Not Well

How Doctors Think
Jerome Groopman
Houghton Mifflin, $26, 320 pp.

As the first waves of baby boomers hit their sixties, the inexorable upward march in the nation’s median age is inexorably expanding the role of doctors in most people’s lives. Medical interactions also become more angst ridden, as thickening case files become signposts on the road to death.

But doctors bring hope as well, for advances in medical technology now often permit graceful recoveries from diseases like heart attacks and cancers which, not so long ago, were usually fatal. For medicine to work its magic, however, a doctor must first correctly interpret a patient’s symptoms and identify the right course of action. It is that crucial diagnostic challenge that Jerome Groopman, a New Yorker essayist and holder of a chair in medicine at Harvard, fears doctors too frequently bungle.

How Doctors Think might more accurately have been titled How Doctors Don’t Think. In a series of elegantly written case reports, Groopman describes an array of common mental pitfalls that entrap even the finest doctors. There is “framing,” for example. For fifteen years, a woman was described as suffering from “bulimia and anorexia nervosa,” until a gifted doctor ignored her case file and discovered that the real problem was a genetic immune reaction to wheat gluten.

Then there is “anchoring”-finding something that fits and sticking with it. A Native American woman is diagnosed with viral pneumonia. The disease is...

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About the Author

Charles R. Morris, a Commonweal columnist, is the author of The Two Trillion Dollar Meltdown (Public Affairs), among other books, and is a fellow at the Century Foundation.