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Every Patient Tells a Story Hardcover – August 11, 2009

4.5 out of 5 stars 150 customer reviews

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Editorial Reviews

From Publishers Weekly

In her first book, internist and New York Times columnist Sanders discusses how doctors deal with diagnostic dilemmas. Unlike Berton Roueché in his books of medical puzzles, Sanders not only collects difficult cases, she reflects on what each means for both patient and struggling physician. A man arrives at the hospital, delirious, his kidneys failing. Batteries of tests are unrevealing, but he quickly recovers after a resident extracts two quarts of urine. An abdominal exam would have detected the patient's obstructed, grossly swollen bladder. The author then ponders the neglect of the physical exam, by today's physicians, enamored with high-tech tests that sometimes reveal less than a simple exam. Another patient, frustrated at her doctor's failure to diagnose her fever and rash, googles her symptoms and finds the correct answer. Sanders uses this case to explain how computers can help in diagnoses (Google is not bad, she says, but better programs exist). Readers who enjoy dramatic stories of doctors fighting disease will get their fill, and they will also encounter thoughtful essays on how doctors think and go about their work, and how they might do it better. (Apr. 14)
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From Booklist

New York Times columnist Sanders says that misdiagnoses account for perhaps as much as 17 percent of medical errors. Some errors result in prolonged or ineffective treatment, while others lead to fatal outcomes. They occur, she says, despite the huge technological advances of recent years. Sometimes the tests and diagnostic tools are to blame; indeed, relying too heavily on test or lab results can produce a false sense of security in both patient and doctor. For all the data they collect, machines lack important components for diagnosis. They cannot hear a patient’s story, touch a patient’s skin, or look into a patient’s eyes. Good diagnosticians are—not unlike TV’s Dr. House—good at puzzles; they employ a large variety of skill sets, including the long-lost art of the thorough physical exam, to solve the mysteries of illness. Besides her own inborn capacity for problem-solving, Sanders’ experience as internist, writer, and consultant to House serves her well here, for absorbing anecdotes generously pepper the exposition. --Donna Chavez

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Product Details

  • Hardcover: 304 pages
  • Publisher: Harmony; 1 edition (August 11, 2009)
  • Language: English
  • ISBN-10: 0767922468
  • ISBN-13: 978-0767922463
  • Product Dimensions: 6.5 x 1.2 x 9.5 inches
  • Shipping Weight: 1.2 pounds
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (150 customer reviews)
  • Amazon Best Sellers Rank: #607,842 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

Format: Hardcover
Every patient would love a look inside her physician's head to glimpse that meticulous moment-to-moment process that yields a great--even life-saving--diagnosis. That's exactly what EVERY PATIENT TELLS A STORY does. Bless Dr. Sanders for having the heart, wisdom and eloquence to lay open the M.D. brain for all of us nervous lay people who, at those moments of health crisis, can only pray we've picked a good doc.
It turns out that the things we patients secretly crave from our doctors--eye contact, focused conversation, LISTENING, the reassuring touch of the physician's educated hands on our painful abdomens or dislocated shoulders--are also the most vital tools of a truly great diagnostician. Of course we're grateful for medical technology, but as Dr. Sanders so brilliantly argues, these technical advancements work best when physicians' own powers of observation--and yes, intuition--are also fully engaged.
The last chapter is a dramatic departure from the rest of the book. Here Dr. Sanders tells us a very personal diagnosis story, one involving the untimely death of her younger sister. The gift of such an intimate conclusion reminds the reader of the humane impulse that so clearly motivated its author on every preceding page.
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Format: Hardcover Vine Customer Review of Free Product ( What's this? )
From the blurbs on the book I expected this to be for Internal Medicine what the series of books by the late Dr. Harold Klawans was for Neurology, a set of stories about clinical puzzles and their resolution. The publisher sells this book short, because while these vignettes are present (albeit in briefer form than in Klawans books), there is so much more! This book is really a grand tour of the role of the physical exam in medicine, through all its stages. You'll learn how doctors are taught the process, its declining role in current practice as hi-tech tests replace doctors looking, listening, and touching. You'll find out why tests can't completely replace a skilled doctor conducting a careful exam, the pressures on doctors to skimp or omit the exam, even the role technology can play in helping doctors evaluate alternative approaches. All accompanied by illustrative stories to pique your interest.

This book may be a disappointment to those led by the title and blurbs on the covers to expect a book just about diagnostic stories, something akin to a compendium of the monthly "Vital Signs" column in Discover magazine. For those concerned about health care issues, though, it provides a thorough background into an area of medicine and insight into the debate over the growing use of expensive tests. The worrisome aspect of this book comes because once you understand the importance of a careful exam, you realize that not only is it being abandoned wholesale by the profession even when it should be retained, you have no way to know whether your doctor is any good at it.

One positive sign related in this book is the renewed interest among medical faculty of the importance of careful physical exams. Doctors must now show proficiency in order to be licensed.
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Format: Hardcover Vine Customer Review of Free Product ( What's this? )
There are books where, from the first page, you just know you are going to like it. This is one of them. As a huge fan of the tv show House, I was excited to read a book by the author, who is a technical advisor to the show. She provides a mix of stories of the type portrayed in the show.. medical mysteries. But, unlike the fictional version, she discusses the science behind the diagnoses, and what goes wrong. So this book is in part a book about medical diagnosis, discussing various techniques that are used, and in part it is very much a critique of medical diagnosis, describing the loss of valuable tools with the current deemphasis on hands on examinations. She includes stories of triumphs, but more importantly, shows how many diagnoses went wrong, and suggests improvements.

Thus, this book is both about medical diagnoses, but it also raises important questions about medical practices that are of interest generally, but i believe would be of interest to and resonate with doctors as well.

The book is very well written. It is clear, concise, and personal.

It also gives a nice depth for how I will look at House when the new season begins. (Perhaps with more medicine and less drama, I hope).

My biggest complaint about the book? Sequel isn't ready yet. Finished it in a day, and would like to read more.

Altogether, a great read. Get it.
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Format: Hardcover Vine Customer Review of Free Product ( What's this? )
I wish I had liked this book more. I wanted to like the book more. The author writes in an engaging and accessible voice about the practice of medicine. I generally enjoy books along these lines, especially the well-written ones, which this is. The premise of this particular book is appealing: the stories of how doctors diagnose difficult cases.

The subtitle promises that the book is full of medical mysteries, and indeed, the stories in the book about people with strange collections of symptoms whose illnesses proved very hard to figure out are as compelling as I expected.

The problem is that these stories are not quite what the book is about. It's as if the author started to write a book about medical mysteries and then got sidetracked. The digressions are about interesting and important issues (why the physical exam is something of a lost art and what this might mean for the practice of medicine, for example). However, they don't fit into the book as it's designed and as it presents itself. It's as if you went to see what you expected to be a romantic comedy film and found yourself faced with something that started out sort of like "When Harry Met Sally", where the middle portion of the movie was more like "Midnight Express", with a few scenes pulled from "The Sound of Music", and then the ending of Harry and Sally, followed by a fragment from a lecture on Plato.

It's not that all the parts aren't worthy themselves. It's that they by no means make a coherent narrative. Worse, imagine that the director, writer, and actors in the mish-mosh movie insisted that it was simply a romantic comedy. That the detective stories are the best parts of the book makes it worse, in some ways.
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