Friday, January 29, 2010

Book Review - Genetic Rounds: A Doctor's Encounters in the Field that Revolutionized Medicine by Robert Marion MD


Title: Genetic Rounds: A Doctor's Encounters in the Field that Revolutionized Medicine 
Author: Robert Marion MD
Year: 2009
Page: 304
Genre: Non-fiction - medical, memoir

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

Summary (from
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


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)

    Rating: 4 Stars

    You may also like these books I had read:

    Have you read this book? 
    If you have, I would love to hear what you think!
    I'll link your review here if you wish!

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    1. This sounds very interesting - I considered being a genetic counselor at one point in my life - I think I would like it. Thanks for the review!

    2. Where were you when I held my Medical reading challenge in 2007? I had like 3 people sign up and none of us even read our books. I LOVE medical books and I've added all four to my TBR list. Thanks SOOO much.

    3. I don't know if I'd read this book, but I do really want to read one of Atul Gawande's books.

      - Christy

    4. You have a very unique style for reviews, that is great. I'm a new follower also, thanks for coming over to mine.

      I work in the Medical Field as an Employee Relations Manager and let me tell you I hear enough of the real, good, bad and ugly to ever read a book on it.

      And reading books as a parent does give you a different view, thats a great point.

    5. @Booksnyc - I wanted to major in genetics in college until I almost failed biochemistry!! Changed my major after that which is too bad!

      @Callista - I didn't start reading medical memoir until late 2008 I think! I worked in healthcare so I have interest in it - I work with doctors a lot so want to read these books to give me some insights on how they think. I wasn't blogging back in 2007 :) I recommend this neurologist's blog - he has some funny and amusing patient stories!

      @norumbega4/christy - Atul's book was a good read - though if I remember correctly, it's probably the most difficult (for lack of better word) read out of the 4 books mentioned here - the other 3 are more 'memoir'/story like, whereas his books are more essay like if that makes sense? I'll probably read his other books at some point.

      @MarcJ - thanks! I just want my review to be simple and I don't have the skills to write in depth analysis :) I used to work as in HR but didn't have a lot of involvement with the doctors though. I made the point about reading some books as a parent may give a different perspective, because my friend (who has a young son) said she won't read certain type of books (sad books involving kids or teenagers) because she'd be too horrified. I guess I can distance myself in that sense.