The Medical Detectives: Essays on the Strange and Unusual

Nursing Book Club

The Medical Detectives: Essays on the Strange and Unusual

Essays on the strange and unusual

By Berton Roueché
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Reviewed By Christine Contillo, RN, BSN

Long before the current crop of physicians was writing about their patients with unusual diseases and making all of us nervous about symptoms we imagined we felt, Berton Roueche was writing essays about unusual medical conditions. In fact, “Eleven Blue Men” was required for an epidemiology course I took at Cornell University years ago and became the defining moment that years later propelled me into a career in public health nursing. There my favorite professional responsibility was always investigating the reportable diseases and trying to find an index case.

The Medical Detectives, nursing, book clubThe Medical Detectives is a selection of Mr. Roueche’s best writing, first released in 1991 and still being reprinted. This book is available in both hard and soft cover through Amazon and at Barnes & Noble. One common thread running through each story is the attention to detail that ultimately enables the practitioner to best the bacterial invader. In many cases the germ is hiding in plain site, waiting for the investigator to put his thinking cap on and to review all the details one more time. Just this week I heard my own doctor say, “What are we missing here?” and I wished that Mr. Roueche could have been in the room with us.

“Eleven Blue Men,” the very first selection, is the tale of 11 very sick men, their color sky-blue, who show up in New York City hospitals in 1944. Think about how fast that information would now be shared among ERs and health departments thanks to current technology, and how slow the process must have been then.

Today Google shows flu trends weeks before the government releases them merely by hits on webpages of people searching for flu symptoms. Even pharmacies can gauge the local flu morbidity by how fast cold remedies are flying off the shelves. In 1944, this would have been a slow, methodical process with the potential of many more sky-blue men before the puzzle was solved. The fact that the illness was limited to 11 shows the devotion of those in the field.

While some of the essays may have been written over a quarter of a century ago, the topics are still current. I frequently advise travel patients to refrain from swimming in fresh water in Africa. Maybe I’d be better off handing them a copy of one selection — “A Swim in the Nile” — and letting them decide for themselves whether risking schistosomiasis is worth a little cooling off.

“All I Could Do Was Stand in the Woods” is about idiopathic hypogeusia. Before finding that explanation, Rudy Coniglio’s doctor thought he was just plain crazy. I knew Mr. Coniglio as one of my public health patients years later, and he often told me he’d been studied by the NIH. I not only thought he was crazy, I was convinced he was making up the story, until I saw it in print.

The doctors and lab technicians who solve these medical mysteries become heroes. Even those cases that only occur once in a lifetime are still enormously interesting to read about. If you’re a fan of  any of the current medical writers, you’ll enjoy this.   

Christine Contillo, RN, BSN, has worked as a nurse since 1979 and has written  for various nursing publications, as well as The New York Times.

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