FIVE PATIENTS

Young Dr. Crichton (of The Andromeda Strain) uses five patients as a quod erat demonstrandum of procedures at Massachusetts General Hospital and as a work-up of the profession in general—the latter being what these enzymatic annals of applied medicine are generally about. The patients include a construction worker with a heart arrest; a man with a fever of 108 who for thirty days defies diagnosis but not the cure which nature effects; a man with a dangling hand; a woman on whom the new Tele-Diagnosis technique is used; and a victim of lupus erythematosus. Via these, Dr. Crichton ranges easily over problems of hospital costs (doubled in the last decade) and the A.M.A.'s anomie; the trend in which a facility such as this must cope with more and more acute emergencies (65,000 go through the Emergency Ward in a year); the newer rapprochement of surgery and medicine dealing as they do with the same tissue; the ward teaching system (and the medical student): the "traditional passivity" in the field and the exigencies of change: etc., etc. His book, as sharply, excitingly written as you might expect, is the best elective reading since Intern.