HOW DOCTORS DIAGNOSE YOU
By
A jumbled assemblage of anecdotes, advice, and gripes that does manage to provide a (disordered) view of the process of diagnosing--a process that internist Gibbons admits he can't quite put into words. But he is entertaining as he talks around how to diagnose--with a variety of case histories that are anecdotal rather than instructive (we don't always know enough about the disease to follow him). And his views on recent trends demonstrate a salutary respect for patients' needs: defensive medicine occurs most often, he notes, in clinical settings where one-to-one relationships don't exist; second opinions are really just a safeguard for insurance carriers, not primarily for the benefit of patients. He does, however, have his pet peeves. In a chapter of advice on helping the doctor, he inveighs against three common, annoying, ""clever"" responses (to the question what-brings you-here-today, ""Taxi""; to what-made-you-decide-to-come-in, ""My wife""; to what's-the-problem, ""That's what I want you to tell me, Doc""). Other injunctions: for heaven's sake, put your gown on properly (the hole goes in the back); and don't stick your tongue out when the doctor looks at your throat, it gets in the way. But we don't always get the why and wherefore: ""An elevated phosphorus could be an overactive pituitary gland""--but so what, and why? With more background and explanation--on the model of Isadore Rosenfeld's The Complete Medical Exam (1978)--readers would be better able to assist their doctors in the diagnosing process. Still, despite the lecturing and the fuzziness, an interesting glimpse of how doctors go about their work.