Dr Nagami has been an infectious diseases specialist since the early 1970’s. This collection describes some of her most memorable cases – either because of the unique diagnostic and therapeutic challenges they presented, or because of how they affected her life. The chapter of AIDS is particularly interesting in this regard: Nagami was already working in the field when the first US cases began appearing in the literature, and she recounts both her intellectual, specialist interest in the evolving picture of the disease, its diagnosis, early impact, and current management, as well as the personal impact AIDS had on one of her closest friends, fellow doctor Henry.
This blend of the personal and the professional (Nagami often intersperses what she was doing with her children into the narrative of an individual patient’s disease and treatment progression) is a unique and – for me – irritating addition to the more standard genre style of, for example, the divine Atul Gawande. This is not to say that other medical writers do not include personal details, but in general these tend to be related to their development as a clinician. I was significantly less interested in the minutiae of Nagami’s day-to-day life than the cases, but my engagement with, and Nagami’s ability to individualise, the cases is a tribute to her empathy and her ability. Not all of the cases are medical triumphs, but the humanity of the patients, and Nagami’s engagement with them as such, was evident throughout. She is also able to describe complicate pathology and intervention in a way that is accessible to the lay reader, without boring the more informed one.
This was an interesting read so soon after Where the Germs Are – Nagami reports that she is the only member of her family to be free of obsessive-compulsive symptomology, and she describes the affect of her work, and her concern of bring the microbes at the heart of her work, home with her. In addition to the cases reports, Nagami’s take home message is clear – don’t obsess over every surface and bug, but take appropriate precautions: vaccinate yourself and your children, and know when to seek help. The chapter on the life-threatening effects of varicella (chicken pbox) on adults should have every non-immune reader running for a vaccination, and made me inordinately appreciative of those miserable two weeks of itchy hell I experienced at age six. - Alex
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