Marion: Genetic Rounds

From Scienticity

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Robert Marion, Genetic Rounds : A Doctor’s Encounters in the Field that has Revolutionized Medicine. New York : Kaplan Pub., 2009; 304 pages.

• New to me author? Yes
• Read this author again? Yes
• Tearjerker? A little misty eyed with some stories
• Where did it take place? US
• FTC Disclosure: Borrowed from the library

Summary

Although he's often uncomfortable about it, as a clinical geneticist, Marion (The Intern Blues) examines his patients' genetic secrets—-information they sometimes don't reveal even to close relatives—-in order to help them make family planning decisions. His ability to solve medical mysteries can be a blessing: after a mother is accused of child abuse, Marion is able to use genetic analysis to diagnose brittle bone disease in the baby and to help return the infant to her mother. But his diagnostic skills become a curse when he tells his former college roommate that his toddler isn't just a slow starter but likely has Bardet-Biedl syndrome: the enraged friend never speaks to Marion again. In a headline-making case, he tries to explain why a pair of twins joined at the head lack speech. Although his short pieces lack the depth and finesse of essays by other physician-writers like Oliver Sachs, and Marion's case studies would frighten even the steeliest of would-be parents, Marion, director of clinical genetics at Montefiore Medical Center and Blythedale Children's Hospital in New York State, is a sympathetic advocate for his patients who lucidly interprets complex medical conditions for lay readers.

First Sentence

One role of medical geneticists is to serve as patient advocates.

Why did I pick this book?

Saw it on the library's new book list online. Decided to reserve it because I am interested in medical related books (as long as it's not too scientific or written with a lot of technical terms/jargon). I had wanted to major in genetics when I was in college (bio-chemistry hated me) so I was particularly interested in a book about medical genetics.

My thoughts

• I really enjoyed this book - it was a fast read and he'd explain the medical terms/conditions in layperson terms so it was easy to understand
• Each chapter was about a patient's stories (mostly pediatric patients) and some were quite touching. There were usually some ethical dilemma involved as well which really made you think what you'd do if you were in the doctor's position? Or if you were the parents? Or if you were the patient?
• I guess since I like forensic science (TV shows like "CSI", "Bones", etc), I enjoyed that this field was trying to solve a puzzle (see quote below for a description of geneticist). Before reading this book, I have some idea what geneticists do, but this book really opened my eye about the role they play in medicine
• Some stories could have been told better if he didn't give away the ending first before explaining what actually happened, as it took the suspense away -- but I suppose he wasn't writing a thriller/suspense novel....
• I couldn't quite decide if I wanted to give this a 4 or 4.5 stars (4.25 would've been perfect!) - since I'm quite harsh with my rating (5 stars are hard to come by!) I think I'll leave it as a 4 stars for now. If I were going into this career field, I'd give it a 4.5 as I'd probably keep it as a reference book
• A note of caution though -- if you are pregnant or have young kids, you may not enjoy the book as much as I did (we don't have any kids) -- you know, it's like you think you have all the symptoms when you read about different diseases online or watch some medical shows? There is no "graphic" description in the book but sometimes reality is more terrifying... it's definitely educational. Just thought I'd mention it -- because I know sometimes when I read books (fictional or non-fiction), they effect me differently than those who have kids, since I can't quite put myself into the parents' position so those books don't affect me as much

Quotations

What do clinical geneticists do?

Often called on to solve mysteries, we play the role of medical detective, noticing subtle symptoms and signs and assembling them into a cohesive diagnosis. One of the heroes of modern clinical geneticists is Sherlock Holmes, Sir Arthur Conan Doyle's amazing detective. It was in Doyle's story "A Case of Identity" that Holmes says, "It is my business to know things. Perhaps I have taught myself to see what others overlook." This is exactly the mantra of the clinical geneticist. [p27]

Insights into doctor/patient relationship

In practicing medicine (and clinical genetics in particular), providing for the emotional needs of the family both at the time of the initial encounter and then on an ongoing basis, can be as important (if not more important) than the provision of physical care. This may be the biggest epiphany I've experienced during the years I've been in practice. [p70]

It's as if I really have two patients: the child with the disease and his or her family. My role in looking after the child is usually fairly straight-forward; my role with the other patient, however is less so. [p137]

A 4 year old patient's story

She (4 year old daughter) handed it (her milk bottle) to me and said, "Here, Mommy. For you." "What's this for?" I asked her. "You crying, Mommy,' she replied, and in her own way, using a few words she had, she let me know that when she'd been little and cried, I always gave her a bottle of milk and that made her feel better. Because I was crying, she figured that giving me a bottle would make me feel better." [p146]

-- Notes by CMF