GIFTS OF TIME

A spellbinding account of the miracles that we are coming to expect from increasingly sophisticated hi-tech medicine. Epstein (Director/Division of Pediatric Neurosurgery, NYU Medical Center), assisted by medical writer Shimberg, describes his work with children suffering from brain-stem and spinal-cord tumors, explaining that techniques he's developed and refined enable him to save the lives of children whose tumors were once considered inoperable. The cases described here (pseudonyms are used for patients, real names for medical personnel) represent the luckier children, for such tumors are difficult to diagnose and are often missed by family physicians. About a quarter of the text consists of first-person narration by Epstein (or ``Fred,'' as he is referred to throughout in a deliberate and generally successful attempt to present himself as a compassionate and empathetic person). What we are shown is the very best that American medicine has to offer—high levels of competence and caring combined (Epstein forms close ties with his patients' families and attends their bar mitzvahs, weddings, and even their funerals). Issues of cost are occasionally mentioned, but only to show how charitable acts sometimes resolve them. Epstein's stated aim is to increase public awareness of the symptoms indicating possible nervous-system tumors, to encourage parents to seek expert help, and to offer them hope—and they succeed admirably. (But the unstated problem remains: Even assuming families locate the needed help, how are they to afford it?) Into the high drama of individual patient's stories, Epstein has mixed some history of neurological surgery, conveying clearly that, although enormous strides have been made, tomorrow's technology will eclipse even today's marvels. The operating-room scenes are riveting, and the patients' stories utterly absorbing and often heart-rending: a first-rate medical casebook.