Neurologists aren't very nice to each other and to other doctors consulting on a case. There is a lot of ego jousting. The author of this book tries hard to be humble, but it's evident that he has high regard for himself and his abilities and unique diagnoses. Down the Rabbit Hole" ( Once Upon a Time in Wonderland), the first episode of Once Upon a Time in Wonderland Allan Ropper's new memoir, Reaching Down the Rabbit Hole, has the hard-boiled style of a Raymond Chandler novel. Like a real-life Dr House, Ropper follows hunches and has sudden startling insights. * The Times * All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher. Yet this unreliability is itself a window into another reality, the distorted Alice in Wonderland world to which the title refers and in which neurological patients are wont to find themselves tormentingly trapped.

No," I said. "It's the recurrence of many, many small strokes over time. That's what's different. You have to think about what could cause this. There must be a cardiac source for the emboli. Do the echo over. It was wrong. If it doesn't show something abnormal on one of her heart valves or in one of the chambers, I'll eat my hat." Arwen Cleary had been a professional figure skater as a teenager, had retired from the Ice Capades upon its dissolution in 1995, had then raised three children, gotten divorced, and moved with her two younger children to a ranch house in Leominster, a distant suburb, where she worked part-time at a local health club. Her medical history was unremarkable: once a smoker, she had quit ten years earlier. Her travels had taken her no place more exotic than Bermuda and no more distant than Orlando. Her only hospitalizations to that point had been in maternity wards. She was remarkably fit and in seemingly good cardiovascular health, if judged only by her appearance and vital signs. But shortly after a visit to a chiropractor, she had suffered a vertebral artery dissection, a form of stroke. Reaching Down the Rabbit Hole, by Dr Allan Ropper and BD Burrell, is very much in the latter tradition. Ropper is a distinguished neurologist at Harvard Medical School. He has many fascinating tales to tell, but he doesn’t. Burrell does. Or at least Burrell is the prose man, turning Ropper’s professional stories into tight little homilies of neurological and existential meaning. I liked Dr Ropper, he came across nicely and informally, but his ego can get a bit wearisome after a while. I am trying not to hold the whole ego thing against him, after all he is a neurologist and fair enough he does an amazing job that very few people can or would choose to do. She's the lady with the hydrocephalus." In other words, she has too much water in the cavities of her brain, a serious problem.

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Reading this is like being a fly on the wall in a neurology ward. There are some real characters, and some real highs and lows. It’s in part an eye opening education and part like watching a car crash. Told in a breezy style through a series of real-life case studies, Ropper's book offers a fascinating glimpse of the ways in which our brain can go wrong. * Financial Times * When all his colleagues think a patient is suffering from a brain tumour or a stroke, Ropper knows that it’s herpes encephalitis. He doesn’t need to look at scans. He can tell from a bedside exam.

Reaching Down the Rabbit Hole A Renowned Neurologist Explains the Mystery and Drama of Brain Disease Is she salivating like she has rabies?" That was my first question, and would turn out to be my only one. My experience told me that Arwen Cleary's echocardiogram had missed something, not just once, but twice. I turned to Hannah after we had left the room, and asked her this crucial question: "Can you put your finger on what's different in this case?" She replied that it was the angiogram, which showed the alarming number of constricted blood vessels and cutoffs in the cerebral arteries.What are you watching?" Hannah asked Vincent, in an inflection she would later inform me was Kansan rather than Missourian. You have to." She spoke with an unnatural monotone, somewhat like a deaf person, without accenting any of her words. That was the aphasia. She struggled with all but the simplest responses, and settled for tropes. My takeaways from the book. 1) Neurological illness is highly specific to the person who has it, and requires long inquiry into the patient's self-reported symptoms. It is easy to miss the correct diagnosis, because presenting symptoms vary from purely physical to psychiatric. It takes years of careful listening to effectively diagnose each case. Two hours later, when she was wheeled into the ICU, Cindy looked toxically ill, with a heart rate of 135 beats per minute and blood pressure of 160/90. She was sweating, salivating, and shivering wildly. Her eyes were wide open but she was by now entirely unresponsive. Her jittery limbs seemed as if they wanted to convulse. Joelle, the senior ICU resident, Hannah's counterpart down on the ninth floor, immediately intubated her.

Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article) I could see that over the course of the previous week, Hannah had begun the transition from resident to full-fledged physician. I could see it in her bearing, in the assertive physicality with which she carried out her examinations, in the firmness of her tone with some of the more difficult patients, and in the controlled sympathy she adopted in family meetings when she had to deliver bad news. She had turned out to be one of our strongest clinicians. I wish I was smart enough to become a doctor because I think their work is so interesting particularly neurology. Dr. Ropper, Reaching Down The Rabbit Hole makes this point with his tales of the variety of illnesses, accidents, and medical conditions neurologists treat. He calls neurology the Queen of medicine because of its diversity. This book never engaged me entirely. It was supposed to be anecdotal--stories about neurology. I found the stories too brief, but that was largely because the author never had a chance to follow up on long-term outcomes. Once he had solved the problem, the patient either died or went home. PDF / EPUB File Name: Reaching_Down_the_Rabbit_Hole_-_Allan_Ropper.pdf, Reaching_Down_the_Rabbit_Hole_-_Allan_Ropper.epubBook Genre: Autobiography, Biology, Health, Medical, Medicine, Memoir, Mental Health, Neuroscience, Nonfiction, Psychology, Science Filled with patient histories and puzzling symptoms waiting to be understood, Reaching Down the Rabbit Hole is a detective novel, and despite his flapping white coat and squeaking Crocs, Ropper is Humphrey Bogart, cerebral yet tough and blessed with a terse wit. -- Christian Donlan * New Statesman * Reaching Down the Rabbit Hole does not particularly try to be funny, yet its commentary on how events happen to arrange themselves has a comic sensibility. Ropper's mirthless exchange of one-liner jokes with a hospital visitor who turns out to be a former comedy writer establishes a fellowship between the men and helps us understand the origins of this show business take on clinical neurology. Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting. But where ultimately do these journeys lead? What lies at the other end of the rabbit hole except the uncomfortable knowledge that who we are and all that we hold certain is precariously contingent?

Stroke offers the most precise and restricted indicator of damage to the brain that nature produces, and therefore allows an understanding of brain function like no other disease. It is highly "readable," and reading strokes reveals a tremendous amount about the nervous system. One of my professors used to say that the residents learn neurology stroke by stroke. But it is not a simple thing.Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.