THE MYSTERY IN THE ROOM

A physician reflects on his multidecade career in rheumatology in this medical memoir.

Aside from a stint at the University of Pittsburgh’s Presbyterian University Hospital, Radis spent much of his medical career on Peaks Island in Maine’s Casco Bay. His Maine experiences lie at the center of his previous two books, Go by Boat (2021) and Island Medicine (2022), but this volume takes an intimate view of rheumatology via specific case studies. “Because nearly all immunologic disorders are life-long,” he writes, much of his consultation with patients requires a focus on “living with a chronic illness.” This means that he often formed a long-term connection with them, and many vignettes begin with an initial meeting with a patient who’s grappling with anxiety, anger, or denial. These evolve into multiyear relationships built on trust and mutual understanding, as physician and patient walk together through diagnosis, medication side effects, chronic pain, and the “relentless progression of their disease.” The book’s conversational style prevents it from being a typical how-to guidebook; indeed, many of its chapters read like medical-mystery TV shows as Radis pieces together clues from patient narratives, family histories, and test results. Interwoven throughout are anecdotes from Radis’ childhood, his education at Bates College, and his medical career: “It was never my goal to become a doctor,” he writes as he describes his early love of the outdoors, growing up in suburban New Jersey. Particularly interesting is his recollection of his father, who died when Radis was only 11: He was a chemical engineer for a plant that manufactured DDT in 1963, when he was asked by his bosses to debate environmental activist Rachel Carson on national television; he declined because “he agreed with her conclusions” after being “shaken to the core” by her book Silent Spring (1962).

What makes this book special, though, is not Radis’ story, but those of patients with whom he worked over the years. These include 12-year-old Amanda, who came to Radis after experiencing rashes, tongue ulcers, and balding, and Lynn, a second-grade teacher and new mother whose postpartum swelling of her fingers made it difficult even to hold her newborn. The book’s novelistic style includes detailed scene-setting, internal monologues, and reconstructed dialogue that offer deeply personal perspectives on each patient. Although the book is geared towards a general audience, it offers sage advice to those in the medical profession. He recalls a time, for example, when he “reprimanded” himself for initially prejudging a new patient and fearing that their conversation would “focus entirely on narcotics for pain.” He advocates for an “emerging philosophy of shared decision-making in patient care” that complements his belief that “patients must feel safe in being honest, making mistakes, [and] asking questions.” The book effectively balances medical realism with stories of resilience. A foreword by Leonard Calabrese (the Theodore F. Classen Chair of Osteopathic Research and Education at the Cleveland Clinic) adds gravitas to a book that aims to tear down the artificial divisions between patients and physicians.

Engaging and often poignant recollections from a longtime doctor.