Grading Key ★★★★★ = outstanding; ★★★★ = excellent; ★★★ = good; ★★ = fair; ★ = poor
Type and Scope of Book:
A single-authored memoir that chronicles the personal journey of Dr Rynearson on his path to becoming a master clinical psychiatrist. The reader is entertained, enthralled, and enlightened by multiple clinical vignettes that are full of pearls illustrating hints for effective history taking, as well as instructive examples about the important role that mental health often plays in physical illness.
Contents:
The book is arranged in short, easy-to-read engaging chapters. The author first describes his own journey and the decisions that led to a career in psychiatry by sharing his inner conflict in not wishing to disappoint his father (a Mayo Clinic internal medicine subspecialist) or his mother (a musician and artist). He slowly gained insight into the struggle within himself. Eventually, he was able to find a perfect fit for himself within the specialty of psychiatry. Through the rest of the chapters, the author shares a number of fascinating clinical vignettes that emphasize lessons that he learned from both his many successful encounters and his failures. Dr Rynearson is careful to not confuse the reader with psychiatric jargon. Although he defines many common psychiatric diagnoses in easily understood terms, Dr Rynearson also shares fascinating historical information regarding these psychiatric diagnoses and therapies. He is keenly aware that readers recall stories (clinical vignettes) more easily than facts; therefore, every teaching point is illustrated by at least one captivating clinical vignette. The author teaches some simple (but often never learned or forgotten) pearls of history taking and ways to connect with patients by simply listening. For instance, one woman presented with severe chronic abdominal pain. She had spent her life savings seeing specialists and had undergone 7 operations. When Dr Rynearson first saw the patient, he asked about her pain. She said it had been present for 11 years. He simply asked “What happened 11 years ago”? She burst into tears and said that her only son had committed suicide 11 years ago by shooting himself in the abdomen with a 10-gauge shotgun. The patient had not discussed this with any of the physicians she had seen previously. When she dealt with this unresolved inner conflict, her abdominal pain resolved. The book is filled with many such pearls. The overriding lesson taught to clinicians is that, in this age of psychopharmacology, pharmacogenomics, and shortened appointment times with patients, one must not forget that often the key to successful treatment requires helping patients to recognize, become insightful of, and express their inner conflicts.
Strengths:
The clinical vignettes are captivating, well written, and represent “real” dilemmas that clinicians might see in their practice. The author highlights teaching points from each of these cases that he himself learned. Therefore, he transfers many clinical pearls of history taking and evaluation of patients with emotional issues that the reader can immediately put into practice. The author reminds us that, by bringing creativity into our own life and profession (such as his original use of art therapy and video technology in his therapeutic patient encounters), one's own personal and professional life can be much more satisfying.
Deficiencies:
If the reader is looking for examples of evidence from published literature to back up Dr Rynearson's vignettes and teaching points, he or she will be disappointed. However, if the reader wishes to be entertained while learning lessons from the career of a master clinical psychiatrist, he or she will be pleased and will enjoy this book.
Recommended Readership:
All clinicians who see and interact with patients
Overall Grading:
★★★★★