The Deadly Dinner Party & Other Medical Detective Stories

Nursing Book Club

The Deadly Dinner Party & Other Medical Detective Stories

Botulism on the menu

By Jonathan A. Edlow, M.D., FACP (Yale University Press, 2009)
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Reviewed By Christine Contillo, RN, BSN

I’ve been to some deadly dull dinner parties, but none which were actually fatal. In his second book, The Deadly Dinner Party, Jonathan Edlow, M.D., FACP, associate professor of medicine at Harvard Medical School and vice-chairman of emergency medicine at Beth Israel Deaconess Medical Center, recounts a dinner party in 1989 where guests contracted a rare, debilitating, often fatal disease: Botulism.

The incident began one Sunday evening when Steve Gelson hosted a potluck dinner for his neighbors to help use up leftovers from a party he’d held the night before. By Tuesday, Gelson and his guests knew that something was very wrong and a medical mystery began to unfold.

Every nurse is a bit of a detective, trying to figure out what’s important to report about what the patient is telling her or how to interpret the symptoms she sees before her eyes. Diagnosis presents a similar challenge — you have to consider all the possibilities and put the clues together to deduce the right answer.

The same is true of cases like the Gelson dinner party. Did everyone who got sick eat the same thing? Were Gelson’s leftovers to blame or was it something else? Did the illness start at the same time for everyone concerned? Was there a cluster of patients with the same symptoms? Those were the questions the epidemiologist had to answer in order to discover the cause before it spread further and before treatment could begin.

Back in 1951, the late Alexander Langmuir, M.D., MPH, created a public health epidemiology service through the CDC to do what he called “shoe leather epidemiology.” When a local health department is overwhelmed by the severity of an incident or sheer number of people involved, the CDC can bring in additional resources for interviewing, data collection or analysis.

Author Edlow has been studying such cases for a number of years and has written about them for mainstream magazines such as Boston Magazine and Ladies’ Home Journal. His style is straightforward and folksy and he includes lots of information that helps the reader interpret what Edlow is describing. For example, he explains what botulism toxin is, what causes it, how it effects the neurological system and why it produces the symptoms it does.

The book provides a wealth of interesting examples of human-pathogen interaction; illnesses introduced by the environment (and Edlow reminds us that we have both an exterior and interior environment); and such strange and fascinating diseases as pseudotumor cerebri, which, frighteningly, mimics a brain tumor.

If you like a good mystery and appreciate good journalism, I think you will enjoy this book as much as I did. Each case reads like a short story and Edlow even tips his hat to literature, playfully naming some of the chapters after well-known books you might recall.     

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.

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