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Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

Lisa Sanders

3.96 · Rating details · 6,596 ratings · 588 reviews

A riveting exploration of the most difficult and important part of what doctors do, by Yale School of Medicine physician Dr. Lisa Sanders, author of the monthly New York Times Magazine column "Diagnosis," the inspiration for the hit Fox TV series House, M.D.

The experience of being ill can be like waking up in a foreign country. Life, as you formerly knew it, is on hold whi A riveting exploration of the most difficult and important part of what doctors do, by Yale School of Medicine physician Dr. Lisa Sanders, author of the monthly New York Times Magazine column "Diagnosis," the inspiration for the hit Fox TV series House, M.D.

The experience of being ill can be like waking up in a foreign country. Life, as you formerly knew it, is on hold while you travel through this other world as unknown as it is unexpected. When I see patients in the hospital or in my office who are suddenly, surprisingly ill, what they really want to know is, ‘What is wrong with me?’ They want a road map that will help them manage their new surroundings. The ability to give this unnerving and unfamiliar place a name, to know it–on some level–restores a measure of control, independent of whether or not that diagnosis comes attached to a cure. Because, even today, a diagnosis is frequently all a good doctor has to offer.

A healthy young man suddenly loses his memory–making him unable to remember the events of each passing hour. Two patients diagnosed with Lyme disease improve after antibiotic treatment–only to have their symptoms mysteriously return. A young woman lies dying in the ICU–bleeding, jaundiced, incoherent–and none of her doctors know what is killing her. In Every Patient Tells a Story, Dr. Lisa Sanders takes us bedside to witness the process of solving these and other diagnostic dilemmas, providing a firsthand account of the expertise and intuition that lead a doctor to make the right diagnosis.

Never in human history have doctors had the knowledge, the tools, and the skills that they have today to diagnose illness and disease. And yet mistakes are made, diagnoses missed, symptoms or tests misunderstood. In this high-tech world of modern medicine, Sanders shows us that knowledge, while essential, is not sufficient to unravel the complexities of illness. She presents an unflinching look inside the detective story that marks nearly every illness–the diagnosis–revealing the combination of uncertainty and intrigue that doctors face when confronting patients who are sick or dying. Through dramatic stories of patients with baffling symptoms, Sanders portrays the absolute necessity and surprising difficulties of getting the patient’s story, the challenges of the physical exam, the pitfalls of doctor-to-doctor communication, the vagaries of tests, and the near calamity of diagnostic errors. In Every Patient Tells a Story, Dr. Sanders chronicles the real-life drama of doctors solving these difficult medical mysteries that not only illustrate the art and science of diagnosis, but often save the patients’ lives. ...more

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Published July 31st 2009 by Harmony (first published 2009)

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Nov 01, 2019 India M. Clamp rated it really liked it

Lisa Sanders in not only a physician (Yale School of Medicine) she is a TV Producer. In fact, she was an Emmy winning producer at “CBS News” prior to becoming a clinician/educator at Yale. She gives us an in-depth contrast to the mechanics of diagnostic medicine to how it is done “in real time” at the patient's bedside.

The physical exam and its' demise are a loss to medicine according to Sanders. Diagnosis is a true art and how to classify such to is an endeavor. From cogwheeling in Parkinson's ...more

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Jun 20, 2012 Reese rated it it was ok

I didn't think it was possible for a book about medical problems to bore me. I now know that it's possible. Yep, Every Patient Tells a Story managed to bore me. Boredom may not be an illness, but in this review, equating the two seems appropriate. I'm not starting with a potpourri of baffling symptoms and trying to arrive at a diagnosis. I have the diagnosis: boredom -- so my task is to identify the causes.

Dr. Lisa Sanders' work reminds me of a medical file in that it's a disorganized collectio ...more

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May 05, 2010 Kristen Nace rated it really liked it

As a medical lab tech, this book was fascinating to me. I spend my weekends working in the local hospital running diagnostic tests of all kinds. Often, I will come to know a patient ( eventhough I never see their face) through their lab resutls. I will make and view a slide of their CBC and count their different white cells. i will take note of their panic potassiums and calciums, their low hemoglobin, etc. and call these results to an er doctor and will often hear an "A-HA!" from the doctor as ...more

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May 17, 2018 Andy rated it liked it · review of another edition

If you like the author's column in the New York Times Magazine, you will like this book. It features well-written stories of so-called "medical mysteries." My problem is this frame of the "mystery" which makes it seem like these are very tough diagnoses and so the patients are just unlucky to have these weird diseases.

Most of the time, the stories reveal diagnoses that could have been made much earlier, more safely and more cheaply if only the doctor had done something basic, like look at the c ...more

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Jul 25, 2010 Angela rated it it was ok

Shelves: non-ficiton

I was a little disappointed in this book. The author is touted writes a column that gave rise to House MD so I expected lots of interesting case histories and weird maladies! Instead the book is a lot about how diagnosis is done and a boring eulogy for what the author describes as the death of the physical exam and the lack of training in basics for doctors. For those interested in the case history type thing I recommend instead Oliver Sachs (Awakening) and The Man Who Mistook His Wife for a Hat ...more

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Feb 19, 2018 Hasnat Sujon rated it it was amazing

Several years ago when I was an Intern, I was chit-chatting with Dr. Sambita Chakravarty in the Pediatrics duty doctors' room. A bearded-man in a knee long panjabi with his wife peeked through the door. The wife had their son on her lap. He was Jamal. 8 years. The man had an anxious face- definitely for his son. I couldn't see the face of the wife as it was covered in a Burqa. She must be anxious. After all she was a mother.

I asked, 'what is the problem?'

Jamal had a fever for about a week. But h ...more

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Nov 07, 2017 Carissa rated it really liked it

Shelves: non-fiction, friend-recommendations, memoir, medical

Dead on with my experience as a complicated, chronic patient, but what makes it so good to me is that it’s from the perspective of doctors who admit the faults of medicine, the diagnostic process, the tendency to blow things off if there’s not something “normal” and initial, basic tests come back normal, the lack of desire to pursue things further, and the common problem of misdiagnosing a patient simply to give them a diagnosis (thinking they should know everything) to the detriment of the pati ...more

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Jan 14, 2018 Jeanette rated it liked it · review of another edition

This title is far more a memoir than it is a book that is directly focused on the subject matter of the title. And it also does not follow so much of her own autobiography path for becoming a medical doctor in any linear progressive order of time or experience level so you don't get that as a "whole" either. Instead it skips. And jumps to various chapter headings which almost randomly center on different aspects or various instruments of the patient physical examination by the medical doctor.

The This title is far more a memoir than it is a book that is directly focused on the subject matter of the title. And it also does not follow so much of her own autobiography path for becoming a medical doctor in any linear progressive order of time or experience level so you don't get that as a "whole" either. Instead it skips. And jumps to various chapter headings which almost randomly center on different aspects or various instruments of the patient physical examination by the medical doctor.

These books usually mesmerize me. Although I read every word and appreciated many of her witnessed misdiagnosis or "troubled/ very ill and yet no answer for successful treatment" patients- I felt after about 1/2 the book that the verbiage of medical historic discoveries founders for techniques and equipment invention, those past century tales and myriads or other non-title related tangents- they all got in the way.

It's good instruction for those who know little about medicine as a diagnosis skill set and also want to know more about a base physical examination. The one a medical doctor should be doing upon first patient arrival for a well visit or for a problem to report episode.

These physical examinations of the patient (even on hospital check in) are not taught as they once were. Nor are all doctors depending on the physical exam to the extent that they did a mere few decades ago. Not only because of lab testing, but because of digital diagnosing.

Overall, the writing style became just too tangent to piece out the essence of the connection to those physical examination skills. The listening, the feeling of touch response, the communication and the related context to the exact period of times involved. It is like a story, in some ways. But far more complex than just a story. You have to hear the silences and also tread into paths that don't reveal signs which warn or point to the features for the information that you don't know that you don't know.

The reading became random memoir and quite tedious at points, as it wandered away from the subject of the diagnosis art. She entered the "tracking" and cognition skill testing too. Which I worked within for a few years, so I should have found it extremely interesting. But it seemed long-winded side explanations in the way she gets "around" the "invisible gorilla" test, for instance. Her writing became tedious, not exciting- as it could have been for such a subject. NOT seeing something that is quite there.

There was a small omission too, I think. I wanted to hear more about how doctors listen as much as what they inquire about "the story". She flirted with that about 3 times but never really delved into selective hearing as she did the "seeing".

She's probably an excellent doctor. Her memory and ability to sense emotive affect and side bars seem superior. ...more

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May 08, 2019 Diana rated it really liked it

Shelves: first-read, non-fiction-read, read-in-2019

In this book, Lisa Sanders who originally wrote a column for the New York Times Magazine looks into why it can be so difficult to diagnose what is wrong with a patient. She also looks into why a doctor can get it wrong. As someone who had to deal with a lot of nope it's not that let's do some more tests, I thought the book was fascinating. I couldn't believe how many times a diagnosis was found because someone asked a colleague to look at a chart. It was an unusual subject and I really loved get ...more

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Aug 24, 2019 Mary rated it really liked it

Shelves: science

Dr. Sanders book highlights how physicians spend less time on initial examinations of patients and rely on test results. Examples of clues missed because of the decline of the hands on approach go on to explore the complex and difficult world of a medical diagnosis and treatment.

Interesting reading discussing the role for computers in diagnosing disease and the generally successfully tactic of calling a knowledgeable colleague to help find the answer. Lots of medical mysteries for those of you ...more

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Jan 11, 2019 Patricia rated it it was amazing

I have avidly followed the author's columns about diagnosing tough medical cases in the New York Times Magazine for years, but I just recently became aware that she wrote a book that was published in 2009. I found it fascinating! It reminded me of the humanity of doctors. I am grateful to live in a time where it is possible to find so much medical information online (with the caveat of looking at reputable and peer reviewed sources, of course). That said, I believe the doctor has a vital role in ...more

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Aug 24, 2019 Tukunjil Nayeera rated it it was amazing

Shelves: american-lit, authoress, nonfiction

“A lot of the appeal of internal medicine is Sherlockian—solving the case from the clues. We are detectives; we revel in the process of figuring it all out. It’s what doctors most love to do.”

This book is a piece of Art and I can't get enough of it! ...more

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Jan 22, 2012 Becca rated it really liked it

Shelves: 2011-2012

Oh my god this book was AMAZING. I am so grateful that Amy let me read this book. It might seem boring because it's a medical book but honestly it's not. This book is a bunch of stories about diagnosising people and how one tiny detail the others. One of the most memorable story that I read was about a girl who constantly smoked weed (marijuana) and got nausea from it. When the doctors found out it was the weed that made her feel this way they told the patient. To my surprise she got angry at th ...more

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Aug 22, 2009 Deb (Readerbuzz) Nance rated it really liked it · review of another edition

Shelves: healing, health

I like some odd genres: Books about Books...Books about People Who Move and Start Over...Books about Cooking...and the genre this book falls into, Books about Doctors.

Don't ask me why.

Books like this one fascinate me. I'm struck by the way doctors work on people's bodies using a clever combination of science and intuition.

This is a particularly intriguing book to me as it deals with the art of diagnosis, using scientific knowledge along with experience and hunches, to figure out why things aren ...more

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Aug 19, 2012 Jellie Dawn rated it it was amazing

Shelves: books-read-in-2013, humor, fiction, science, informative, life, medicine

From the writer of the series House M.D, Dr. Lisa Sanders. Great read. Recommended for doctors and med students!

----
Update: August 7,2013

I got what I wanted and more. This book doesn't only give information but wisdom and inspiration for every medical student who wants to forge a refreshing and exciting path for himself/herself in the medical arena. Truly a book for all (and not just medical students). ...more

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Apr 10, 2019 Samantha N. rated it it was amazing

Shelves: sophomore-year-reading-challenge

I was drawn to this book not only because of its genre but also because of its title. For the past 3 years, I’ve been extremely interested in anything and everything medicine related, especially the medical mysteries, the gray areas that no one has been able to figure out yet. This title caught my eye when I was browsing through a list of the best books written about medicine online. Every patient’s experience with a disease, illness, or syndrome is different. In a hospital with big ugly white w I was drawn to this book not only because of its genre but also because of its title. For the past 3 years, I’ve been extremely interested in anything and everything medicine related, especially the medical mysteries, the gray areas that no one has been able to figure out yet. This title caught my eye when I was browsing through a list of the best books written about medicine online. Every patient’s experience with a disease, illness, or syndrome is different. In a hospital with big ugly white walls, it’s easy to forget that you are a person rather than a diagnosis. That you are a person rather than a number on a clipboard. But every patient tells a story.

Throughout this book, Lisa Sanders describes many different medical mystery cases and the components that made them so difficult to solve. Lack of knowledge. Misdiagnosis. Overlooking a major clue. Medication. Red Herrings. Though doctors in the 21st century are assumed to have the answers to almost everything, that’s not always the case. Mistakes are made every day. Deadly mistakes. Sanders discusses why and how the major clues in these cases were overlooked: doctors aren’t taught how identify different heart sounds correctly anymore, doctors rely on technology instead of doing physical exams, doctors don’t listen to the full story before coming to a conclusion. Lastly, Sanders talks about what it’s like to make a wrong call that affects a patient’s life, the stubbornness of the medical society to make changes, and her own personal familial experience of searching for answers she will never be able to know for sure.

The reason that I liked this book so much was because it was honest. Sanders laid out the facts proving how much growing the medical community needs to do even though she’s a member of it. As a person who has seen my fair share of doctors, it felt almost nice to see the things I was noticing written on paper by a medical professional. For example, Sanders, in one chapter, explained how crucial a patient’s story is to making a diagnosis. When the pain started. How it happened. What it feels like. Where it is. But, she writes, “In one study doctors listened for an average of sixteen seconds before breaking in— some interrupting the patient after only three seconds.” As a doctor, having experience and vast knowledge on different ailments has its pros and cons. In most instances, before a patient can finish (or start) telling them what brought them to the office that day, they already “know” what’s going on. They already “know” what the rest of the patient’s story looks like. Without even hearing it. However, it’s this attitude that can cause doctors to make the wrong diagnosis in many instances. Some can be deadly.

I really loved this book. I could agree and connect with most of the material that Sanders presented me with. However, there was one scenario she wrote about that made me a bit, for a lack of a better word, furious. Sanders explained how unfortunate and detrimental it is that the physical exam is “dead.” Because of new technology, such as MRIs and CT scans, doctors don’t use their hands to exam areas of pain as much anymore. I, myself, have been affected in a negative way by this fact, and it’s aggravating. In short, it took a doctor over a year to press on my abdomen and find the tangled nerve that was causing me so much pain. But by the time the acute finding was remedied, the pain was chronic because I was misdiagnosed for so long. If I had gotten a correct physical exam before that appointment, when things first started, my life would be very different. Anyways, Sanders goes on to talk about Dr. Jeff Sedlack, who is a doctor that teachers general surgery residents. Dr. Sedlack got so tired of complaining about trainees taking patients with abdominal pain straight to the CT scanner and skipping the physical exam that he set up a competition to bribe them into doing these exams. Each resident would get one point for examining a patient suspected of appendicitis if they did it before they got a CT scan. Residents who didn’t would be disqualified. The resident with the most points got a prize. The competition was such a success that the hospital continued with it. I don’t understand this at all. Someone is in a life or death situation, and you won’t do a physical exam to save their life rather than wait to get a CT scan, but you’ll do it for a point? I have no words.
...more

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Jan 20, 2019 Wenqi rated it liked it

To start off with, I love medicine but I don't love this book.

This book was recommended by a professor of mine who's doing her research on clinical reasoning. Needless to say, I dived into this book in the excitement that I would be able to enhance my clinical reasoning skill.

Instead, the further I read, the more I felt repulsed by the book. This is not the medicine I knew of. Day in day out, medical students are taught to take a thorough history and perform our physical examination properly. We ...more

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Jul 21, 2018 Karnish Thakkar rated it it was ok

☯️
Good things :

-Acknowledgment of amazing internist Faith Fitzgerald,Dr.Joseph bell the real inspiration of Sherlock holmes for arther conan doyle(so technically house m.d. medical series was inspired by Sherlock detective series which was inspired by dr bell medical man),Giovanni Battista the anatomy guy,rené theophylline hyacinth laennec the stetho guy.
-evolution of the definition of disease (symptoms~organ dysfunction ~&then add objective observations )
-importance of autopsy & physical exam
- ...more

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Oct 07, 2020 M. Nicole Lane rated it liked it · review of another edition

Equal parts satisfying and disturbing.

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Nov 03, 2009 Amy rated it really liked it

Shelves: i-heard-about-it-on-npr, met-or-know-the-author, made-me-look-something-up, taught-me-something, home-library, nonfiction

A while back, I heard that a Dr Lisa Sanders was the medical consultant for one of my favorite TV shows, House. The name rang a bell because it was the same as one of my best friends from high school -- only the last I'd heard, she was a producer at CBS. Through the miracle of FaceBook, after several decades we reconnected. My Lisa had indeed had a career change and now was a physician. Twists and turns of fate had led her to write a medical column for the New York Times, which in turn led to th A while back, I heard that a Dr Lisa Sanders was the medical consultant for one of my favorite TV shows, House. The name rang a bell because it was the same as one of my best friends from high school -- only the last I'd heard, she was a producer at CBS. Through the miracle of FaceBook, after several decades we reconnected. My Lisa had indeed had a career change and now was a physician. Twists and turns of fate had led her to write a medical column for the New York Times, which in turn led to the offer to be the consultant for a new show about a narcissistic, curmudgeonly, drug addicted, brilliant physician. As she tells the story, she figured she'd say yes, because the show surely wouldn't be around too long. I think this year is season 6. The show is a huge hit, due in large part to the talents of Hugh Laurie (one of my all-time favorite actors), who plays the unconventional Gregory House. Lisa came to town on her book tour and we spent a lovely day together. When she left, I had two great things: a reconnection with an old friend and a signed copy of Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis.

The Medical Mystery bits were definitely my favorites. I am a nurse, and have seen far too much in my 29 years of practice to be surprised by anything that happens in health care. Lisa's investigation of diagnoses, where we came from, where we are and where we are heading was interesting, but I guess I'm a gossip at heart and wanted to get to the "juicy" bits: the case studies and how the mysteries were solved. All in all, the book was quite readable and informative (though I kept hearing her voice in my head as I read.) I wonder how it would be for someone non-medical, or for someone who is rather jaded on our current health care system. Lisa definitely conveys the angst of being suddenly and dramatically ill for the patient, and the problems faced and battled by physicians seeking to help them.

I do love that Lisa has met Hugh Laurie and pronounced him a terrific person. She gave him a copy of the book to read, and then gushed, "And he actually read it!" I love his blurb on the front cover:
“If you need to be reminded that there are still diseases that can’t be cured in an hour—including commercial breaks—then this book is for you. Fantastic stuff.” ...more

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Mar 10, 2018 Richard rated it really liked it

This book may not be what you expect it to be. As you can see by the other reviews, many readers were disappointed because it did not meet their exceptions. Perhaps it needs a different title such as "Putting Human Contact Back into Medical Practice" or "Doctors and Patients are not Machines".

I love reading the "Vital Signs" section of Discover magazine and find the cases in the TV show "House" (Sanders is the medical consultant) fascinating. However, this book is not a simple case by case study ...more

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Nov 26, 2014 Risa rated it it was ok

As a medical scientist, and someone just generally into medical anything, this book seemed like an obvious choice. The "Every Patient Tells a Story" sounds like House, MD in a book format. SIGN ME UP! Unfortunately, uh, there are hardly any patient stories. This is one long book on the benefits of the physical exam. Sure the author throw us a bone here and there, in the form of a very brief patient case, then followed by yet another 50 pages about the physical exam and 10 more pages full of stat ...more

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Apr 08, 2018 Nima Morgan rated it it was amazing

A very fascinating read, great for the layman and the medical community.

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Mar 19, 2020 Rebecca rated it liked it

Recommended to Rebecca by: Book Group NJ- Janessa Brunt

I'm giving this book 3 1/2 stars. I loved the insights into how doctors need to connect all different dots, or put puzzle pieces together to solve the mystery of a diagnosis. (It got a little repetitive for me in the second half of the book.) But all in all, great insights!!

p.6- If she was going to figure it (the diagnosis) out, it would be because she'd find a clue that others (other doctors) had overlooked. The patient's story is often the best place to find that clue! It is our oldest diagnos ...more

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Apr 27, 2020 ahmad afridi rated it liked it

Shelves: medicine-surgery, non-fiction, education

This topic is very interesting, the art of diagnosis is the very type of detective work, where a physician is a detective and his area of investigation is patients' body and the stories they tell you. the physician has a map of the human body in his mind, knows how different organs work, and how are they linked with each other, how a rich interplay of different molecules constitutes a living human, how disorders in any of its components manifest itself via signs and symptoms. The physician then

...more

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Aug 26, 2019 Kiwi Carlisle rated it liked it

Shelves: 2019

I wanted to read this book because I had occasionally read and enjoyed Dr. Sanders’ columns in the New York Times Magazine. On starting it, I was pleased to see her heavy emphasis on the importance of the physical exam to the art and science of diagnosis.

I’ve been a standardized patient for about 15 years in a program that teaches physical examination and history taking to medical students. Thus, I was quite startled by Dr. Sanders’ assertion that these skills aren’t being taught anymore. ORLY, ...more

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Jun 19, 2017 Evalina rated it it was amazing

Shelves: non-fiction, need-to-add-to-my-library, medical

Sanders has a very clear and interesting tone to her writings. As she takes you through the diagnosis' that have perplexed doctors, she is able to write in such a way that causes the reader to experience the mental processes that go on in the mind of a doctor. This was an exciting and interesting read for me. I look forward to reading her other works. ...more

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Mar 29, 2017 Allie rated it really liked it

Thought provoking and from a physician's perspective. This book has aspects of it that help encourage patients to ask more questions and look for answers with their provider. We need more books that inspire patients to probe further than the initial diagnosis. ...more

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Jul 24, 2017 Marilyn F rated it liked it

Maybe a little over 3, but would have liked more of the solving of the medical mysteries and not quite so much waxing on what is right/wrong with the medical profession and its practice in the U.S.

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Jul 26, 2017 Mbgirl rated it liked it

Shelves: medicine

Stick to medicine, Dr Sanders!! Be an excellent diagnostician and don't forget the priceless skill of a proper fiZ exam ...more

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About Lisa Sanders

Lisa Sanders

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Lisa Sanders, M.D., is an internist on the faculty of the Yale University School of Medicine. She writes the monthly column Diagnosis for The New York Times Magazine, is the author of Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis, and served as a technical advisor on Fox TV's House, M.D. She lives in New Haven, Connecticut. ...more

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“..I don't count Jennifer among my mistakes. She had a severe infection and precious little reserve. Nevertheless, I think of her often. Those minutes of terror and confusion I felt standing powerless in her room served as a visceral reminder throughout my training... that the big picture isn't enough in medicine...” — 2 likes

“The basic sciences of anatomy, physiology, biology, and chemistry are linked to a patient at the bedside through very specific stories that doctors learn and eventually create. These stories, what researchers now call illness scripts, contain key characteristics of a disease to form an iconic version, an idealized model of that particular disease. … It is the story that every doctor puts together for herself with the knowledge she gains from books and patients. The more experience a doctor has with any of these illnesses, the richer and more detailed the illness script she has of the disease becomes.” — 1 likes

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