A highly pleasurable must-read.
A revealing, often disturbing look at what goes on in doctors’ minds when treating patients, plus some advice to patients on how to work with their doctors to improve that process.
Oncologist and New Yorker staff writer Groopman (The Anatomy of Hope, 2004, etc.) draws on conversations and interviews with other doctors, research in the field and his own experiences as both doctor and patient to unravel the question of how doctors reach a diagnosis and decide on a treatment. While the clinical algorithms and practice guidelines that medical students are taught and that are promoted by hospital administrators and insurance companies are useful in many cases, he argues that they discourage doctors from thinking creatively when symptoms are vague and test results inconclusive. Groopman categorizes the kinds of errors in thinking that doctors can make (drawing on stereotypes, thinking too narrowly, clinging to an original diagnosis while ignoring later evidence), and he uses real cases as examples. In one, doctors who diagnose a Vietnamese infant as having a rare inherited disease are only persuaded otherwise by the adoptive mother’s insistence on retesting her blood. In another, various doctors continue to accept an initial misdiagnosis over a 15-year period until one doctor makes the correct diagnosis by taking the time to question and observe the patient closely and pay attention to her answers. When Groopman receives four different diagnoses and plans for treatment for his painful, inflamed right hand, he consults a fifth specialist, and together they analyze the types of cognitive errors that led to the series of misdiagnoses. His revelations about the performance records of radiologists and others who must read and interpret tests will be disconcerting to anyone expecting technology to produce certainty, and his chapter on the influential marketing tactics of pharmaceutical manufacturers will dismay those expecting doctors to demonstrate objectivity. In an epilogue, Groopman speaks directly to the would-be patient, offering pertinent questions that one might direct to his or her physician to promote broader thinking about an ailment.
A highly pleasurable must-read.Pub Date: March 19, 2007
ISBN: 0-618-61003-0
Page Count: 320
Publisher: Houghton Mifflin
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: Jan. 15, 2007
An extraordinary true tale of torment, retribution, and loyalty that's irresistibly readable in spite of its intrusively melodramatic prose. Starting out with calculated, movie-ready anecdotes about his boyhood gang, Carcaterra's memoir takes a hairpin turn into horror and then changes tack once more to relate grippingly what must be one of the most outrageous confidence schemes ever perpetrated. Growing up in New York's Hell's Kitchen in the 1960s, former New York Daily News reporter Carcaterra (A Safe Place, 1993) had three close friends with whom he played stickball, bedeviled nuns, and ran errands for the neighborhood Mob boss. All this is recalled through a dripping mist of nostalgia; the streetcorner banter is as stilted and coy as a late Bowery Boys film. But a third of the way in, the story suddenly takes off: In 1967 the four friends seriously injured a man when they more or less unintentionally rolled a hot-dog cart down the steps of a subway entrance. The boys, aged 11 to 14, were packed off to an upstate New York reformatory so brutal it makes Sing Sing sound like Sunnybrook Farm. The guards continually raped and beat them, at one point tossing all of them into solitary confinement, where rats gnawed at their wounds and the menu consisted of oatmeal soaked in urine. Two of Carcaterra's friends were dehumanized by their year upstate, eventually becoming prominent gangsters. In 1980, they happened upon the former guard who had been their principal torturer and shot him dead. The book's stunning denouement concerns the successful plot devised by the author and his third friend, now a Manhattan assistant DA, to free the two killers and to exact revenge against the remaining ex-guards who had scarred their lives so irrevocably. Carcaterra has run a moral and emotional gauntlet, and the resulting book, despite its flaws, is disturbing and hard to forget. (Film rights to Propaganda; author tour)
Pub Date: July 10, 1995
ISBN: 0-345-39606-5
Page Count: 432
Publisher: Ballantine
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: May 1, 1995
BOOK REVIEW
BOOK REVIEW
BOOK REVIEW
The memoir of George Dawson, who learned to read when he was 98, places his life in the context of the entire 20th century in this inspiring, yet ultimately blighted, biography. Dawson begins his story with an emotional bang: his account of witnessing the lynching of a young African-American man falsely accused of rape. America’s racial caste system and his illiteracy emerge as the two biggest obstacles in Dawson’s life, but a full view of the man overcoming the obstacles remains oddly hidden. Travels to Ohio, Canada, and Mexico reveal little beyond Dawson’s restlessness, since nothing much happens to him during these wanderings. Similarly, the diverse activities he finds himself engaging in—bootlegging in St. Louis, breaking horses, attending cockfights—never really advance the reader’s understanding of the man. He calls himself a “ladies’ man” and hints at a score of exciting stories, but then describes only his decorous marriage. Despite the personal nature of this memoir, Dawson remains a strangely aloof figure, never quite inviting the reader to enter his world. In contrast to Dawson’s diffidence, however, Glaubman’s overbearing presence, as he repeatedly parades himself out to converse with Dawson, stifles any momentum the memoir might develop. Almost every chapter begins with Glaubman presenting Dawson with a newspaper clipping or historical fact and asking him to comment on it, despite the fact that Dawson often does not remember or never knew about the event in question. Exasperated readers may wonder whether Dawson’s life and his accomplishments, his passion for learning despite daunting obstacles, is the tale at hand, or whether the real issue is his recollections of Archduke Ferdinand. Dawson’s achievements are impressive and potentially exalting, but the gee-whiz nature of the tale degrades it to the status of yet another bowl of chicken soup for the soul, with a narrative frame as clunky as an old bone.
Pub Date: Feb. 1, 2000
ISBN: 0-375-50396-X
Page Count: 288
Publisher: Random House
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: Dec. 15, 1999
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