Monday, September 16, 2013
Close Calls, Cold Cases And The Mysteries Of Medicine
By Brendan Reilly, M.D.
Published by Atria Books, September 3rd, 2013
The thought processes and decisions made by doctors when evaluating, diagnosing and treating their patients have always fascinated me and I was thoroughly intrigued by the title of this book.
It did not disappoint me. Dr Brendan Reilly is one of a rare breed of doctors who is able to admit that yes, he has made mistakes, some serious, yes they did sometimes have major consequences and that yes, he has learned from them. He takes us inside his thoughts as he goes about his busy ward rounds, making considered decisions and split-second decisions alike, showing the reader why he makes both, what it is really like to be working long stretches without sleep, how one copes, how one stays on top of the frenetic and frantic workload and how he personally deals with the sadness and tragedy that affects patients and families when life-threatening diagnoses affect them.
His thoughts on the way that technology has permeated the entire health care system are very well worth reading. New equipment is adopted and wholeheartedly embraced often without due consideration or research, which means that it is very easy for doctors to become over-reliant on diagnostic testing regardless of the fallibility in producing both false positives and false negatives; mammograms are a case in point where up to 25% of breast cancers are not diagnosed by routine yearly mammograms. Just how far can or should medicine go with regards to screening and treating people? Could there - or should there - be a cut-off point?
Some of his patients have affected the way he works for many, many years after their lives and deaths and he is not afraid to discuss the importance of families being aware of their loved ones' wishes regarding end of life care and catastrophic medical emergency care. None of us likes to think that we might be stricken with a severe accident or illness at a young age, but to ignore the possibility will not make it go away. His own decisions regarding the medical care of his ailing elderly parents are made with his personal knowledge and experiences as a doctor balanced with his own thoughts, feelings and needs as their son.
This is one of the most absorbing books I have read this year and I simply could not put it down. Well worth the time spent reading it and I will certainly be purchasing a hard copy to keep on my bookcase.