SECOND OPINIONS

A collection of eight case studies revolving around questions of diagnosis and treatment, by Harvard physician and New Yorker writer Groopman (The Measure of Our Days, 1997).

Most doctors, if they write at all, write mainly about disease and cannot resist certain subjects. Groopman covers them all in eight chapters and a prologue, and they are cracking good stories. In the traditional when-I-got-sick essay, a patient’s insistence that physicians cure his slipped disk converts it to a permanent disability. A second story in this genre describes the nightmarish odyssey of Groopman, his wife, and their sick son as they search for a competent doctor over the course of a holiday weekend. The author encounters many tragedies along with a few triumphs. A woman dies of leukemia (misdiagnosed by her HMO) and, after failing to save her life, Groopman must defend himself against a frustrating malpractice suit. He discovers a rare but curable blood disease in a friend's father; unfortunately, local physicians have diagnosed it as a common, incurable condition. They resent his interference, and the patient declines to question their judgment. A young woman asks to be tested for the breast-cancer gene and discovers she has it. Can she prevent the inevitable by having her breasts removed? Groopman discusses the pros and cons, but the woman springs a surprise. Inevitably, literary doctors write of a personal encounter with aging: Groopman's grandfather descends into Alzheimer's, a sad tale of a beloved man growing repulsive and burdensome. Wisely, Groopman rarely addresses larger issues: he expresses admiration for the busy family physician, although those in his book are mostly blunderers; he denounces HMOs that deal with skyrocketing costs by cutting benefits, but he offers no alternative plan of action. His focus is more specific than general. Not profound literature, yet undeniably fascinating: Groopman has a good ear and a dramatic flair, and he delivers

entertaining, often scandalous portraits of doctors at work.