Views & Reviews Review of the Week

A taste for medical detective stories

BMJ 2009; 339 doi: http://dx.doi.org/10.1136/bmj.b4648 (Published 12 November 2009) Cite this as: BMJ 2009;339:b4648
  1. Kevin Barraclough, general practitioner, Painswick, Gloucestershire
  1. k.barraclough{at}btinternet.com

    Unusual case histories are the starting point for an unexpectedly good book on how doctors make a diagnosis, finds Kevin Barraclough

    Slightly to my surprise, this is a wonderful book. The author is a US physician who is an adviser on the television series House. I have always rather enjoyed House, but I did wonder whether the book was just going to be a catalogue of “fascinomas.” Certainly there are a fair few of them. If I come across a case of West Nile virus or adult Still’s disease in Painswick I am now forewarned about their clinical features. But the clinical vignettes are actually there to illustrate the author’s more interesting musings on the role of diagnosis in the 21st century.

    The book is structured (with a touch so light that one is almost unaware of it) into four parts: the clinical history in diagnosis, physical examination (which the author sees as a lost art), diagnostic tests, and the last part dealing with the causes of medical diagnostic error.

    Each point …

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