As medical students, the two of us are in a state of transition. We are on the way to identifying ourselves as doctors, but not quite there yet. Many things medical have been de-mystified for us, but others remain mysterious. And in her book, Suzanne O’Sullivan offers diverse and detailed insights into one such mystery, that well-known but often misunderstood condition – epilepsy. Acknowledging the many unknowns, she describes how clinical neurologists, even with all the modern advances in technology, continue to rely on traditional principles of medical practice to discern the diagnosis from complicated stories that patients may offer.
Her book is a collection of rare cases, where epilepsy manifests in its most elaborate and unusual forms. Yet with her methodical explanations of the patients’ stories, the reader is able to follow each case through and understand the sequence of events. The descriptive illustrations of brain anatomy form a valuable visual aid, helping readers to contextualise structure in its clinical relevance. Every story unfolds clearly and chronologically, before readers’ eyes, allowing them to perceive the patient’s journey and its challenges, as well as challenges facing the medical professionals. Throughout the book, Dr O’Sullivan successfully de-mystifies and humanises ‘the doctor’, openly discussing the limits of her own knowledge and the limitations of Medicine in general – the Science yet to be discovered, the Technology yet to be invented. In her own words, “I was clutching at straws and we both knew it”, when talking about one of her consultations.
Although only twelve cases are described, each one offers such a distinctive presentation that the book provides a comprehensive and aesthetically-satisfying picture of epilepsy. That the effects of epilepsy are not limited to convulsive seizures is highlighted. Symptoms other than witnessed convulsions are included, but also described are the more personal effects that epilepsy may have on patients and those closest to them. The depth with which their lives are portrayed, from actions that could cause embarrassment to those that might cause danger, affords patients the same humanity and sincerity as Dr O’Sullivan gives to the medical position.
The author’s care for her patients shows in the portrayal of their cares and emotions: she makes the reader care too and care to know what she has to say as an author. But her passion and love of the scholarship of her subject is also evident; as she describes the brain in detail, she continues to draw the reader in – ‘the nervous system is beautiful. It is intricate.’
Something which the book does not tackle is the most common expressions of epilepsy, and to a reader with little previous understanding of this condition, simply focusing on the rarer cases could leave them with a skewed perception: this book does not tick the box for epilepsy in the medical school curriculum, but was never intended to.
By contrast, Dr O’Sullivan explains each case with the assumption that her reader has no previous medical knowledge – good both for medical students and for non-medical students! Each time medical jargon is used, it is clarified, thereby expanding the readership able to engage in her work. In addition, analogies are used deftly to improve the book’s comprehensibility, such as, ‘…staring at an MRI scan tells you no more about how the brain works than staring at a computer’s circuitry tells you about how a computer processes information’. They also improve the book’s readability.
This book may be a collection of individual histories, but it reads as a story of the brain, and an introduction to the most daunting of organs. It is engaging and thoughtful. It humanises epilepsy, a condition that has been associated with demonic possession, attacks from God, and many other myths and prejudices. Supernatural misconceptions are mercifully rare in Western society today, but other misconceptions and prejudices persist. Dr O’Sullivan’s humane treatment of Epilepsy as a subject and of those affected by it or involved with it, isn’t exactly ‘brainstorming’, but was genuinely mind-broadening for us.
As her book will have a popular readership, it definitely represents good value for money but was also time well-spent, at least at our level of Medicine.