I'm a junkie for medical stories. You give me a good narrative description of a mysterious set of symptoms, and I'm hooked. If you share my obsession with patient histories and diagnostic case-studies, then I highly recommend Complications, by Atul Gawande (2003). It's easily the best medical book I've ever read. Gawande writes with the clarity of Chekhov (another writerly doctor) and the analytical rigor of Bertrand Russell. He simultaneously humanizes surgeons - they also make mistakes - while leaving you in awe of their talents. (What kind of person can hold a heart in their hands?) The book also left me determined to never get a central line inserted by a first year surgical resident.
That's all by way of introducing this factoid, which I picked up in Gawande's new book, Better.
U.S. homicide rates have dropped in recent years to levels unseen since the mid-1960's. Yet aggravated assaults, particularly with firearms, have more than tripled during that period. A key mitigating factor appears to be the trauma care provided: more people may be getting shot, but doctors are saving even more of them. Mortality from gun assaults has fallen from 16 percent in 1964 to 5 percent today.
I'd never even thought about the effect of medical care on homicide rates. I assumed that the drop in murders was largely due to 1) better policing, especially as embodied by the broken windows theory and 2) the legalization of abortion. But perhaps, as Gawande points out, more gunshot victims are simply surviving their gunshot wounds. I know that homicides aren't the only crime statistic that has declined, but their national decline has been particularly steep, at least until last year.
I won't say Better is better than Complications, but it's still pretty great. If you love doctor stories, and are interested in how to improve the performance of the medical field, then I highly recommend Gawande's latest. What are your favorite medical books?
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My reading goes back a good while, so these tend to be older works, but they stand up to time.
Anything by Berton Roueche -- dating back to the 1950s, most of his writings were first published in the New Yorker, which says a lot about his writing ability and style to start with. Most are epidemiological mysteries. There have been several compilations published over the years, with at least one relatively recently.
http://www.amazon.com/Medical-Detectives-Plume-Berton-Roueche/dp/045226…
Also, if you can find a copy of Milton Helpern's memoirs, Autopsy, from 1977, that's a great read too. He was NYC's chief medical examiner for years and was also involved as a consultant in many major criminal and forensic cases nationwide.
Spot-on with Gawande. Complications is great and I am looking forward to reading Better. They're not exactly medical case stories (more research, less first-person story-telling), but both Powerful Medicines by Jeffrey Avorn and PostMortem by Stefan Timmerman are wonderfully written books that traverse similar thought-provoking ground.
Not As a Stranger by Morton Thompson
This is an interesting post especially because its one that will strike up an insteresting conversation with in a group of professionals.