Up the Down Escalator: Medicine, Motherhood, and Multiple Sclerosis

by Lisa Doggett

A memoir of triumph in the face of a terrifying diagnosis, Up the Down Escalator recounts Dr. Lisa Doggett’s startling shift from doctor to patient, as she learns to live with multiple sclerosis while running a clinic for uninsured patients in central Austin. Recounting before and after the discovery of her MS, she chronicles vexing symptoms while trying to be an attentive mother, wife, and a caring family doctor.

2024 Gold Winner, Benjamin Franklin Awards, Health & Fitness Category

2023 Finalist, IAN Book of the Year Awards, Health/Medicine/Fitness/Dieting Category

Facing the prospect of a career-ending disability as she adjusts to life with multiple sclerosis, Dr. Lisa Doggett is forced to deal with a new level of uncertainty and vulnerability, and the everyday fear that something new will go wrong. Taking off her white coat—becoming a patient herself—she confronts unimaginable fears, copes with her limitations, and sidesteps her skepticism of alternative medicine to seek help from unlikely sources. Drawing on riveting patient stories, Doggett reveals the dark realities of the dysfunctional U.S. healthcare system, made all the more stark when she becomes the one seeking care.

MS pushes Doggett—a perfectionist at heart—to soften her inner drill sergeant and embrace self-compassion. As a patient, she learns to advocate for herself to ensure on-time medication deliveries and satisfactory treatment plans; to navigate chronic dizziness, relapses, and parenting frustrations; and to push her physical limits as a runner to go farther than ever before. As the director of a health clinic for the uninsured, Doggett’s MS inspires an even deeper empathy as she confronts challenging cases, prompting her to work harder on behalf of those in her care, many of whom struggle with illnesses more serious than her own.

This hopeful and uplifting book will encourage those living with chronic disease, and those supporting them, to power forward with courage and grace. It will spark conversations to redefine perfect parenting and trigger uncomfortable discussions and outrage about the vicious inequalities of health care in the U.S. Most of all, it will inspire readers to embrace the gifts of an imperfect life and look for silver linings, despite life’s detours that sabotage plans and take them off their expected paths.

Genres: Nonfiction, Memoir, Medicine, Health, Audiobook, Disability

379 pages, Kindle Edition

Published August 15, 2023

About the author

LISA DOGGETT is a family physician, award-winning author, runner, and self-proclaimed health nut who was diagnosed with multiple sclerosis in 2009. Her work focuses on improving healthcare for vulnerable populations and helping people with MS and other chronic conditions live their best lives. She is a columnist for the nonprofit news outlet, Public Health Watch. Her work has also been published in the New York Times, the Dallas Morning News, Motherwell, the Austin American-Statesman, and more. She lives in Austin, Texas with her pediatrician husband, their two daughters, and one crazy dog. Her memoir, Up the Down Escalator, was a finalist in the 2023 IAN Book of the Year Awards.

Reviews

[Libby Doggett · Rating 5 out of 5]

Reading this powerful, well-written book was excruciating for me. Why? Because I am Lisa ‘s mother. As I read the chapters describing the months, and even years, after her diagnosis of Multiple Sclerosis (MS), I said to myself, “Where is Lisa’s mother? Where was I? Why wasn’t I helping her more?” I know that I didn’t do enough, and in some cases, was not even aware of how difficult her life was. Yes, I had my own work in Washington at the time, but I should have been there more physically, as well as emotionally.

It has taken me many years to even read much about MS. Every time I would attempt to learn more, I was so scared that I quickly found something else to do. Learning of a child’s medical challenges, particularly when the disease can be severe, can be terrifying for a parent. I wondered if Lisa would live to be my age. I wondered how this might impact her wonderful marriage. I wondered if she would have to use a wheelchair. I was happy that she already had children and didn’t have to have experience a pregnancy while dealing with MS, but I worried how she would have the energy to raise her lovely daughters who were quite young at the time.

Now, 12 years after Lisa first learned she had MS, my attitude is totally different. I see a strong, passionate, amazing woman, who is a doctor, caring wife and mother, and a wonderful daughter. She has a rich and meaningful life even though MS has made it more challenging. This story of her raw vulnerability, overwhelming life commitments, and her courage to help herself and others are all told in her memoir.

[Caroline · Rating 5 out of 5]

Although I rate most things I read, I don't often write reviews. Even now, I'm not totally sure where I want to go with this. The title caught my attention earlier this year during a search for books about MS. It interested me because it's something that I've been tested for and want to learn more about. I put off reading it because I'm not a non-fiction reader generally, but the other day I finally decided to go for it.

First, the fact that Lisa narrates her own book is something that I truly appreciate. It's hard to put yourself out there in writing like this and talk about things that aren't necessarily easy or comfortable, but to then go a step further and read your own work makes it, to me, even more poignant.

Second, although I still have no diagnosis, I felt like so much of what Lisa talked about in terms of symptoms could have been me she was talking about. I've fought medical battles in both the US and now in Canada, and I found it really interesting to compare some of my recent experiences with Lisa's. It was definitely an eye-opener for me.

And finally, I felt like this book was also truly a learning experience for me in humanity. Sometimes I find myself thinking that doctors are somehow more healthy or almost some kind of super-humans that are supposed to have all the answers. Through Lisa's words and narration, she's helped me to remember that medical staff of all kinds are still just regular people, and things happen to all of us. It's made me think more about my own primary doctor and how she must be trying to balance the responsibilities of raising at least one child, working at a not-for-profit community clinic, and a third job somewhere else. Yet I always find that she takes the time with me and listens to me, and truly is trying to do her best to help me. This also has helped me to see things from the side of the medical professionals when my appointment is late and there are other places I'd rather be, that doctors, (most of them anyway), want to make a difference, and bureaucracy is a thing everywhere, no matter what profession you're in, or where you live.

[Lori · Rating 4 out of 5]

Thank you to NetGalley and the publisher for this ARC opportunity!

Dr Lisa Doggett is a medical doctor who not only helps her own patients (and works in a free clinic for individuals who don’t have health insurance), but she herself has MS, which makes her story interesting and inspiring.

The author speaks about the complications of the healthcare system from her first hand account which is very validating for anyone who has had to navigate the healthcare system for themselves or a loved one. The fact that she is so hardworking, passionate, and caring, balancing both a career and home life as a wife and mother is inspiring. Many physicians who don’t experience the symptoms she does do not even work as hard!

Thank you for sharing your story, Dr Doggett!

[Hasan Seede · Rating 5 out of 5]

Dr Lisa Doggett’s journey as a physician navigating life as a patient is inspiring especially because of her unwaivering dedication to public health and community throughout

[AnnieM · Rating 3 out of 5]

I appreciate this book for the author's candor and willingness to see her struggles - being diagnosed at a young age with a chronic illness (MS), working and having two young children. What makes this book particularly compelling is she herself is a physician. Her clinic treats patients who are low income, some are uninsured, some are undocumented and she shares the experience of trying to help solve chronic issues while at the same time coming up against systemic challenges. Over the arc of the story, I felt her empathy increases even more as she herself has to experience painful diagnostic tests or waiting and waiting for the results. Her husband is also a physician so their lives are overloaded as they adapt to her facing the MS diagnosis and the uncertainty of how the disease may progress. In the end, she decides to leave the clinic (and she misses her patients tremendously) but it was taking a toll on her -- stress is the enemy of chronic illnesses. I felt like I learned a lot about her and her family, and about practicing medicine in community clinics. She does end on a hopeful note and I appreciated the journey with her.

Thank you to Netgalley and HCI Books, Health Communications Inc for an ARC and I left this review voluntarily.

[Amanda Negro · Rating 3 out of 5]

Up the Down escalator gives the unique insight of Dr. Lisa Doggett who spent her career helping her clinic patients navigate the broken healthcare system as she works through her own diagnosis of MS. Doggett recognizes her own privilege and her frustration dealing with her doctors, insurance companies, and electronic healthcare platforms despite that privilege.

Doggett describes what it is like both as a doctor treating patients with chronic illnesses as well as what it is like to be a patient with an unpredictable chronic illness. Juggling work, marriage, and kids is hard and adding her requirements to maintain the components of her health that are in her control only complicate and add to that difficulty.

I recommend this book to anyone struggling to manage life with a chronic illness. The writing is good (if a little self serving at points) and I’m happy to have read Doggett’s account.

Thank you to NetGalley and the publisher for this opportunity to read and review this book.

[Naomi Hanser · Rating 5 out of 5]

I love this book. It's funny and honest and liberating. Much of it resonated with me, with the struggles we face working demanding jobs and supporting our families while having to deal with and often ignore our own needs. Most of our jobs do not flex or pivot with unexpected hardship, like M.S. Nor do our little kids.

Dr. Doggett is unflinchingly honest. She reveals her secrets—skeletons that many of us keep in our closets, but she shows they are really examples of the shared, common, human condition. Her book validates moments of desperation, self-doubt, frustration, anger. When her own behavior causes regret and shame, she demonstrates ownership, grace and self-forgiveness.

She also captures the tragedies of neglect in our healthcare system – one that fails individuals who are underserved and underinsured, rendering their diseases worse and adding despair.

The ending of the book is beautiful. It brings hope and strength to those of us who need inspiration. Your readers are rooting for you. Thank you Dr. Doggett!

[Shirley Givens · Rating 4 out of 5]

I was living with MS for years before being officially diagnosed in 2021.  I got annual MRIs, and I did not take any meds due to side effects.  I had one flare up in 2021.  My legs decided to a break and I was numb from the waist down. I decided to try MS-4.  The numbness and Muscle spasms went away after a couple of weeks, but it took almost 3 months to walk properly without a cane.  In June, it will be four years without incident, and I am extremely happy that I made the decision to not take any meds and went for the MS-4 formula even though my neurologist got upset and one told me to quit my job because I will be disabled.  Well, I am not disabled, I still refuse to take those meds, and I am doing just fine.  Believe in yourself and go with your instincts.  Doctors don't know it all. I’m surprised a lot of people with MS haven’t heard of the MS-4 protocol, Visit uinehealthcentre. net I hope you find it helpful

[Sierra Bailey · Rating 5 out of 5]

Lisa Doggett has done an incredible job of writing her memoir in a way that is both relatable and enlightening. Many of us can only imagine the pressure of being a practicing doctor, a mother to two young children (2 and 4), a wife to a spouse with an equally demanding career, and in the midst of all of this, experiencing the symptoms which led to a diagnosis of MS.

Lisa writes in an incredibly candid manner that puts into words what most only feel. It's an incredible glimpse into the inside of being diagnosed and then living with an autoimmune disease. But aside from that, this is a beautiful story about motherhood, the struggle with balancing a career, marriage, and the pressure we feel to do so well.

I received an earlier electronic copy to review and devoured it in one sitting.

[Christine Cazeneuve · Rating 4 out of 5]

An impressive and emotional story about a very determined Mom and Doctor who is diagnosed with MS at a very, very early age in her life. How she deals with the diagnosis and her honesty about it is so raw and candid. Her sheer determination in handling her marriage, her children (age 2 and 4 at time of diagnosis) and her profession is nothing short of amazing. Lisa Doggett is not only a doctor but she ran a clinic for people with no health insurance and all the struggles dealing with that scenario. Her candor throughout her story is uplifting and shows you that you should never give in nor give up. A very good read. Thank you to NetGalley, the author and publishers for an advanced copy in exchange for my honest review.

[Deanna · Rating 5 out of 5]

Up the Down Escalator is an inspiring and relatable story for any working professional, especially moms managing it all, those recently diagnosed with an illness or anyone juggling the healthcare industry. I found the book to be just what I needed at this point in my life and recommend it to all my friends. The author writes beautifully, as she combines a unique ability to inspire through her own story of coming to terms with her diagnosis and also informative with her explanations of the current state of our healthcare system and inequities that must be addressed. Through her writing, it’s obvious Lisa is an incredibly generous person, amazing mother, and dedicated physician. I appreciate the opportunity to understand her journey and the inspiration it offered me.

[Myra McIlvain · Rating 4 out of 5]

Lisa Doggett's refreshing honesty held my attention throughout this book. She is a young physician in a public health clinic who confronts her MS diagnosis, deals with impossible bureaucratic demands, raises two small children, and mostly gets support from her doctor husband. Amid all that stress, she does not pull any punches––she is scared as she navigates MS, the US and the Texas healthcare systems are a disgrace, equality in medicine is nonexistent, and her two small children almost drive her crazy. And yet, she continues to plug along giving readers a sense that hope (not healing) is around the corner.

[Amanda · Rating 5 out of 5]

I highly recommend this excellent memoir! I know Lisa Doggett, and that is what first prompted me to pick this up, but I have already recommended the book to several people who do not have that personal connection. Any mother, particularly one who works outside the home, and any person dealing with an uncertain medical condition or a diagnosed one or who is facing any kind of life challenge can relate to Lisa’s story. I listened to the audiobook, and loved to hear her story in her own words. Pick it up (or better go on runs or walks with Lisa in your ears). You won’t regret the time spent with Lisa in this book!

[Ahufford · Rating 5 out of 5]

While the author’s MS diagnosis is understandably devastating, it forces her out of her patterns of overworking and attempts at controlling many aspects of her life. It’s a lesson for all of us who struggle with work/life balance. She has to make big changes and big decisions along the way. As a reader it helped me further examine flaws in my own work/life balance ecosystem. I read it at a moment where I also needed to make changes, and it’s helped me summon courage to take the next step.

I found it highly readable and finished it quickly.

[Wendy Swift · Rating 5 out of 5]

I thoroughly enjoyed Lisa Doggett's memoir that not only shed light on her experience managing MS, but as importantly, the shortcomings of the American medical system as evidenced during her time managing a clinic for the underserved. I appreciate that Doggett did not write a book that strictly focused on herself and when she did write of her disease progression, she was quick to situate it in the greater context of others who struggle with this disease and other debilitating conditions. It is a captivating work that sustained my interest from beginning to end.

[Denise Chojnacki · Rating 4 out of 5]

How do you juggle a career, parenthood and a chronic illness? Lisa Doggett tells her inspirational story about how she not only was an advocate for her patients, but through her illness became her own advocate as well. She relates how scary a diagnosis like MS is and the living in constant wonder if things will take a turn for the worse. She also conveys with honesty how hard it was to live with the symptoms and handle everyday life. It was quite a journey but the ending just made me smile at how her persistence drove her to do something to prove that the odds can be overcome.

[Jaime Portillo De la O · Rating 4 out of 5]

MS - What not to do

I was informed of the practical basics of the disease without much medical lingo, cutting-edge clinical advancements that directly shaped the author's daily life, and her daughter's true well-being.

The book has real numbers, a lack of predictions, and a description of the surroundings and interactions, which opens a glimpse into an island of today's medical world.

I hypothesize that from now on with effective available treatments, diagnosis, treatments, medications, and even a seemingly miraculous cure is not out of reach, not at all.

[Cathy · Rating 5 out of 5]

Lisa's memoir will resonate with moms and anyone who has encountered unwelcome news that changed the course of their life.

The book chronicles Lisa's transformation from doctor to patient with multiple sclerosis (MS) while she was directing a clinic for people without insurance in central Austin.

It was interesting, inspiring, and also made me laugh out loud!

[Mary Trainer · Rating 5 out of 5]

Beautifully written. You do not have to have MS in order to relate to this book. Anyone who has ever confronted a chronic illness, took care of or advocated for a loved one, works in the healthcare industry, is a parent, or has ever thought that they can’t do it, this book is for you! This book is truly inspiring!

[Deborah · Rating 5 out of 5]

Saturday reset- easy relatable read

Thank you for sharing your story. I think it’s nice to relate to someone else who had dizziness/motion… I too have tried many things. Also love your can do spirit… and dedication to your career but also to your health.

[Katelyn · Rating 4 out of 5]

Doggett was a busy doctor with young children when she learned that she had MS. I enjoyed this memoir that takes you through both her personal and professional life, as she reconciles with her medical diagnosis over a decade.

[Toniwake · Rating 5 out of 5]

Wonderful to read a book by a colleague in Austin! It is thoughtful and compassionate. Her experiences as a busy working mother/physician are very relatable and her perspective on the journey of a chronic disease are thought provoking!

[Karen Rooff]

A quick and worthwhile read which highlights Doggett's clear, firsthand experiences as both a physician and a patient of our messed up medical system.

As a fellow Type A person, I relate to the idea that chronic illness is a suckerpunch.

[Austingirlie · Rating 4 out of 5]

The book enlightened me a bit more about MS which I have a personal connection with. I loved all the Austin references and the plights the author discusses about healthcare in our state are all too real.

[Jacque Waller · Rating 5 out of 5]

As a former colleague of Dr. Doggett’s, I am so proud of her work! She is an inspiration!

[Leonardo Tomás Cardillo · Rating 5 out of 5]

www.lisadogget.com

[Laura · Rating 5 out of 5]

After having recently been diagnosed with m.s. I found this book very apropos and a bit reassuring.

[Andrea Keeler · Rating 4 out of 5]

Very repetitive but interesting!

[Carol Christensen · Rating 5 out of 5]

Great read and so well written! I learned a lot not only about MS but also about our ailing medical system. A recommended read for everyone.