Fascinomas - Fascinating Medical Mysteries
Meador (Medicine/Vanderbilt Univ.; True Medical Detective Stories , 2012, etc.) offers a pleasant set of anecdotes about puzzling symptoms and the work of the “physician detective.” Combining “fascinate” with the suffix “-oma” (which often designates a tumor), Meador coins a term for the medical conundrum of doctors being left stumped until a new piece of evidence comes to light. Yet the author insists that, when trying to understand an illness, getting to know a patient is just as important as grasping symptoms. Even a very careful doctor can overlook warning signs or fail to ask the right questions. The first of Meador’s patient sketches, all based on real cases shared by his colleagues, concerns a girl whose temporary paralysis was caused by a hidden tick bite—a diagnosis reminiscent of medical TV dramas like House or Scrubs . Other peculiar findings, related to Meador by his Vanderbilt colleagues or other doctors, involve typhus from rats, an allergy to yellow dye and carbon monoxide poisoning. Some patients cling to self-diagnoses despite their doctors’ opinions to the contrary; this is especially true of conditions with a psychological component, such as hypoglycemia and fibromyalgia. Simply having a name for an illness can function like a crutch that patients are reluctant to relinquish. At times, this self-definition can go further: In cases of Munchausen syndrome, patients keep themselves sick, perhaps by injecting wound sites with their own feces to induce infection. Asking simple questions and establishing rapport with even such self-deluded patients can give physicians an entrée into discussing underlying mental issues. Meador ends with what is perhaps the collection’s most bizarre story: A college senior developed lichen planus rash after drinking copious amounts of cinnamon schnapps, which contains gold flakes—his blood level of gold was 86 micrograms, compared to a normal level of less than 1 microgram. A few anecdotes would benefit from more detail, and the overall effect could be less provincial if Meador included tales from further afield. Many of his “characters” sound, perhaps unfairly, like ignorant country folks due to their transcribed Tennessee dialect and folksy names. A quick, enjoyable book of health-related who- and whatdunits.