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Views & Reviews Review of the Week

Poet turned patient

BMJ 2011; 342 doi: (Published 23 February 2011) Cite this as: BMJ 2011;342:d1215
  1. Leyla Sanai, retired consultant anaesthetist, Gartnavel General Hospital, Glasgow
  1. leyla.sanai{at}

Doctors can make the difference between a horrific experience of illness and a tolerable one. Leyla Sanai found parallels with her own experiences in this memoir about a patient with a rare idiopathic autoimmune illness

Imagine losing power and feeling in your arms and legs. This is what happened to Sarah Manguso when she was 21 and a student at Harvard, when she noticed an inability to walk straight, and her hands and feet became paraesthetic. Fearing that her fellow students would assume she had an alcohol problem, she contacted her parents, who fetched her and sought medical advice.

Manguso’s first diagnosis was Guillain-Barré syndrome. She was given daily apheresis (plasma exchange) in intensive care for a week and then discharged. But the symptoms returned. She was initially told that it was a minor hiccup, but, as is often the case, the patient knew better. Manguso’s problems worsened, and she was soon back for more apheresis. It turned out that her illness was not Guillain-Barré after all but a related autoimmune disorder, chronic inflammatory demyelinating polyradiculoneuropathy, in which similar antibodies are made to the myelin sheaths of neurones. Unlike Guillain-Barré, the disorder may recur.

Manguso’s memoir is a collage of her memories of her illness: remissions and relapses; different doctors and nurses; the effect on her of their kindness or arrogance; her return to Harvard; and her long, slow recovery. …

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