Second Opinions: Eight Clinical Dramas of Decision Making on the Front Lines of Medicine

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9780140298628: Second Opinions: Eight Clinical Dramas of Decision Making on the Front Lines of Medicine

A unique insider's view of today's complex and often contentious world of medicine

Anxious about the prognosis, lost in a blur of technical jargon, and fatigued from worry or pain, people who are ill are easily overwhelmed by treatment choices. Told through eight gripping clinical dramas, Second Opinions reveals the forces at play in making critical medical decisions. Dr. Jerome Groopman illuminates the world of medicine where knowledge is imperfect, no therapy is without risks, and no outcome is fully predictable. He portrays moments of astute diagnosis and misguided perception, of lifesaving triumphs and shattering failures.

These real-life lessons prepare us to navigate the uncertain terrain of illness, and enable us to balance intuition and information, and thereby make the best possible decisions about our health and future.

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Review:

Respected AIDS and cancer specialist Jerome Groopman, M.D., discussed the convergence of illness and spirituality in his first book, The Measure of Our Days. In Second Opinions: Stories of Intuition and Choice in the Changing World of Medicine, he shifts his focus to the ways intuition informs his medical decisions and enhances the quality of his patient relationships (even giving him an edge when examining a patient on referral). In eight chapters that vividly recount cases whose outcomes hinge as much on the doctor's gut feeling and empathy as on his expertise, Groopman eschews the impersonal and know-it-all role of the doctor, describing instead dire cases in which careful consideration of both the emotional and medical issues positively impacted his approach to treatment.

"A clinical compass is built not only from the doctor's medical knowledge but also from joining his intuition with that of his patient," Groopman writes. "This melding of minds occurs when the physician probes not only his patient's body but also his spirit." This uniquely integrated compass is the guide that determines the safest, least traumatic treatment for people who are in advanced stages of illness or whose diagnoses are clinical conundrums. Of the eight stories here, there's Isabella, who was diagnosed with asthma but actually has acute leukemia; Peter, whose sickness is an enigma although he's clearly dying of a vicious lung-tissue disorder; and Alex, who will die from bone marrow failure unless its exact cause is identified. Groopman's narrative nimbly relates all the details of his patients' battles as well as the professional and emotional steps he takes when facing a medical challenge. In most cases, he has been sought out to provide a second opinion of the patient's diagnosis and proposed treatment. More often than not, the original diagnosis was inaccurate and Groopman's meticulous and insightful examinations yield findings that mean the difference between life and death.

Second Opinions is a thoughtful, riveting book and a compelling tribute to the efficacy of medical care when handled responsibly and with empathy. It is also a cautionary collection of stories that reveal oversights inevitable in the health-care industry's rush to maximize efficiency, and as such it teaches an important lesson about the patient's role in ensuring a high quality of care. While Groopman runs the risk of seeming self-congratulatory, he proves himself a trustworthy advocate of patient empowerment and his sincere, articulate portrayal of intuition's subtle force will be inspirational for anyone confronting illness. --Rebecca Wright

About the Author:

Jerome Groopman, M.D. is the Recanati Professor of Immunology at Harvard Medical School, Chief of Experimental Medicine at Beth Israel Deaconess Medical Center, and one of the world's leading researchers in cancer and AIDS. He and his work have been featured in The New York Times, The Wall Street Journal, and Time magazine, as well as in numerous scientific journals. He lives with his family in Brookline, Massachusetts.

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