What do you think?
Rate this book
Reaching Down the Rabbit Hole: A Renowned Neurologist Explains the Mystery and Drama of Brain Disease
"Tell the doctor where it hurts." It sounds simple enough, unless the problem affects the very organ that produces awareness and generates speech. What is it like to try to heal the body when the mind is under attack? In this book, Dr. Allan Ropper and Brian Burrell take the reader behind the scenes at Harvard Medical School's neurology unit to show how a seasoned diagnostician faces down bizarre, life-altering afflictions. Like Alice in Wonderland, Dr. Ropper inhabits a world where absurdities abound:
• A figure skater whose body has become a ticking time-bomb
• A salesman who drives around and around a traffic rotary, unable to get off
• A college quarterback who can't stop calling the same play
• A child molester who, after falling on the ice, is left with a brain that is very much dead inside a body that is very much alive
• A mother of two young girls, diagnosed with ALS, who has to decide whether a life locked inside her own head is worth living
How does one begin to treat such cases, to counsel people whose lives may be changed forever? How does one train the next generation of clinicians to deal with the moral and medical aspects of brain disease? Dr. Ropper and his colleague answer these questions by taking the reader into a rarified world where lives and minds hang in the balance.
• A figure skater whose body has become a ticking time-bomb
• A salesman who drives around and around a traffic rotary, unable to get off
• A college quarterback who can't stop calling the same play
• A child molester who, after falling on the ice, is left with a brain that is very much dead inside a body that is very much alive
• A mother of two young girls, diagnosed with ALS, who has to decide whether a life locked inside her own head is worth living
How does one begin to treat such cases, to counsel people whose lives may be changed forever? How does one train the next generation of clinicians to deal with the moral and medical aspects of brain disease? Dr. Ropper and his colleague answer these questions by taking the reader into a rarified world where lives and minds hang in the balance.
272 pages, Hardcover
First published September 30, 2014
Ratings & Reviews
Friends & Following
Create a free account to discover what your friends think of this book!
Community Reviews
Displaying 1 - 30 of 449 reviews
April 7, 2023
I have a great interest in neurology, psychoneurology especially. I really liked Oliver Sacks, except when he concentrated on himself. I also like Harold Klawans who tells neurological stories with lots of 'ah-ha' moments. Compared to those two authors, it seems to me that Allan Ropper is just too delighted with himself. The book is patronising in tone and very self-congratulatory. I mean, he's just such a genius and has to let us know it. I know it is an American thing to not be shy about one's own accomplishments and a British thing, to be self-deprecating at all times even though it's quite fake, but nonetheless I didn't enjoy the tone of the book.
Apropos of nothing really, but this reminds me of British game shows. It is very alien to the British to applaud oneself or one's accomplishments, whereas Americans jump up and down and shout out how proud they are of themselves, this makes British people cringe. However, it makes much more exciting television, so the producers now have got the British to run around arms in the air shouting out and generally looking awkard and embarrassed. Everyone feels the same inside, it's just a difference in expression and probably the one people prefer is the one of the culture they were brought up in.
Some of the stories are quite good. Especially of the girl who was displaying all the symptoms of psychosis and needed locking up but was cured within a few hours of having a teratoma (tumour with bits of hair, brain, bone all kind of inappropriate things) removed along with the ovary it was growing on. The symptom that clinched the diagnosis? She was frothing at the mouth, like a rabid dog.
Something I learned from the book. That what a patient reports are symptoms and they are all subjective, things we feel, and have to be taken at face value. But what a doctor sees are signs, and they are objective. I'd never thought of it that way. Put the two together and you are on your way to a diagnosis.
I've rounded up the book from a very precise 2.75 to a 3 because it wasn't a bad read, just not a very good one.
Original review 1 Feb 2015. Rewritten April 2023 because I think I was a bit free with the punches and my view of the book and author has mellowed somewhat with time.
Apropos of nothing really, but this reminds me of British game shows. It is very alien to the British to applaud oneself or one's accomplishments, whereas Americans jump up and down and shout out how proud they are of themselves, this makes British people cringe. However, it makes much more exciting television, so the producers now have got the British to run around arms in the air shouting out and generally looking awkard and embarrassed. Everyone feels the same inside, it's just a difference in expression and probably the one people prefer is the one of the culture they were brought up in.
Some of the stories are quite good. Especially of the girl who was displaying all the symptoms of psychosis and needed locking up but was cured within a few hours of having a teratoma (tumour with bits of hair, brain, bone all kind of inappropriate things) removed along with the ovary it was growing on. The symptom that clinched the diagnosis? She was frothing at the mouth, like a rabid dog.
Something I learned from the book. That what a patient reports are symptoms and they are all subjective, things we feel, and have to be taken at face value. But what a doctor sees are signs, and they are objective. I'd never thought of it that way. Put the two together and you are on your way to a diagnosis.
I've rounded up the book from a very precise 2.75 to a 3 because it wasn't a bad read, just not a very good one.
Original review 1 Feb 2015. Rewritten April 2023 because I think I was a bit free with the punches and my view of the book and author has mellowed somewhat with time.
February 10, 2015
As a retired neurologist, I really wanted to like this book, but I found it very disappointing. I have tremendous respect for Dr. Ropper. Principles of Neurology, the textbook of neurology that he currently edits, is still my favorite introduction to general neurology. I have heard him speak several times and always found him to be an eloquent and thoughtful speaker. This book seemed to have been written by someone else and perhaps it was. Most disturbing was the dismissive and patronizing attitude towards patients with conversion disorder and other psychogenic causes of neurologic-like syndromes. I have always tried to teach my residents and students that these patients are perhaps the most challenging patients we see because they not infrequently also have a real neurological problem hidden amongst the psychiatric noise, and missing this can be catastrophic and even fatal. I will never forget a patient who died of "pseudoseizures." She had been sent to the hospital for an EEG but started having continuous seizures before reaching the EEG lab. Her attending neurologist insisted these were pseudoseizures and did not need to be treated. By the time it was recognized that she was truly in status epilepticus (continued or repetitive seizures) her brain had been permanently injured and she died. It turned out that she had unrecognized porphyria, a metabolic disorder that can cause psychiatric problems as well as neurological problems including seizures. At the very least, most patients with psychogenic neurologic-like disorders have symptoms that are real to them, and they deserve to be treated with compassion, respect, thoroughness, and honesty.
Read
May 10, 2018A moderately interesting story of the life of a neurologist, marred by the gigantic ego of the author. I'm sure you need a gigantic ego to do the job and there are plenty of stories where he gets stuff wrong (at first, before getting it right obv) but the overall impression is of being sat next to someone at a dinner party who starts off seeming an absolutely fascinating and enthralling raconteur and by the third course you're wondering who you ought to stab in the eye with a dessert fork: yourself or him.
This is not helped by the "I don't care, sod off" attitude he (his persona) takes to people with psychosomatic conditions, many of whom seem to have been sexually abused. He sees someone who is literally so traumatised by family abuse their entire body stops functioning, and his attitude is "stop wasting my time, I have real patients to help" rather than, I dunno, "let me refer you to another department and ideally the police". And yet the narrator repeatedly applauds himself for his own humanity, humility, kindness, and willingness to listen compared to other neurologists. It makes you wonder what the rest of them are like.
This is not helped by the "I don't care, sod off" attitude he (his persona) takes to people with psychosomatic conditions, many of whom seem to have been sexually abused. He sees someone who is literally so traumatised by family abuse their entire body stops functioning, and his attitude is "stop wasting my time, I have real patients to help" rather than, I dunno, "let me refer you to another department and ideally the police". And yet the narrator repeatedly applauds himself for his own humanity, humility, kindness, and willingness to listen compared to other neurologists. It makes you wonder what the rest of them are like.
September 29, 2014
Reaching Down the Rabbit Hole is a really fascinating book. It's a little fictionalised, so we get dialogues and little portraits of character, enough that we can care about the cases discussed. Dr Ropper is pretty much everything an ideal doctor should be: knowledgeable, capable of acting fast, capable of explaining complex processes clearly, intuitive, willing to listen, willing to admit he's wrong... At every stage, he emphasises to the reader and to the residents he's teaching that each case is individual, that the right answer for one person isn't the right one for the next, and so on.
There are a couple of very good chapters on Parkinson's and ALS, some fascinating things like the fact that an ovarian teratoma can cause seizures and all sorts of neurological symptoms, etc. At every turn, it demonstrates the complexity of the brain, the limits of our understanding.
What nearly spoiled it all for me was the fact that Ropper really does revert to talking about hysteria. When I quoted a section to my mother, a psychiatrist, she texted back to ask if the book was written in 1899 -- that's how out of date that section seems. For the most part, he even seems sympathetic to these patients, which is more than I can say for a lot of people who dismiss hysteria/psychosomatic illnesses/conversion disorder, etc. But in this case there seems to be a barrier in his thinking: he sees a young woman with a teddy bear, and he immediately chalks it up to hysteria. Whatever her symptoms: hysteria is the answer. Sure, he dresses it up as "conversion disorder", but what he means is still pretty much the Victorian hysteria. He uses that term as a direct synonym for conversion disorder, psychosomatic problems, etc.
And it's exactly that attitude that makes life difficult for people who have mental illnesses, insight and even a glimpse of the way that people are going to look at them. If I'm going into a doctor's office with some problem, I prepare myself for the inevitable questions about my levels of anxiety, my depression during the last few weeks, is there anything at home I'm struggling with... Because there's a diagnosis of GAD and depression right there in my file, I know that nine out of ten doctors will listen to my symptoms and hear only psychosomatic. And some of those will even blame me for that -- me, the thinking rational person -- even though I could no more help it than I could pick the stars out of the sky.
I started having horrible stomach pains in 2010, my second year of university, at the same time as I started a pretty steep descent into anxiety. Doctors were reasonably sympathetic, but continually told me that what was happening to me, whatever it was, just happened because of my anxiety. Here's a pill, take it and everything will go away. And I believed them: the pain had to be in my head, because I have an anxiety disorder. I knew they wouldn't believe in the pain and so I didn't either.
Even at the point where my physical symptoms were completely blatant, when you could do a physical exam and precisely locate the source of the pain, my GP was reluctant to send me for an ultrasound because, in his opinion, I was probably just stressed about my master's degree. He repeatedly asked if I was happy, if I was sure I was doing the right thing in my career, while I was trying to ask for pain relief. When eventually I pushed hard enough, he sent me for an ultrasound, warning me that I was wasting everyone's time.
My gallbladder was packed with stones, and the only option was to remove it.
At one point in this book, Ropper discusses signs and symptoms. Symptoms are what the patient reports; signs are what the physician observes. Don't stop listening to the symptoms just because you think you can see the signs. Don't get blinded to one thing because another has already been diagnosed.
There are a couple of very good chapters on Parkinson's and ALS, some fascinating things like the fact that an ovarian teratoma can cause seizures and all sorts of neurological symptoms, etc. At every turn, it demonstrates the complexity of the brain, the limits of our understanding.
What nearly spoiled it all for me was the fact that Ropper really does revert to talking about hysteria. When I quoted a section to my mother, a psychiatrist, she texted back to ask if the book was written in 1899 -- that's how out of date that section seems. For the most part, he even seems sympathetic to these patients, which is more than I can say for a lot of people who dismiss hysteria/psychosomatic illnesses/conversion disorder, etc. But in this case there seems to be a barrier in his thinking: he sees a young woman with a teddy bear, and he immediately chalks it up to hysteria. Whatever her symptoms: hysteria is the answer. Sure, he dresses it up as "conversion disorder", but what he means is still pretty much the Victorian hysteria. He uses that term as a direct synonym for conversion disorder, psychosomatic problems, etc.
And it's exactly that attitude that makes life difficult for people who have mental illnesses, insight and even a glimpse of the way that people are going to look at them. If I'm going into a doctor's office with some problem, I prepare myself for the inevitable questions about my levels of anxiety, my depression during the last few weeks, is there anything at home I'm struggling with... Because there's a diagnosis of GAD and depression right there in my file, I know that nine out of ten doctors will listen to my symptoms and hear only psychosomatic. And some of those will even blame me for that -- me, the thinking rational person -- even though I could no more help it than I could pick the stars out of the sky.
I started having horrible stomach pains in 2010, my second year of university, at the same time as I started a pretty steep descent into anxiety. Doctors were reasonably sympathetic, but continually told me that what was happening to me, whatever it was, just happened because of my anxiety. Here's a pill, take it and everything will go away. And I believed them: the pain had to be in my head, because I have an anxiety disorder. I knew they wouldn't believe in the pain and so I didn't either.
Even at the point where my physical symptoms were completely blatant, when you could do a physical exam and precisely locate the source of the pain, my GP was reluctant to send me for an ultrasound because, in his opinion, I was probably just stressed about my master's degree. He repeatedly asked if I was happy, if I was sure I was doing the right thing in my career, while I was trying to ask for pain relief. When eventually I pushed hard enough, he sent me for an ultrasound, warning me that I was wasting everyone's time.
My gallbladder was packed with stones, and the only option was to remove it.
At one point in this book, Ropper discusses signs and symptoms. Symptoms are what the patient reports; signs are what the physician observes. Don't stop listening to the symptoms just because you think you can see the signs. Don't get blinded to one thing because another has already been diagnosed.
September 26, 2022
This starts out strong, with an introduction into various complex and interesting neurology patients. We have hydrocephalus, subarachnoid haemorrhage, strokes and even ovarian teratomas. It's fascinating stuff, told in a way that feels accessible and not too weighed down by medical jargon. However, I did find the stories petered out somewhat towards the end, and I also really didn't like the way Allan Ropper describes some of his patients. Is 'blonde, very attractive, a little on the plump side, but very lovely' really appropriate? No, I think not.
Also, this is obviously American and that's just not where my interests lie. Yes, the neurology is the same but the health system and the mindset of medical staff is very different in a health care system that is free at the point of delivery like the NHS.
OK, but not the best of these types of books I've read.
Also, this is obviously American and that's just not where my interests lie. Yes, the neurology is the same but the health system and the mindset of medical staff is very different in a health care system that is free at the point of delivery like the NHS.
OK, but not the best of these types of books I've read.
June 27, 2016
I wanted to like this science based nonfiction book because I always like books like this. But the title seemed somewhat inaccurate for this book. It wasn't about the mystery and drama of brain disease.....it was really all about one particular neurologist. I, I, MY, MY, ME, ME was incredibly repetitive....just sayin'. I was also shocked by some of his statements....it sounded more like disregard for others. I wish I had liked this.
April 16, 2019
3.5 Stars
A neurologist takes us through multiple cases he’s dealt with over a short course of time. Some very interesting cases with many diseases I’d never even heard of. A great read, especially if you enjoy books like The Tale of the Dueling Neurosurgeons.
A neurologist takes us through multiple cases he’s dealt with over a short course of time. Some very interesting cases with many diseases I’d never even heard of. A great read, especially if you enjoy books like The Tale of the Dueling Neurosurgeons.
August 26, 2016
I read it wondering if the author, a neurologist, would ever turn professional insight on himself. If he did, he would realize he spends an entire book blowing eighteen over-inflated tires of sexist, egotistical, out of touch diesel right up his own glowing red exhaust stack. I was hoping for someone to talk about being a neurologist and the rigors of having such an interesting title, an adjunct to the great "Do No Harm". Instead, I got the self-important musings of a tactless, namedropping, arrogant misogynist.
I kept reading hoping he would stop talking about himself and talk about something interesting, but alas, his reference to women neurologists using a reflex hammer to test brain reaction in unconscious patients by saying they, "tend to press harder than men, as if to insure that no one is getting out alive" was my final straw.
This neurologist should've seen a neurologist before writing this book.
I kept reading hoping he would stop talking about himself and talk about something interesting, but alas, his reference to women neurologists using a reflex hammer to test brain reaction in unconscious patients by saying they, "tend to press harder than men, as if to insure that no one is getting out alive" was my final straw.
This neurologist should've seen a neurologist before writing this book.
January 19, 2015
This entire review has been hidden because of spoilers.
September 1, 2015
The cases are generally interesting, but the narrator is a hard voice to like. A subtitle that would better catch the tone is "The Many Times I Have Been Right (And Others Wrong)"
August 25, 2022
This was an interesting book. A little hard to follow at times but full of fascinating insights and stories into the world of neurology. It was a little sad, in fact most of the stories are sad as there is not always a happy ending and this is real life.
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.
There were some technical details here, I didn't get it all of course, I have no history in medicine but I understood enough for the stories to make sense even without that knowledge. I wasn’t keen on the way it jumps around and between cases of similar illnesses but I get why he did it, it just didn’t work for me.
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.
Not a bad read at all, very good for an Amazon Prime book. This is a 3.5 for me, I just need to decide whether to round up or down.
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.
There were some technical details here, I didn't get it all of course, I have no history in medicine but I understood enough for the stories to make sense even without that knowledge. I wasn’t keen on the way it jumps around and between cases of similar illnesses but I get why he did it, it just didn’t work for me.
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.
Not a bad read at all, very good for an Amazon Prime book. This is a 3.5 for me, I just need to decide whether to round up or down.
January 15, 2016
The author was so terribly self absorbed he ruined the fascinating parts of what was supposed to be the content of the story.
September 3, 2022
I enjoyed this book by a neurologist in Boston, apparently senior in his field and at the time of publication (2014) already in his sixties. It gave a real insight into the workings of a teaching hospital and the wide-ranging skills that a neurologist must have in order to work out exactly which component of a person's brain/spinal column or other bodily part might be causing drastic neurological symptoms, especially when the symptoms are similar for multiple conditions. For example, a woman who was having seizures and foaming at the mouth was recognised by Dr Ropper as having a benign tumour on an ovary. With that removed, she recovered completely. Another man had been affected by a virus and was almost totally cured by antibiotics apart from a slight speech defect.
It was interesting to learn how the change of the medical profession following the introduction of scanning technology - MRI, CT etc - has caused an over reliance on such technologies rather than listening to the patient or patient's family to learn their actual symptoms. In several cases, the scans either looked normal or the radiologist failed to notice something on them (which led to a fatality in the latter instance). Only neurology, it seems, still involves a discipline that engages with the patient in order to diagnose their problem, and even there the cessation of follow-up autopsies on those who die mean that learning opportunities are lost.
One aspect that is a little irritating is that the author seems to have a massive ego - usually it is only he who can diagnose the problem. However, he does own up to misdiagnosing the patient mentioned above who died, due to Ropper's own preconceived notion of what was wrong with him - a misdiagnosis shared by everyone else who had treated him over the preceding three days. Wondering why he was getting worse, Ropper checked the MRI scan carried out at the previous hospital and labelled 'normal' and spotted something which by that time had progressed to the point of destroying the man's spinal column.. I do wonder whether some of the impression of ego has come more from the co-writer who accompanied the doctor on his rounds and wrote up the cases, as people who have dealt with Dr Ropper in person say he doesn't come across as full of his own importance at all.
One chapter where he doesn't show his usual compassion is when dealing with those who have psychological problems that cause them to mimic neurological illnesses. I can see why he would be impatient in the case of a woman who, caught in a plane crash with a man she was having an affair with, pretended to have amnesia. However, he sometimes deals with children of very controlling families where he suspects sexual abuse. Perhaps he should flag those cases with social services, though I accept it must be difficult where there is no proof. It does make him seem uncaring to show dismissiveness in those instances.
The book is a bit rambling in the way it treats the cases, which have been fictionalised as have the doctor's colleagues, to avoid breaches of personal privacy. Overall, the book was interesting but had the flaws mentioned so I rate it at 3 stars.
It was interesting to learn how the change of the medical profession following the introduction of scanning technology - MRI, CT etc - has caused an over reliance on such technologies rather than listening to the patient or patient's family to learn their actual symptoms. In several cases, the scans either looked normal or the radiologist failed to notice something on them (which led to a fatality in the latter instance). Only neurology, it seems, still involves a discipline that engages with the patient in order to diagnose their problem, and even there the cessation of follow-up autopsies on those who die mean that learning opportunities are lost.
One aspect that is a little irritating is that the author seems to have a massive ego - usually it is only he who can diagnose the problem. However, he does own up to misdiagnosing the patient mentioned above who died, due to Ropper's own preconceived notion of what was wrong with him - a misdiagnosis shared by everyone else who had treated him over the preceding three days. Wondering why he was getting worse, Ropper checked the MRI scan carried out at the previous hospital and labelled 'normal' and spotted something which by that time had progressed to the point of destroying the man's spinal column.. I do wonder whether some of the impression of ego has come more from the co-writer who accompanied the doctor on his rounds and wrote up the cases, as people who have dealt with Dr Ropper in person say he doesn't come across as full of his own importance at all.
One chapter where he doesn't show his usual compassion is when dealing with those who have psychological problems that cause them to mimic neurological illnesses. I can see why he would be impatient in the case of a woman who, caught in a plane crash with a man she was having an affair with, pretended to have amnesia. However, he sometimes deals with children of very controlling families where he suspects sexual abuse. Perhaps he should flag those cases with social services, though I accept it must be difficult where there is no proof. It does make him seem uncaring to show dismissiveness in those instances.
The book is a bit rambling in the way it treats the cases, which have been fictionalised as have the doctor's colleagues, to avoid breaches of personal privacy. Overall, the book was interesting but had the flaws mentioned so I rate it at 3 stars.
August 19, 2016
Stories about a neurologist in an acute hospital. Tales of people with complex and often mind-boggling presentations, like the man who drove for half a day in circles in his car.
Reviewers likened Dr. Allan Ropper's work to those of Oliver Sack's. I would say that it is far from fair or accurate to compare the account in this book with Sack's compassionate, insightful and warm writings of his patient's plights or his ability to shed light on the mysteries of the human mind and to encourage empathy.
Why? As noted by previous reviewers, the Dr. Ropper featured in this book is his own biggest fan. No, literally. In the first few chapters, you will realise that he (says that he) is the only one getting things right on his team. He is the most brilliant, most astute, most knowledgeable, most experienced. While I have no doubt about his expertise and his positive reputation in his field, I also can't help but note that he has little regard for his colleagues and the junior doctors. They should have just listened to him. Being Chinese, I also noticed that all the Asian colleagues in his writing are either nameless (the Chinese American female neurosurgeon - even the janitor has a name!) or got the wrong end of the stick (i.e. Chin, the poor senior registrar who treats everyone to lunch and got thieved by his junior as a "lesson").
And his patients - oh god! If the Dr. Ropper in the book were to be my consultant, I would walk out of the consultation room - fuming because of his tone and attitude. For example, calling a patient with psychogenic epilepsy as hvaing "sham epilepsy" - it might be important not to be repetitive in this narrative, but semantics do evoke strong emotions and thoughts, and must be chosen carefully so as not to give the wrong impression. However, the narrator did a good job of pointing out the social inequalities in the local area, and was empathetic with Black American patients, whom he felt are on the fringe of the Bostonian society, which sometimes prevent them from accessing help.
Nevertheless, there are some wonderful accounts of rare cases, such as the young Asian Korean woman who was fuming like she has rabies. That definitely requires an experienced eye to make an accurate and prompt diagnosis, and to prevent further damage to the patient's physical functioning and quality of life.
I have noted from a previous reviewer that the writing in this book doesn't seem to match Dr. Ropper's real life demeanor - his talks, conferences, lectures - where he presents himself as a thoughtful and considerate character. If this narrative in this book is the doing of a money-minded publisher who just wants to create a "hit" by creating unnecessary drama at the patient's and staff's expense, then Dr. Ropper would strongly benefit from getting another literary agent.
Ovverall, I would recommend reading this book with a pinch a salt. Focus on the neurological experiences, laugh at the silly drama.
Reviewers likened Dr. Allan Ropper's work to those of Oliver Sack's. I would say that it is far from fair or accurate to compare the account in this book with Sack's compassionate, insightful and warm writings of his patient's plights or his ability to shed light on the mysteries of the human mind and to encourage empathy.
Why? As noted by previous reviewers, the Dr. Ropper featured in this book is his own biggest fan. No, literally. In the first few chapters, you will realise that he (says that he) is the only one getting things right on his team. He is the most brilliant, most astute, most knowledgeable, most experienced. While I have no doubt about his expertise and his positive reputation in his field, I also can't help but note that he has little regard for his colleagues and the junior doctors. They should have just listened to him. Being Chinese, I also noticed that all the Asian colleagues in his writing are either nameless (the Chinese American female neurosurgeon - even the janitor has a name!) or got the wrong end of the stick (i.e. Chin, the poor senior registrar who treats everyone to lunch and got thieved by his junior as a "lesson").
And his patients - oh god! If the Dr. Ropper in the book were to be my consultant, I would walk out of the consultation room - fuming because of his tone and attitude. For example, calling a patient with psychogenic epilepsy as hvaing "sham epilepsy" - it might be important not to be repetitive in this narrative, but semantics do evoke strong emotions and thoughts, and must be chosen carefully so as not to give the wrong impression. However, the narrator did a good job of pointing out the social inequalities in the local area, and was empathetic with Black American patients, whom he felt are on the fringe of the Bostonian society, which sometimes prevent them from accessing help.
Nevertheless, there are some wonderful accounts of rare cases, such as the young Asian Korean woman who was fuming like she has rabies. That definitely requires an experienced eye to make an accurate and prompt diagnosis, and to prevent further damage to the patient's physical functioning and quality of life.
I have noted from a previous reviewer that the writing in this book doesn't seem to match Dr. Ropper's real life demeanor - his talks, conferences, lectures - where he presents himself as a thoughtful and considerate character. If this narrative in this book is the doing of a money-minded publisher who just wants to create a "hit" by creating unnecessary drama at the patient's and staff's expense, then Dr. Ropper would strongly benefit from getting another literary agent.
Ovverall, I would recommend reading this book with a pinch a salt. Focus on the neurological experiences, laugh at the silly drama.
February 6, 2016
This book was interesting enough for me to finish it in three days, but it's not a book I would tell anyone to go buy right now. Pick it up if you find it at a book exchange or in a bargain bin, though. It is well-written and generally entertaining, but it spends more time on the drama of brain disease than on the mystery of it. A sick person comes into the hospital, no one can figure out what's wrong with him or her until our hero neurologist walks into the room and proves he's smarter than everyone else, and then their long and painful process of recovery (or not) is extensively described, including how it made the doctor feel. It is not like the books by Oliver Sacks, because it describes common brain diseases more than rare ones, which makes it less exciting than it could have been, no matter how touching the stories about Parkinson's and ALS sufferers are. There is also a lot of reflection on what it means to be a doctor in general and a neurologist in particular, which is at times interesting but often strays towards the overly self-congratulatory. Allan Ropper is clearly very impressed by his own genius. I also thought it was funny that at one point in the book he makes fun of other doctors for boasting about their celebrity patients and then continues to mention on every other page that he treated Michael J. Fox for Parkinson's.
November 12, 2014
Some parts of this were interesting. However, I thought the doctor had a tendency to pat himself on the back while turning a blind eye to cases that he called hysterics. He seemed particularly insensitive to these cases, even though he suspected sexual abuse and other issues. Overall, I like his old school approach.
February 16, 2021
- Τα ελικόπτερα τρώνε τα μωρά τους;
-Ναι,σίγουρα...πιθανά...μάλλον...
-Πώς μπορείς να έχεις επίγνωση πως δεν έχεις επίγνωση;
-Μόλις μιλήσαμε με τον Θάνατο κι ο Θάνατος μας είπε πως έχει έρθει η σειρά σας.
●Μια βουτιά χωρίς ανάσα στον μυστηριώδη και αχαρτογράφητο ωκεανό της διαταραγμένης εγκεφαλικής λειτουργίας, μια ματιά από την κλειδαρότρυπα στην καθημερινή μάχη ενός κλινικού νευρολόγου ενάντια στον εκφυλισμό του πιο θαυμαστού οργάνου του ανθρώπου.
●Με απλό και κατανοητό τρόπο, παρουσιάζονται οι μαρτυρικές καταστάσεις που βιώνουν οι ασθενείς με νευρολογικές ασθένειες,η αντίληψη που έχουν οι ίδιοι οι παθόντες για τη νέα διαστρεβλωμένη πραγματικότητά τους, ο ρόλος και η αντιμετώπιση των οικείων τους κλπ.
●Ένα συγκλονιστικό και ανατριχιαστικό ταξίδι στα άδυτα της πιο συναρπαστικής ιατρικής ειδικότητας,που θέτει αμείλικτα ερωτήματα,οι απαντήσεις των οποίων δεν είναι πάντα αυτές που φανταζόμαστε.
☆Αν είστε λάτρεις των βιβλίων εκλαικευμένης επιστήμης, τότε αυτό σίγουρα αξίζει την προσοχή σας.
5🌟
-Ναι,σίγουρα...πιθανά...μάλλον...
-Πώς μπορείς να έχεις επίγνωση πως δεν έχεις επίγνωση;
-Μόλις μιλήσαμε με τον Θάνατο κι ο Θάνατος μας είπε πως έχει έρθει η σειρά σας.
●Μια βουτιά χωρίς ανάσα στον μυστηριώδη και αχαρτογράφητο ωκεανό της διαταραγμένης εγκεφαλικής λειτουργίας, μια ματιά από την κλειδαρότρυπα στην καθημερινή μάχη ενός κλινικού νευρολόγου ενάντια στον εκφυλισμό του πιο θαυμαστού οργάνου του ανθρώπου.
●Με απλό και κατανοητό τρόπο, παρουσιάζονται οι μαρτυρικές καταστάσεις που βιώνουν οι ασθενείς με νευρολογικές ασθένειες,η αντίληψη που έχουν οι ίδιοι οι παθόντες για τη νέα διαστρεβλωμένη πραγματικότητά τους, ο ρόλος και η αντιμετώπιση των οικείων τους κλπ.
●Ένα συγκλονιστικό και ανατριχιαστικό ταξίδι στα άδυτα της πιο συναρπαστικής ιατρικής ειδικότητας,που θέτει αμείλικτα ερωτήματα,οι απαντήσεις των οποίων δεν είναι πάντα αυτές που φανταζόμαστε.
☆Αν είστε λάτρεις των βιβλίων εκλαικευμένης επιστήμης, τότε αυτό σίγουρα αξίζει την προσοχή σας.
5🌟
February 8, 2015
Wish I could review this book. I won it on September 28 as a giveaway on goodread. Never received the book. Looks like other people liked the book. I always read the books I win and do a review on them. Too bad I did not get my copy. I sent a message asking why I did not receive my copy but never heard back. UPDATE;I received my copy of this book last week. I can now do a review of the book i won in first reads giveaways. Dr. Allan Ropper is a Neurologist in Boston. In his book he writes many cases he has worked on over the years.
Most of the persons are fictionalized persons to give samples of different "diseases" of the brain. the figures skater whose body has become a ticking bomb. the man found in traffic circling around because he could not find his way home.there are several cases of people who are suffering from ALS or Lou Gehrig's disease. This is a pretty interesting read It can be fascinating, terrifying, heartbreaking. There are so many Neurological illnesses a person can get. Dr. Ropper discusses many of them in his factual book. there is even a chapter using Michael j. Fox when he discusses Parkinson's disease. There is a chapter on seizures and Epilepsy. interesting but a tough one to read since i have a son who has epilepsy. I liked that Dr. Ropper gave stories and examples to describe his cases. Glad i finally got my copy. If you find reading about medical cases, you may find this a good read.
Most of the persons are fictionalized persons to give samples of different "diseases" of the brain. the figures skater whose body has become a ticking bomb. the man found in traffic circling around because he could not find his way home.there are several cases of people who are suffering from ALS or Lou Gehrig's disease. This is a pretty interesting read It can be fascinating, terrifying, heartbreaking. There are so many Neurological illnesses a person can get. Dr. Ropper discusses many of them in his factual book. there is even a chapter using Michael j. Fox when he discusses Parkinson's disease. There is a chapter on seizures and Epilepsy. interesting but a tough one to read since i have a son who has epilepsy. I liked that Dr. Ropper gave stories and examples to describe his cases. Glad i finally got my copy. If you find reading about medical cases, you may find this a good read.
October 29, 2014
We may have a new Oliver Sacks! I hope this is just the first of several books from Ropper. Ropper offers the somewhat different vantage point of being focused on neurology, which means more of his stories are about the physical debilitations of neurological problems with no psychological effects. His description of dealing with multiple patients with Lou Gehrig's is worth a read in itself.
July 17, 2023
Meh, 2.5.
Neuroloog met ego doet en denkt dingen
Neuroloog met ego doet en denkt dingen
October 23, 2022
so it wasn’t COMPLETELY terrible, i skimmed through most of it and it did help with my personal statement, but it was boring and i wouldn’t read it again. not for entertainment purposes anyways.
June 27, 2018
Reaching Down The Rabbit Hole is a strange semi fictionalised account of a neurologists journey through exploring rare and complex brain diseases and disorders. I enjoyed much of the book, particularly a couple of the patient stories. The writing style was rather heavy and overly “wordy” which some readers may find challenging. However, for the most part, I was able to keep a good understanding of the point the author was trying to convey.
The difference in American healthcare (as opposed to the British) was very obvious here. It still astounds me that healthcare is considered a privilege in the states. The discussion about medical ethics and neuropsychiatry are two of my favourite aspects of the book. As with all books of this genre, there are some tongue in cheek moments and some which some readers may raise an eyebrow at.
This isn’t a beginners guide to neurology and psychiatry, but it is well explained and rationale is given for decisions made by the author and his team for the care of his patients.
A worthwhile read for medical professionals and those read in neurology.
The difference in American healthcare (as opposed to the British) was very obvious here. It still astounds me that healthcare is considered a privilege in the states. The discussion about medical ethics and neuropsychiatry are two of my favourite aspects of the book. As with all books of this genre, there are some tongue in cheek moments and some which some readers may raise an eyebrow at.
This isn’t a beginners guide to neurology and psychiatry, but it is well explained and rationale is given for decisions made by the author and his team for the care of his patients.
A worthwhile read for medical professionals and those read in neurology.
December 5, 2014
Disclaimer: This ARC was given to me for free in exchange for an honest review from Netgalley.
This was a really interesting look into the ward of not only a teaching hospital, but a look into some puzzling neurological diseases and how they vary individually, sometimes nothing like the textbook case. I did find the author's tone a little dry and condescending, but I am taking account that he is an older man. This was a pretty good book all-in-all.
This was a really interesting look into the ward of not only a teaching hospital, but a look into some puzzling neurological diseases and how they vary individually, sometimes nothing like the textbook case. I did find the author's tone a little dry and condescending, but I am taking account that he is an older man. This was a pretty good book all-in-all.
January 31, 2019
This was an interesting book written by a clinical neurologist, which provided a lot of insight into the field, was intelligently written, and also was pitched at a good level for the non-specialist. Plenty of case studies are discussed, as are aspects of the author's role in a Boston hospital department, and it comes across well. There are some parallels with the better of Oliver Sacks' books.
However, due perhaps to the nature of neuroscience as opposed to psychology, the described conditions were a little less interesting to me than, for instance, the abnormal psychological illnesses described by Sacks in 'The Man Who Mistook His Wife For A Hat'. The likes of motor neurone disease, traumatic brain injury, Parkinsons Syndrome, stroke etc. are all of course more common in a medical context but are hence less 'academically' or 'scientifically' interesting to me as a reader interested in medicine and psychology than the rarer disorders. Reading the book as someone more turned on by factual content than human interest stories, there was only so much I could get from it.
However, due perhaps to the nature of neuroscience as opposed to psychology, the described conditions were a little less interesting to me than, for instance, the abnormal psychological illnesses described by Sacks in 'The Man Who Mistook His Wife For A Hat'. The likes of motor neurone disease, traumatic brain injury, Parkinsons Syndrome, stroke etc. are all of course more common in a medical context but are hence less 'academically' or 'scientifically' interesting to me as a reader interested in medicine and psychology than the rarer disorders. Reading the book as someone more turned on by factual content than human interest stories, there was only so much I could get from it.
January 13, 2020
This is an absorbing collection of stories about patients with various neurological conditions. I found it much more engaging than the more famous The Man Who Mistook His Wife for a Hat by Oliver Sacks - lighter on the medical explanations, but better written and more 'human.'
Well worth a read.
Well worth a read.
February 19, 2021
I would give this book 3.5 stars.
I did prefer Do No Harm.
I did prefer Do No Harm.
August 31, 2014
Full review at http://thebookshelfgargoyle.wordpress... (Oct 8)
I received a digital copy of this title from the publisher via Netgalley.
Ten Second Synopsis:
Dr. Allan H. Ropper and Brian David Burrell comprehensively explain, through the lived experiences of a number of patients, the complex and sometimes utterly bizarre nature of the brain and the things that can go wrong with it.
I;m going to take a punt and proclaim that this is the most accessible and gripping book about neurology that you will ever read. Together, Ropper and Burrell have hit on a fantastic and engaging narrative style that is matter-of-fact, personal and touches on all the existential fears floating around in the human psyche relating to the potential for death or permanent disability and how one might reasonably (or unreasonably) face these fears. Another interesting point in the book is Ropper’s up-front acknowledgement that doctors and medical professionals are not infallible and are subject to the same pressures, doubts and muck-ups that plague the rest of us.
was really surprised at how deeply I got into this book, and how much of its content has popped up in my thoughts since I finished reading it. Coincidentally, the ALS/Motor Neurone Ice Bucket Challenge started hitting the internet while I was making my way through this book and while I already knew a small amount about the disease, it was nicely topical to be able to read into the topic more deeply just at that time. If you’re a fan of Michael J. Fox (and who isn’t, really?), it turns out that Ropper has been involved in treating and advising Mr Fox through his diagnosis of Parkinson’s disease, so there’s a bit of bonus celebrity-related material in here too. While I was engaged and challenged by the more emotional and worrying patient stories, I also very much enjoyed the initial chapters of the book which aptly described the range of bizarre cases that can pop up in the neurology department and the interesting and unexpected ways in which medical staff go about trying to figure out what’s wrong.
All up, if you’re interested in the brain in all its mysterious glory you should probably keep this book on your radar.
Recommended.
I received a digital copy of this title from the publisher via Netgalley.
Ten Second Synopsis:
Dr. Allan H. Ropper and Brian David Burrell comprehensively explain, through the lived experiences of a number of patients, the complex and sometimes utterly bizarre nature of the brain and the things that can go wrong with it.
I;m going to take a punt and proclaim that this is the most accessible and gripping book about neurology that you will ever read. Together, Ropper and Burrell have hit on a fantastic and engaging narrative style that is matter-of-fact, personal and touches on all the existential fears floating around in the human psyche relating to the potential for death or permanent disability and how one might reasonably (or unreasonably) face these fears. Another interesting point in the book is Ropper’s up-front acknowledgement that doctors and medical professionals are not infallible and are subject to the same pressures, doubts and muck-ups that plague the rest of us.
was really surprised at how deeply I got into this book, and how much of its content has popped up in my thoughts since I finished reading it. Coincidentally, the ALS/Motor Neurone Ice Bucket Challenge started hitting the internet while I was making my way through this book and while I already knew a small amount about the disease, it was nicely topical to be able to read into the topic more deeply just at that time. If you’re a fan of Michael J. Fox (and who isn’t, really?), it turns out that Ropper has been involved in treating and advising Mr Fox through his diagnosis of Parkinson’s disease, so there’s a bit of bonus celebrity-related material in here too. While I was engaged and challenged by the more emotional and worrying patient stories, I also very much enjoyed the initial chapters of the book which aptly described the range of bizarre cases that can pop up in the neurology department and the interesting and unexpected ways in which medical staff go about trying to figure out what’s wrong.
All up, if you’re interested in the brain in all its mysterious glory you should probably keep this book on your radar.
Recommended.
September 5, 2017
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.
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.
2) In instances of conversion hysteria, the family of the patient is frequently overbearing and probably causal to the symptoms. Some families demand that the neurologist solve this problem right now and provide a solution that will indicate easy treatment with drugs or reassurance that the illness is nothing to worry about at this point in the patient's life. Either solution is rarely the case. The neurologist is often blamed by these families because he or she is regarded as a shaman who can cure all ills and provide happy endings. Somehow the illness becomes the doctor's fault.
3) Neurological illness manifests in frequently bizarre symptoms. Some of them are similar enough to previous cases in the doctor's experience that he or she can by inductive reasoning come up with a dead-on diagnosis.
4) Initial examinations and cuts into flesh of patients are performed by the doctor of lowest stature among the group of residents and interns. It's surprising that the first cuts aren't done by candy stripers, followed by maintenance staff and kitchen workers. The resident or intern making the first cut is often terrified at the experience, and this is the school of hard knocks that newly minted doctors all have to go through. It seems brutal, but it's standard practice.
5) 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.
Ultimately for me, the book was interesting but not absorbing. This is probably my own shortcoming.
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.
2) In instances of conversion hysteria, the family of the patient is frequently overbearing and probably causal to the symptoms. Some families demand that the neurologist solve this problem right now and provide a solution that will indicate easy treatment with drugs or reassurance that the illness is nothing to worry about at this point in the patient's life. Either solution is rarely the case. The neurologist is often blamed by these families because he or she is regarded as a shaman who can cure all ills and provide happy endings. Somehow the illness becomes the doctor's fault.
3) Neurological illness manifests in frequently bizarre symptoms. Some of them are similar enough to previous cases in the doctor's experience that he or she can by inductive reasoning come up with a dead-on diagnosis.
4) Initial examinations and cuts into flesh of patients are performed by the doctor of lowest stature among the group of residents and interns. It's surprising that the first cuts aren't done by candy stripers, followed by maintenance staff and kitchen workers. The resident or intern making the first cut is often terrified at the experience, and this is the school of hard knocks that newly minted doctors all have to go through. It seems brutal, but it's standard practice.
5) 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.
Ultimately for me, the book was interesting but not absorbing. This is probably my own shortcoming.
This entire review has been hidden because of spoilers.
July 23, 2017
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.
Fans of House will enjoy reading this book.
The chapter that deals with ALS (Lou Gehrig's Disease) is very difficult to read. He presents the lives of two different patients and describes the cruel progress of their disease and the difficult decisions they face and the extreme changes and challenges ALS brings to their lives.
Dr. Ropper enjoying teaching, training, and working with the interns, residents, and medical students he trains. He describes one case where a patient of his dies from an abscess that turns his spinal cord to jelly. The patient was paralyzed from the neck down with no hope of any function being restored. Initially, Dr. Ropper and his team thought the man was suffering from the more common Gillian Barre Syndrome but they were wrong. Ropper discusses the mistakes and oversights that occurred that caused this misdiagnosis. Mostly cause by a radiologist missing evidence of this rare condition on the MRI. He focuses on what a valuable lesson this was for him and his students.
Also a very interesting discussion of death. He also discusses treating the actor Michael J. Fox for his Parkinson's Disease.
Fans of House will enjoy reading this book.
The chapter that deals with ALS (Lou Gehrig's Disease) is very difficult to read. He presents the lives of two different patients and describes the cruel progress of their disease and the difficult decisions they face and the extreme changes and challenges ALS brings to their lives.
Dr. Ropper enjoying teaching, training, and working with the interns, residents, and medical students he trains. He describes one case where a patient of his dies from an abscess that turns his spinal cord to jelly. The patient was paralyzed from the neck down with no hope of any function being restored. Initially, Dr. Ropper and his team thought the man was suffering from the more common Gillian Barre Syndrome but they were wrong. Ropper discusses the mistakes and oversights that occurred that caused this misdiagnosis. Mostly cause by a radiologist missing evidence of this rare condition on the MRI. He focuses on what a valuable lesson this was for him and his students.
Also a very interesting discussion of death. He also discusses treating the actor Michael J. Fox for his Parkinson's Disease.
This entire review has been hidden because of spoilers.
February 11, 2020
Finished this yesterday but only just got round to writting a review. I really enjoyed elements of this book. I was able to learn many new medical termonologies pertaining to neurology which was cool and the individual cases that where discussed where fascinating , interesting on a academic level but deeply moving on a human one . It's written in a way that isn't overly intimidating for somebody like myself , a lehemen within this field. The only reason I've rated this three stars out of five is because I felt at times Dr Ropper , the author expressed inappropriate contempt towards patients he believed to be suffering from mental health disorders oppose to serious neurological ones . He was very dissmisive of these patients and their claims , potentially to the detriment of their health . It felt like he was dabbling in what I would refer to as " confirmation bias " . Despite my previous remarks I would still say this book is definitely worth a read .
Displaying 1 - 30 of 449 reviews