Every Patient Tells A Story

A riveting exploration of the most difficult and important part of what doctors do, by Yale School of Medicine physician Dr. Lisa Sanders, author of the monthly New York Times Magazine column "Diagnosis," the inspiration for the hit Fox TV series House, M.D. "The experience of being ill can be like waking up in a foreign country. Life, as you formerly knew it, is on hold while you travel through this other world as unknown as it is unexpected. When I see patients in the hospital or in my office who are suddenly, surprisingly ill, what they really want to know is, ‘What is wrong with me?’ They want a road map that will help them manage their new surroundings. The ability to give this unnerving and unfamiliar place a name, to know it—on some level—restores a measure of control, independent of whether or not that diagnosis comes attached to a cure. Because, even today, a diagnosis is frequently all a good doctor has to offer." A healthy young man suddenly loses his memory—making him unable to remember the events of each passing hour. Two patients diagnosed with Lyme disease improve after antibiotic treatment—only to have their symptoms mysteriously return. A young woman lies dying in the ICU—bleeding, jaundiced, incoherent—and none of her doctors know what is killing her. In Every Patient Tells a Story, Dr. Lisa Sanders takes us bedside to witness the process of solving these and other diagnostic dilemmas, providing a firsthand account of the expertise and intuition that lead a doctor to make the right diagnosis. Never in human history have doctors had the knowledge, the tools, and the skills that they have today to diagnose illness and disease. And yet mistakes are made, diagnoses missed, symptoms or tests misunderstood. In this high-tech world of modern medicine, Sanders shows us that knowledge, while essential, is not sufficient to unravel the complexities of illness. She presents an unflinching look inside the detective story that marks nearly every illness—the diagnosis—revealing the combination of uncertainty and intrigue that doctors face when confronting patients who are sick or dying. Through dramatic stories of patients with baffling symptoms, Sanders portrays the absolute necessity and surprising difficulties of getting the patient’s story, the challenges of the physical exam, the pitfalls of doctor-to-doctor communication, the vagaries of tests, and the near calamity of diagnostic errors. In Every Patient Tells a Story, Dr. Sanders chronicles the real-life drama of doctors solving these difficult medical mysteries that not only illustrate the art and science of diagnosis, but often save the patients’ lives.

A collection of more than fifty hard-to-crack medical quandaries, featuring the best of The New York Times Magazine's popular Diagnosis column—now a Netflix original series “Lisa Sanders is a paragon of the modern medical detective storyteller.”—Atul Gawande, author of Being Mortal As a Yale School of Medicine physician, the New York Times bestselling author of Every Patient Tells a Story, and an inspiration and adviser for the hit Fox TV drama House, M.D., Lisa Sanders has seen it all. And yet she is often confounded by the cases she describes in her column: unexpected collections of symptoms that she and other physicians struggle to diagnose. A twenty-eight-year-old man, vacationing in the Bahamas for his birthday, tries some barracuda for dinner. Hours later, he collapses on the dance floor with crippling stomach pains. A middle-aged woman returns to her doctor, after visiting two days earlier with a mild rash on the back of her hands. Now the rash has turned purple and has spread across her entire body in whiplike streaks. A young elephant trainer in a traveling circus, once head-butted by a rogue zebra, is suddenly beset with splitting headaches, as if someone were “slamming a door inside his head.” In each of these cases, the path to diagnosis—and treatment—is winding, sometimes frustratingly unclear. Dr. Sanders shows how making the right diagnosis requires expertise, painstaking procedure, and sometimes a little luck. Intricate, gripping, and full of twists and turns, Diagnosis puts readers in the doctor’s place. It lets them see what doctors see, feel the uncertainty they feel—and experience the thrill when the puzzle is finally solved.

"A first-person narrative that takes readers inside the medical profession as one doctor solves real-life medical mysteries"--Provided by publisher.

On average, a physician will interrupt a patient describing her symptoms within eighteen seconds. In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong—with catastrophic consequences. In this myth-shattering book, Jerome Groopman pinpoints the forces and thought processes behind the decisions doctors make. Groopman explores why doctors err and shows when and how they can—with our help—avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact our health. This book is the first to describe in detail the warning signs of erroneous medical thinking and reveal how new technologies may actually hinder accurate diagnoses. How Doctors Think offers direct, intelligent questions patients can ask their doctors to help them get back on track. Groopman draws on a wealth of research, extensive interviews with some of the country’s best doctors, and his own experiences as a doctor and as a patient. He has learned many of the lessons in this book the hard way, from his own mistakes and from errors his doctors made in treating his own debilitating medical problems. How Doctors Think reveals a profound new view of twenty-first-century medical practice, giving doctors and patients the vital information they need to make better judgments together.

ABC of Clinical Reasoning Being a good clinician is not only about knowledge — how doctors and other healthcare professionals think, reason, and make decisions is arguably their most critical skill. The second edition of the ABC of Clinical Reasoning breaks down clinical reasoning into its core components and explores each of these in more detail, including the applications for clinical practice, teaching, and learning. Informed by the latest evidence from cognitive psychology, education, and studies of expertise, this edition has been extensively re-written and updated, and covers: Key components of clinical reasoning: evidence-based history and examination, choosing and interpreting diagnostic tests, problem identification and management, and shared decision-making Key concepts in clinical reasoning, such dual process theories, and script theory Situativity and human factors Metacognition and cognitive strategies Teaching clinical reasoning From a team of expert authors, the ABC of Clinical Reasoning is essential reading for all students, clinical teachers, curriculum planners and clinicians involved in diagnosis. About the ABC series The ABC series has been designed to help you access information quickly and deliver the best patient care, and remains an essential reference tool for GPs, junior doctors, medical students and healthcare professionals. Now offering over 80 titles, this extensive series provides you with a quick and dependable reference on a range of topics in all the major specialties. The ABC series is the essential and dependable source of up-to-date information for all practitioners and students in primary healthcare. To receive automatic updates on books and journals in your specialty, join our email list. Sign up today at www.wiley.com/email

A healthy young man suddenly loses his memory, making him unable to remember the events of each passing hour. Two patients diagnosed with Lyme disease improve after antibiotic treatment only to have their symptoms mysteriously return. A young woman lies dying in intensive care bleeding, jaundiced, incoherent and none of her doctors know what is killing her. Dr Lisa Sanders, whose hugely popular New York Times column inspired the hit TV show House, M.D., takes us to patients bedsides to witness the process of solving these and other diagnostic dilemmas, providing a first-hand account of the expertise and intuition that lead doctors to make the right decisions. An endlessly fascinating medical detective story, Diagnosis opens up as never before the finer workings of the human body, and celebrates the dedicated physicians who we may all someday need to trust with our lives.

A look at the emotional side of medicine—the shame, fear, anger, anxiety, empathy, and even love that affect patient care Physicians are assumed to be objective, rational beings, easily able to detach as they guide patients and families through some of life’s most challenging moments. But doctors’ emotional responses to the life-and-death dramas of everyday practice have a profound impact on medical care. And while much has been written about the minds and methods of the medical professionals who save our lives, precious little has been said about their emotions. In What Doctors Feel, Dr. Danielle Ofri has taken on the task of dissecting the hidden emotional responses of doctors, and how these directly influence patients. How do the stresses of medical life—from paperwork to grueling hours to lawsuits to facing death—affect the medical care that doctors can offer their patients? Digging deep into the lives of doctors, Ofri examines the daunting range of emotions—shame, anger, empathy, frustration, hope, pride, occasionally despair, and sometimes even love—that permeate the contemporary doctor-patient connection. Drawing on scientific studies, including some surprising research, Dr. Danielle Ofri offers up an unflinching look at the impact of emotions on health care. With her renowned eye for dramatic detail, Dr. Ofri takes us into the swirling heart of patient care, telling stories of caregivers caught up and occasionally torn down by the whirlwind life of doctoring. She admits to the humiliation of an error that nearly killed one of her patients and her forever fear of making another. She mourns when a beloved patient is denied a heart transplant. She tells the riveting stories of an intern traumatized when she is forced to let a newborn die in her arms, and of a doctor whose daily glass of wine to handle the frustrations of the ER escalates into a destructive addiction. But doctors don’t only feel fear, grief, and frustration. Ofri also reveals that doctors tell bad jokes about “toxic sock syndrome,” cope through gallows humor, find hope in impossible situations, and surrender to ecstatic happiness when they triumph over illness. The stories here reveal the undeniable truth that emotions have a distinct effect on how doctors care for their patients. For both clinicians and patients, understanding what doctors feel can make all the difference in giving and getting the best medical care.

Liz Kalinowska and Daška Hatton invite you into the therapy room to experience a therapeutic encounter through the lens of Craniosacral Therapy, discussing ways that therapists and clients can work together to optimise the success of treatment. Describing a unique journey through ten bodywork sessions from the standpoints of a fictional client 'Anna', and her therapist, 'Sarah', the authors take you behind the scenes to witness the client's voyage of discovery, and how the encounter appears to her therapist during the course of treatment. The book shows how the perspectives of both participants develop and widen through their shared experiences and examines the ups and downs of the therapeutic relationship. Boundary, transference and trust issues are explored as Liz and Daška share their own experiences of more than 40 years in practice and examples from myth and legend help to place the work in a wider context.