, Derry, New Hampshire


November 1, 2013

'One Doctor' is a mixed bag of medical maladies

“One Doctor: Close Calls, Cold Cases, and the Mysteries of Medicine” by Brendan Reilly, M.D.

c.2013, Atria Books $28; 464 pages

The debate over the value of modern technology is always raging. Which is better, the newfangled techniques of tried-and-true methods? In the new book “One Doctor” by Brendan Reilly, M.D., you’ll see that moth-eaten methods may beat modern.

“New York doctors don’t work weekends.”

That’s what one of Brendan Reilly’s patients claimed, surprised to see Reilly at her bedside on an early Saturday morning at New York’s Presbyterian Hospital. He was there because he believes that the doctor who “knows you best” is the one who should assume the majority of the caregiving. That’s not the way most medical centers work these days, but it’s the way he prefers to practice medicine.

For Reilly, doing things the old-fashioned way is often better than technology, when making a proper diagnosis. Machines, he points out, can miss the smallest of symptoms: a non-dilated pupil, an errant reflex, a hidden blood clot or rare bacteria that mimics something else.

“Diagnosing disease,” he says, “has something to do with patterns.” Good doctors – “grandmasters,” he calls them – know how to recognize those patterns without “wasteful, redundant, or ineffective” medical intercession. Such recognition, near-intuition, and the ability to deal with a day when “doctoring feels like pinball” are talents he cultivates in his residents and students.

Even so, there are times when a doctor is stumped by a medical mystery that requires rapt attention and sleuthing skills. That’s when it’s mandatory to listen to a patient, the patients’ ailing body, and one’s own subconscious, as well as medical knowledge new and old. Such mysteries may result in instinctual reaction, and a cure. Other times, they might end with the surety that it’s time to stop.

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