Reaching Down the Rabbit Hole: A Renowned Neurologist Explains the Mystery and Drama of Brain Disease by Dr. Allan H. Ropper & Brian David Burrell
"Tell the doctor where it hurts." It sounds simple enough, unless the problem affects the very organ that produces awareness and generates speech. What is it like to try to heal the body when the mind is under attack? In this book, Dr. Allan Ropper and Brian Burrell take the reader behind the scenes at Harvard Medical School’s neurology unit to show how a seasoned diagnostician faces down bizarre, life-altering afflictions. Like Alice in Wonderland, Dr. Ropper inhabits a world where absurdities abound:
• A figure skater whose body has become a ticking time-bomb • A salesman who drives around and around a traffic rotary, unable to get off • A college quarterback who can’t stop calling the same play • A child molester who, after falling on the ice, is left with a brain that is very much dead inside a body that is very much alive • A mother of two young girls, diagnosed with ALS, who has to decide whether a life locked inside her own head is worth livingHow does one begin to treat such cases, to counsel people whose lives may be changed forever? How does one train the next generation of clinicians to deal with the moral and medical aspects of brain disease? Dr. Ropper and his colleague answer these questions by taking the reader into a rarified world where lives and minds hang in the balance.
Reaching Down the Rabbit Hole is primarily a compilation of neurology cases treated by Dr. Allan Ropper at the Brigham and Women’s Hospital in Boston. The stories of the patients and their often bizarre symptoms are vivid: heart-wrenching, funny, thought-provoking, but always fascinating. To me one of the most poignant was the young mother with ALS, whose natural maternal desire to see her daughters’ lives as they grew was in constant conflict with the necessity of suffering an ever-declining quality of life. In addition to human interest, the cases provoked reactions of a more philosophical sort, such as the patient about whom Ropper comments that he lacks insight and seems to know that he lacks insight, to which his colleague inquires how a person could be aware that he did not have insight. Think about THAT for a bit!It was interesting to see how conditions far removed from what a lay person would call neurology can show neurological symptoms, such as an ovarian teratoma (a type of tumor), and to realize how difficult it might be to diagnose such a condition accurately. I believe the author wanted to convey what he considers the unique role neurologists play in medical diagnosis, but he could have done a better job.The book came across as rather disorganized. A chapter would begin describing a particular patient, then abruptly take up the story of another patient, and then perhaps a third, before resuming the discussion of the first. Each chapter stands alone for the most part, and the overall message of each chapter, as well as the overall message of the book, could have been more explicit.The subtitle of this book is “A Renowned Neurologist Explains the Mystery and Drama of Brain Disease”. Unfortunately, there is not nearly enough explanation, beginning with the basics. The author makes a big point of being a “clinical neurologist”, but he did not explain to me just what a clinical neurologist is. There are many other medical terms and concepts that the average reader would not know that are also not defined, e.g., he says the cases in the book occurred over a period of two services on the neurology ward and two on the ICU. How long is a “service”?With better organization, this could have been a much better book, but if you are looking for vivid pictures of the ways neurological diseases manifest themselves and the ways modern-day doctors treat them, you will probably enjoy it.
• A figure skater whose body has become a ticking time-bomb • A salesman who drives around and around a traffic rotary, unable to get off • A college quarterback who can’t stop calling the same play • A child molester who, after falling on the ice, is left with a brain that is very much dead inside a body that is very much alive • A mother of two young girls, diagnosed with ALS, who has to decide whether a life locked inside her own head is worth livingHow does one begin to treat such cases, to counsel people whose lives may be changed forever? How does one train the next generation of clinicians to deal with the moral and medical aspects of brain disease? Dr. Ropper and his colleague answer these questions by taking the reader into a rarified world where lives and minds hang in the balance.
Reaching Down the Rabbit Hole is primarily a compilation of neurology cases treated by Dr. Allan Ropper at the Brigham and Women’s Hospital in Boston. The stories of the patients and their often bizarre symptoms are vivid: heart-wrenching, funny, thought-provoking, but always fascinating. To me one of the most poignant was the young mother with ALS, whose natural maternal desire to see her daughters’ lives as they grew was in constant conflict with the necessity of suffering an ever-declining quality of life. In addition to human interest, the cases provoked reactions of a more philosophical sort, such as the patient about whom Ropper comments that he lacks insight and seems to know that he lacks insight, to which his colleague inquires how a person could be aware that he did not have insight. Think about THAT for a bit!It was interesting to see how conditions far removed from what a lay person would call neurology can show neurological symptoms, such as an ovarian teratoma (a type of tumor), and to realize how difficult it might be to diagnose such a condition accurately. I believe the author wanted to convey what he considers the unique role neurologists play in medical diagnosis, but he could have done a better job.The book came across as rather disorganized. A chapter would begin describing a particular patient, then abruptly take up the story of another patient, and then perhaps a third, before resuming the discussion of the first. Each chapter stands alone for the most part, and the overall message of each chapter, as well as the overall message of the book, could have been more explicit.The subtitle of this book is “A Renowned Neurologist Explains the Mystery and Drama of Brain Disease”. Unfortunately, there is not nearly enough explanation, beginning with the basics. The author makes a big point of being a “clinical neurologist”, but he did not explain to me just what a clinical neurologist is. There are many other medical terms and concepts that the average reader would not know that are also not defined, e.g., he says the cases in the book occurred over a period of two services on the neurology ward and two on the ICU. How long is a “service”?With better organization, this could have been a much better book, but if you are looking for vivid pictures of the ways neurological diseases manifest themselves and the ways modern-day doctors treat them, you will probably enjoy it.
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