Suzanne O’Sullivan’s book on functional neurological disorders is written with the aim of sharing her experiences with patients suffering from perceived mysterious illnesses, and shedding light on their pathogenesis. It is written for the general public to enjoy but, for me, being in possession of undergraduate level medical knowledge of clinical neuroscience, gave some useful context.
Written in a first-person narrative format, Dr O’Sullivan describes in chronological order her visits to different corners of the world and the patients she meets. Each chapter is divided according to the instance of functional neurological disorder that she encounters, with a bit of humour and is mostly self-contained. Rich descriptions are given for each destination and each patient interaction; expansive explanations of pathogenesis are provided with the links to social, economic, psychological, and biological factors. Her clinical reasoning is laid out plainly and the clinical examinations are explained for the uninitiated, and the partially initiated!
Although separated by chronology, the author links the chapters together through building on previously established explanations and with progressively more nuance. Previously touched upon concepts are revisited in a way that adds resonance, without intrusive repetition. While psychosocial models and theories were referenced occasionally throughout the book, the student in me might have preferred more original referencing and specification of the various media sources.
As to the psychosocial models and biological explanations, quite convincing explanations are given for the pathogenesis of functional neurological disorders, albeit without scientific verification. Furthermore, in arguing that there is bias in disease parameter definitions, the author does not acknowledge the myriad of established epidemiological data that inform such definitions and tends to make light of possible pre-disease states. As a student of medicine (including neurology), I would have liked more on potential public health opportunities.
Overall, The Sleeping Beauties: And Other Stories of Mystery Illness, provides an intriguing and informative read on functional neurological disorders, providing the author’s personal explanation, alongside links to socioeconomic factors. It’s definitely an enjoyable read, and useful for me (and for my fellow students/trainees) in trying to synthesise a truly complex but essential part of medicine. Of course, it isn’t a textbook, or a science tome, and shouldn’t be read as one.