Reaching Down the Rabbit Hole: Extraordinary Journeys into the Human Brain

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When you no longer have a reason to get out of bed, that’s when you’re going to take a long look at the worth of your life.” Change the plan you will roll onto at any time during your trial by visiting the “Settings & Account” section. What happens at the end of my trial?

I could see that over the course of the previous week, Hannah had begun the transition from resident to full-fledged physician. I could see it in her bearing, in the assertive physicality with which she carried out her examinations, in the firmness of her tone with some of the more difficult patients, and in the controlled sympathy she adopted in family meetings when she had to deliver bad news. She had turned out to be one of our strongest clinicians. 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. Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article) Reaching Down the Rabbit Hole tells it like it is on the front line of clinical neurology. Engagingly written, informative, often funny, it also manages to be moving without slipping into the sentimentality that too often infests medical writing... If ever anything goes wrong with my brain, I'd like a doctor like Ropper to help sort me out. -- Paul Broks * Daily Telegraph * 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.

By the time Vincent Talma and Cindy Song had settled in at the Brigham, Arwen Cleary had been there for four days. She came by ambulance on the morning of July 1, and was admitted to neurological intensive care from the Emergency Department later that evening. Of the three cases, hers was the least clear-cut, the most troubling, and one that had the potential to become an absolute shambles. According to her medical records, her problems had begun two years earlier, when she showed up at a central Massachusetts hospital with disabling nausea, difficulty walking, and vomiting. Like all universities, Boston College has a health center that provides minimal services overnight, on holidays, on weekends, and during the summer, relying on referrals to local emergency rooms for anything serious. The after-hours nurse, who was used to such things, assumed that Cindy had been using recreational drugs and was "just flipping out." Nothing unusual as far as the nurse was concerned, but Cindy's mother was outraged. Convinced simply from cultural experience that there were no drugs involved, she would not let that stand. Cindy was so jittery and sweaty that the nurse gave in and called an ambulance to take her to the Brookline Hospital emergency room. Once there, Cindy remained agitated, stopped responding to questions, and started thrashing, as though reacting to hallucinated visions. This prompted a round of phone calls to the eight local psychiatric hospitals to see if there was a bed for an acutely psychotic young woman. Such beds are hard to come by, and it took a hard sell by the emergency room doctor to secure the promise of one by the next afternoon, "if you could just hang onto her and give her Haldol in the meantime." Yet this unreliability is itself a window into another reality, the distorted Alice in Wonderland world to which the title refers and in which neurological patients are wont to find themselves tormentingly trapped.

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. 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. 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. The phrase A and O times three means "awake, oriented to self, oriented to place, and oriented to time." Some people add a fourth: oriented to situation. The problem is that everybody is "oriented times one" unless they are hysterical or dead. We started him on acyclovir, an antiviral medication, and he soon improved. Five days later, Vince was discharged, talking normally again, and, for better or worse, just like his old self.What Burrell and Ropper produce is a portrait of an immensely talented neurologist and teacher who is always the smartest man in the room. Almost every anecdote ends with Ropper emerging the hero of the moment. It’s too carefully written to be crassly boastful, but it’s not exactly an essay in professional humility.