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If you would like to suggest a book for review, or write a review, please email sara.williams@mps.org.uk


Reviews The Mind’s Eye


By Oliver Sacks (£17.99, Alfred A. Knopf, 2010) Reviewed by Joanna Jastrzebska,


consultant psychiatrist, New Zealand


Have you ever got lost in a familiar place or failed to recognise an acquaintance’s face? What if it happened to you every day? How would you live with it? How would you adapt? In his newest book The


Mind’s Eye, Oliver Sacks tells stories of people who struggle with prosopagnosia (face blindness) and other vision problems. We have a concert pianist who loses her ability to read music and recognise everyday objects. We meet an aphasic woman who masters her ability to express herself through gesture and mime. We are told a story of a man of letters who finds a way


Taking the Medicine


By Druin Burch (£9.99, Vintage, 2010) Reviewed by Dr Aidan M O’Donnell, consultant anaesthetist, New Zealand. He can be


contacted through his website – www.aidanodonnell.info.


Imagine yourself in 1610, standing on a balcony at night overlooking the sleeping town of Padua. Beside you is Galileo, his telescope pointed at the stars. He whispers to you that he has calculated that the Earth, like the other planets, is moving around the Sun. As you feel the cool stone beneath your feet, it is clear – obvious! – that the balcony, Padua, and the Earth are completely still, not whizzing round in space at enormous speed, and you would be forgiven for thinking that Galileo was profoundly deluded. We forget how difficult it was to accept the heliocentric solar system in the first place. This is just one illustration of how hard it can be for any scientist to disregard what common sense dictates is obvious, in favour of what rational intellect insists must be true. Druin Burch’s book, Taking the Medicine, is a detailed and powerful account of a truth which is, in its way,


around his post-stroke alexia to continue to read and write. We also learn how prosopagnosia has affected the lives of many people, including Sacks himself. Sacks is a great neurologist and his knowledge shows in the ease with which he presents the complexity of our vision. Moreover, he goes beyond the mechanics of the eye and visual cortex and demonstrates how problems with vision affect people’s lives, and how human adaptability can overcome the blow. He makes us realise how much we take for granted and how plastic our brains are. Sacks is a great storyteller, too (does his psychiatry background help here?). His essays are not only interesting but also touching, particularly where he shares his personal struggles with prosopagnosia


and ocular melanoma. Even through the most difficult moments, Sacks doesn’t stop being a scientist and continues illustrating psychophysiology behind the phenomena he’s experiencing. I admit, I found the entries from Sacks’ journal a little disturbing. Although emotional and full of tension (I was skipping descriptive bits to see what happened next), they are somehow mechanical and lacking human aspect. The question of how having a cancer and losing his beloved stereoscopy have affected Sacks as a person and a doctor is left unanswered.


as hard to accept as the heliocentric solar system: the truth of evidence- based medicine. Hinted at by Hippocrates (“experience is fallacious”), it has taken millennia to be understood. Put simply, doctors cannot reliably tell for themselves which treatments are best for their patients, no matter how great their expertise, or how good their intentions, without randomised controlled trials to eliminate their inadvertent biases and prejudices. Burch writes passionately, but with plenty of scholastic wallop. The first section of the book is a history both of medical treatments and of experimental methods, and is full of fascinating detail. The second section involves a colourful biography of Archie Cochrane, the feisty pioneer of evidence-based medicine. The book reaches its peak in the final section, and deals with several powerful themes: thalidomide, cancer in children, and the introduction of anti-HIV drugs. I found it as compelling as a thriller. Burch’s writing is uncompromising and unforgiving. A unifying theme is the seductive illusion of medical


The Mind’s Eye is an


interesting read for medics and non-medics, but some passages would benefit from less jargon or explanations in (abundant) footnotes. Even Sacks’ TV-show consultation style – quoting letters from fans and turning up on their doorstep to diagnose their unusual conditions – although unnerving at times, is forgiveable. If I ever happened to have a strange neurological problem I’d love Sacks to pay me a home visit to explain what’s going on in his conversational, easy- to-understand manner.


certainty. He writes: “...With the most advanced molecular underpinnings, the best laboratory scientists, with superb and highly motivated doctors and researchers, extensive trials in cancer models, then in animal models, then on a small scale in actual children – with all of this, the greatest cancer experts in the world were unable to predict what worked and what did not without actually doing a trial.” A secondary theme is that many medical treatments make only modest improvements in individuals, yet when applied to populations can provide enormous benefits. I first came across Druin Burch’s writing on a well-known doctors’ internet service. I found his clarity of thought and his uncompromising viewpoint extraordinary. This book has changed both the way I practise and the way I think about my job. It should be read, not just by medical students and doctors, but by anyone who has ever swallowed a tablet. The truth of evidence-based medicine may be hard to swallow, but at least it won’t get you in trouble with the Inquisition.


REVIEWS


ASIA CASEBOOK | VOLUME 19 | ISSUE 3 | SEPTEMBER 2011 www.medicalprotection.org


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