyme disease, its cause, and the controversies surrounding it. The book is also an exploration of how medical mysteries are solved and of how many observations and discoveries are connected and finally pieced together to yield solutions. The book is written in a clear, readable style that should appeal to both medical professionals and members of the general public. It offers insights into the way medical science actually works. Edlow discusses not only the parts played by Burgdorfer, Steere, Benach, Malawista, and others in the story of Lyme disease, but also the critical parts played by lesser-known persons. The story of Lyme disease would be very different without the work of European physicians in the 19th and early 20th centuries; two mothers from Lyme, Connecticut, Polly Murray and Judith Mensch; two Navy physicians, William Mast and William Burrows; and an officer from the Centers for Disease Control and Prevention, David Snydman, who worked with the Connecticut Department of Public Health. (See Figure.) It is important to mention that, especially in regard to its depiction of highly specialized physicians, this book is a cautionary tale. In chapter 9, "The Blind Men and the Elephant," the author contrasts the views of the Navy physicians, Mast and Burrows, with those of the Yale Rheumatology Group. The two Navy doctors were right: Lyme disease is a systemic infectious disease that responds to treatment with antibiotics, not a new form of arthritis that does not respond to antibiotics. Ultimately, the book clearly points out that modern medical discoveries are not the work of one person. Science and medicine are the work of many people, a series of small discoveries and observations and of connections that lead to new insights. Edlow details how patients, their family members, and scientists and physicians contributed to the knowledge of the illness we now call Lyme disease. The author also delves into the controversy surrounding Lyme disease. He describes the contrasting views and the failure of academic physicians to be open-minded. I believe that the one flaw in this book is that it does not clearly delineate the risks unconventional approaches pose to patients. Be that as it may, anyone who is curious about Lyme disease or medical discovery in general will find this book interesting reading. Raymond Dattwyler, M.D.
Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS. --This text refers to an out of print or unavailable edition of this title.

From Booklist

Mark Twain wrote that the difference between fact and fiction is that fiction has to make sense. Edlow, an author of medical detective stories and a Harvard professor of medicine, indulges the luxury facts allow while chronicling the evolution of Lyme disease, and with its blind alleys and plot twists, the story of this puzzling illness validates Twain's statement. Almost nothing about Lyme disease makes sense. From its "discovery" in a rural New England town in the mid-1970s--after it was believed that modern antibiotics had all but eradicated infectious disease--to the ongoing debate over its duration, prevention, treatment, and even diagnosis, it has remained a topic of considerable controversy. As the title, which refers to the concentric, red-ringed lesion resulting from the bite of an infected tick, suggests, this well-documented book is about a newly targeted infectious disease, and it is as important for the light it sheds on the nature of scientific inquiry within the contemporary social and political context as it is for its information about Lyme disease. Donna Chavez
Copyright © American Library Association. All rights reserved --This text refers to an out of print or unavailable edition of this title.

See all Editorial Reviews

Product Details

• Paperback: 308 pages
• Publisher: Yale University Press; 2 edition (April 10, 2004)
• Language: English
• ISBN-10: 0300103700
• ISBN-13: 978-0300103700
• Product Dimensions: 9 x 6.1 x 0.9 inches
• Shipping Weight: 12 ounces (View shipping rates and policies)
• Average Customer Review: 4.8 out of 5 stars  See all reviews (12 customer reviews)
• Amazon Best Sellers Rank: #527,543 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

13 of 13 people found the following review helpful:

5.0 out of 5 stars Cracking the Borrelia burgdorferi Case, April 4, 2004

By 

Robert I. Hedges - See all my reviews
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This review is from: Bull's-Eye: Unraveling the Medical Mystery of Lyme Disease (Hardcover)

In his book "Bull's Eye", Dr. Jonathan Edlow takes the reader through the medical detective work leading to the discovery of the spirochete Borrelia burgdorferi, the agent responsible for Lyme disease. It also deals with several other tick-borne illnesses such as Rocky Mountain spotted fever, Q fever, and babesiosis. Unlike most readers, I have a unique perspective on this work as a former suffer of Lyme disease due to a tick bite I got while hiking in the St. Croix River valley of Minnesota in 1998. Fortunately, my physician, a gifted diagnostician, promptly tested for Lyme disease, and after a treatment of antibiotics (and anti-inflammatory drugs for the migratory arthritic pain involved), I became Lyme free after a careful prescription and testing regimen. It is with that background that I read "Bull's Eye", and I heartily endorse it as the best historical treatment of Lyme disease I have yet seen. I also have the benefit of being a biologist by education, so I was already acquainted with most of the terminology involved. This book is excellent for Doctors and other medical professionals, and is totally suitable to the layman as well, although someone with limited background may end up re-reading sections and flipping to the Appendix and Glossary occasionally.

The book is really a medical detective story, and a gripping one at that. It begins with the symptoms of an unknown disease clustered around Lyme, Connecticut in the mid 1970s. Initially believed to be Juvenile Rheumatoid Arthritis (JRA), authorities began questioning that diagnosis after demographic patterns were not consistent with JRA, and the disease exhibited significant clustering (which JRA does not do.) Initially brought to the attention of authorities by two area mothers, Polly Murray and Judith Mensch, their initial concerns were rebuffed. Through their perseverance, ultimately several teams of doctors began investigating the illness, believed to be linked to an insect vector due to the geographic distribution of the illness and the seasonality of the illness. Navy Doctors William Mast and William Burrows were quick to realize the curative effect of antibiotics on the disease, though not all doctors agreed. Notably Dr. Allan Steere of the Yale rheumatology department believed that antibiotics were not indicated until four years worth of data were analyzed. Although in 20/20 hindsight this is an obvious gaffe, I am sympathetic to the conundrum faced by Dr. Steere, as obviously he didn't want to prescribe unnecessary antibiotics. Where I am not sympathetic to Dr. Steere is in his seemingly arrogant, quick dismissal of the Navy doctors and their corporate and medical knowledge, particularly in light of their ninety percent cure rate with antibiotic therapy. I am somewhat academically amused that Steere and the Yale 'experts' were generally incorrect in most of their initial assumptions. Although I am personally grateful for the work of all the researchers involved, including Dr. Steere, I was exceptionally impressed with Mast and Burrows in addition to noted tick expert Dr. Willy Burgdorfer (after whom the Lyme disease spirochete is named) and his efforts to find the agent responsible for the disease. Working with ticks is extremely difficult: they are small, hard, and contaminated with a gazillion things. Isolating the one agent being searched for, in this case an unknown spirochete, is extraordinarily difficult.

Dr. Edlow is an excellent writer and anyone with interest in the medical field would love this book. The doctor who treated my Lyme disease recently left practice. When he left I went to see him specifically to thank him for all his efforts on my behalf and to give him a copy of "Bull's Eye." It was the least I could do.

8 of 8 people found the following review helpful:

5.0 out of 5 stars Fair treatment of a real controversy, June 8, 2003

By A Customer

This review is from: Bull's-Eye: Unraveling the Medical Mystery of Lyme Disease (Hardcover)

When I received this book and saw "Yale University Press" emblazoned on the back, I thought, "Oh, no" another biased view of Lyme disease coming from the institution long associated with the conservative, repressive view (Edlow calls it "conventional") of Lyme disease. I must admit I was pleasantly surprised. This was a much better book than I expected and the Yale Lyme view is kept in perspective.

Edlow does a good job of presenting the politics of Lyme Disease, outlining the positions of the two camps he identifies as the "conventional" and "alternative" in a fairly unbiased fashion. (He even points out the irony of the terms. When it comes to Lyme disease, the conventional side advocates some pretty wacky theories without much scientific basis and the alternative side advocates sufficient antibiotics to control the disease.)

I was a little annoyed by Edlow's fawning over Allan Steere, the figurehead of the conventional camp. But read closely and you will see that Steere and his followers have been wrong in just about every one of their initial positions and Steere is given too much credit for his contributions to the science of Lyme Disease. Contrary to Edlow's apologies for him, Steere, arrogance personified, is slow to pick up on the obvious and is most often wrong. Abused patients and other scientists led the charge.

This is a minor quibble. There is excellent information on Lyme testing, the vaccination fiasco, and Lyme politics. There is much about the process of medical discovery. Edlow is quite fair and concludes with the real issue -- the conventional camp, holding institutional power, should not be censoring and abusing proponents of alternate viewpoints. If you have Lyme disease, think you might, or know someone who does, read Karen Forschner's book first. If you feel you need some balance, want more background, or are interested in medical sleuthing and politics, read Edlow's, too.

9 of 10 people found the following review helpful:

5.0 out of 5 stars A Fast-Paced Historical Mystery, August 2, 2003

By 

Charles T. Foskett (Arlington, MA United States) - See all my reviews
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This review is from: Bull's-Eye: Unraveling the Medical Mystery of Lyme Disease (Hardcover)

Its not often a layperson can be introduced to complex science and come away learning, understanding and appreciating technical issues while enjoying the process. Jonathan Edlow accomplishes all this and more. In addition to allowing the reader to quickly and easily learn and understand the subtleties of Lyme disease and a wide range of related medical topics, the author also introduces us to a broad cast of characters: Lyme disease victims, their families and protagonists; sophisticated academic researchers on several continents; medical sleuths with the single-mindedness of hounds on the hunt; and physician-healers struggling to make sense of the unknown and unknowable as they treat their suffering patients. Edlow makes them all real human beings and allows us to get into their minds and see the mystery of Lyme disease from each different viewpoint. Finally, Edlow assembles all this in a fast-paced mystery story decorated with historical examples and analogies that makes it clear to the reader that discovery and history are unfolding in each exciting chapter.

Bulls Eye is a great read. If Dr. Edlow can repeat this accomplishment in arenas other than medicine, he will be widely recognized as another John McPhee.