The Medical Detectives (review)

254 BOOK REVIEWS instead of scrutinizing one category or the other. All quibbles aside, though, Professor Feder's serious and intelligent work deserves attention and commands respect. —Peter W. Graham Virginia Polytechnic Institute and State University Berton Roueché. The Medical Detectives. New York: Times Books, 1981. 372 pp. $15.00. Those susceptible beings who find themselves manifesting symptoms of every complaint they hear about should not open Berton Roueché's The Medical Detectives. Hardier readers will find this collection of essays fascinating. Since 1944 Mr. Roueché has written "Annals of Medicine," an occasional feature of the New Yorker, and his book reprints pieces that originally appeared in the periodical between 1947 and 1980. The thirtythree -year span of the essays permits us to discern evolutions in epidemiological methods, changing styles in doctor-patient relations, and Roueché's own development as a masterful medical journalist whose early artfulness ("His complaint, like his occupation, was an undistinguished one. He had a stomach ache.") gives way to the self-effacing transparency of a writer who lets the march of events provide its own fascination, who permits his principals to speak for themselves whenever possible, and who limits display of his own learning to the concise and edifying miniature histories that enhance such essays as "A Man Named Hoffman" and "Antipathies." As the collection's title suggests, Roueché's usual focus is on the ingenious unraveller of a medical enigma. The recurrent collective hero of his volume is the Center for Disease Control (CDC), whose epidemiologists and support specialists trace the course of epidemics as familiar as hepatitis ("The West Branch Study"), as exotic as tularemia ("A Rainy Day on the Vineyard"), and as downright bizarre as stramonium poisoning contracted by eating tomatoes grafted onto Jimson weeds ("Something a Little Unusual"). In addition there are puzzling individual case studies such as "The Orange Man," the medical history of the first recorded victim of carotenemia-lycopenemia, and "All I Could Do Was Stand in the Woods," a chronicle of hypogeusia or taste and smell dysfunction, a seldom recognized but easily treated consequence of salivary zinc deficiency . That ultimate doctor-tease, the apparent but illusory somatic dis- Book Reviews 155 order, also challenges Roueché's detectives. In "Two Blue Hands" what looks like cyanosis proves to be a red herring. In "Sandy" a popular elementary-school student falls ill and inadvertently engenders a hysterical epidemic that, due to a series of coincidences, plausibly presents itself as gas poisoning. Throughout this collection the medical investigator who sets out to decipher a public or private riddle generally succeeds. Two of the most recent essays, however, show how serious the consequences can be when the detective we call a doctor falls into error. "Empty as Eve" (1974) tells the poignant story of a professional woman who, having undergone electroshock treatment for depression caused by unsuccessful peridontic surgery, must herself become a detective searching, with only partial success, for the past she has lost to shock therapy. "Live and Let Live" (1979) offers the yet more harrowing account of a young woman suffering from Wilson's disease (a genetic derangement of the body's ability to metabolize copper) and manifesting classic symptoms (progressive clumsiness , drooling, slurred speech, the distinctive Kayser-Fleischer corneal rings) yet shunted as an intractable neurotic from psychiatrist to unperceptive psychiatrist. In these two pieces Roueché succeeds in presenting humanitarian insight without lapsing from reportorial objectivity: no small feat. —Peter W. Graham Virginia Polytechnic Institute and State University Trautmann, Joanne, editor. Healing Arts in Dialogue: Medicine and Literature (Medical Humanities series). Carbondale: Southern Illinois University Press, 1981. xix + 178 pp. $16.95. Healing Arts in Dialogue is the record of a series of five meetings held in 1975 and 1976 by the Institute on Human Values in Medicine, one of four such serial conferences designed to consider the relationship of non-scientific disciplines to medicine. Joanne Trautmann, Professor of Humanities at the Hershey Medical Center of Pennsylvania State University , brought together a disparate group interested in very different ways in the relationship, real and potential, between medicine and literature . Many of the participants have double or interdisciplinary careers. They include Nancy C. Andreasen, a psychiatrist who has...