“getting the patient’s story is central. . . approaching it like a detective, adopting a Sherlock Holmesian strategy to finding out the background history and making the connections. . . tracing the patient’s movements and habits in the lead-up to the moment they discerned something was wrong. It is like a jigsaw, and even pieces that appear dull at the outset can be as important as any other piece when we come to see the whole picture . . . [Neurologists] keep probing, Columbo-style, until they are satisfied that they have found out as much as possible – there is always ‘Just one more question …’”
Niall Tubridy’s Just One More Question provides the lay reader with an introduction to neurology, the medical speciality concerned with diseases of the brain and nerves. Dr. Tubridy, who practises and teaches in Dublin, is a frank and amiable guide, and his book is more accessible, lighter on medical jargon and anatomical terminology, than many other recent medically themed nonfiction books—say, Fragile Lives, Stephen Westaby’s memoir of his work as an innovative and risk-taking heart surgeon, or Gavin Francis’s Shapeshifters: On Medicine and Human Change. Tubridy’s book focuses mostly on the stories of patients: some with more commonly known neurodegenerative diseases, such as dementia, multiple sclerosis, Parkinson’s Disease, and motor neuron(e) disease (ALS); others with lesser-known neurological conditions, including Guillain–Barré syndrome (in which the immune system rapidly attacks the peripheral nerves, sometimes leading to life-threatening weakening of the muscles of respiration), transient global amnesia (for which the exact cause remains unknown), paroxysmal kinesigenic choreoathetosis (“spasmodic flailing . . . brought on by the initiation of voluntary movement”), and cerebral spinal fluid leaks (which occur when the fluid that bathes and cushions the spinal cord and brain issues from a tear in the meninges, the membranes that line the skull and the vertebral canal).
As well as presenting many stories of his patients over the years, Tubridy includes elements of the memoir. The reader learns a little about the doctor’s childhood, family (particularly about his dad, a psychiatrist who specialized in treating those with addictions, and his brother, Ryan, a high-profile Irish TV presenter), his medical training (in Dublin, London, Paris, and Melbourne), and Irish culture in general. The author describes a typical day at the hospital, aspects of his work as a professor of neurology, and some of the issues and challenges he faces in his interactions with patients, not the least of which is their tendency to consult Dr. Google and settle on the most dire of diagnoses before even setting foot in his consultation room. He addresses many medical professionals’ fear, wariness, and even dismissal of neurology as a specialty that might offer patients diagnoses but little in the way of treatments. He also discusses a challenge common to all physicians these days: the drive for efficiency, which in Ireland goes by the name of “key performance indicators”. These determine how many patients doctors see a day, how much time is spent with each, and when patients can be safely discharged from hospitals so beds can be freed up. Being efficient, however, has costs: doctors feel emotionally exhausted; patients feel robbed of care.
To counter the skepticism with which neurology is viewed, Dr. Tubridy seeks to provide a somewhat more optimistic view of the specialty that clearly fascinates him. He balances stories of patients with poor outcomes with those whose conditions can be treated, ameliorated, and sometimes cured. I enjoyed his engaging and informative book.
Rating: 3.5 (rounded up)