Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

In her new book, Lisa Sanders examines the state of diagnostic skills.

The chances are good that you already know the work of Lisa Sanders, M.D. ’97, HS ’00, assistant clinical professor of medicine: she writes the monthly “Diagnosis” column in theNew York Times Magazine. Or maybe you’ve seenHouse, the Emmy-winning, oddly addictive, not-quite-believable hospital melodrama for which Sanders is a consultant. Now Sanders has written a book that combines the medical sleuthing of “Diagnosis” andHousewith an examination of the state of diagnostic skills among contemporary physicians. The book also provides “insider” pleasures for those familiar with the School of Medicine or Yale-New Haven Hospital: Many of the names of the physicians who unravel these medical mysteries are familiar, from Nancy Angoff to Majid Sadigh, from Eric Holmboe to Frank Bia.

With each story of a difficult diagnosis, Sanders expands on the issues that made it so. Recurrent chest pain and weakness in a young man. A heart attack? It turns out to be pernicious anemia. A woman with long-term weakness and joint pain. “Chronic” Lyme disease? No—polymyalgia rheumatica.

Sanders argues that physical examination is poorly taught, both in medical school and during residency. “See one, do one, teach one” doesn’t suffice for the complex skills of hands-on examination.

She ends with a moving story of the search for the cause of her own sister’s death at 42.

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