Genetic Rounds: A Doctor’s Encounters in the Field that Revolutionized Medicine

Nursing Book Club

Genetic Rounds: A Doctor’s Encounters in the Field that Revolutionized Medicine

The ability to dissect the human genome allows us to identify mutations associated with specific diseases

By Robert Marion, M.D. (Kaplan Publishing, 2010)
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Reviewed By Christine Contillo, RN, BSN

Robert Marion, M.D. is my favorite sort of physician —one who realizes that the patient he sees sitting in front of him is usually part of a family. When you give that patient bad news, you are really speaking to a larger group, possibly changing all their lives in some way. In his book Genetic Rounds, Dr. Marion lets us see exactly what it feels like to share that intimate health information.

Robert Marion, M.D., graduated from medical school in 1975. In his own words, at that time genetics was “a course my classmates and I had to pass in order to do what we’d all really come to medical school to do, that is, to take care of patients.” In the 35 years since, the ability to dissect the human genome has radically changed the field.

Mutations in genes can be spotted and associated with specific diseases. Now predispositions to certain chronic illness can be predicted with the hope that lifestyle or environmental changes can make a difference, or that future treatments will be developed. The ethics of sharing this information has medical, financial and religious ramifications.

What was an “insignificant sub-specialty” of medicine decades ago may soon revolutionize medical care. The author believes that geneticists have much to offer medicine but are still underutilized.

Sharing Stories

Although he includes a brief instruction about the science of genetics, the book is not a dry medical treatise. Rather, Marion shares stories about his patients — 16 short essays — that give the reader a greater understanding of some very unusual conditions. Some, like amyotrophic lateral sclerosis, better known as Lou Gehrig’s Disease, appear later in life. Some, like trisomy 13 are immediately apparent in newborns and point to a progressively poor prognosis.

We meet doctors who can’t quite put their fingers on exactly what is wrong but now have the tools to search past routine bloodwork. We can almost feel the emotions of family adjusting to fatal illness and wonder how they can possibly cope. It’s unlikely that we will come across many of these patients ourselves; some conditions are so rare that a physician may see only a handful in a career. However, genetics, the Internet, search engines and social networking now allow these patients to find specialists to help them and groups with whom they may share their stories.

I thoroughly enjoyed reading Genetic Rounds because I felt that I could work with Dr. Marion in a clinical setting. He allows us to picture him in and out of a lab coat and admits to something I rarely hear doctors say — that sometimes he just doesn’t know how to respond. He tears up, he occasionally attends funerals to give comfort to parents. If I were getting bad news, and we’ve all sat in that seat, I’d want him or a physician like him to be the one telling me.  

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Christine Contillo, RN, BSN is a public health nurse who suggests joining a book club as a reason to put down trashy magazines and look smart on the subway.

This article is from workingnurse.com.

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