Reaching Down the Rabbit Hole, by Allan H Ropper

Shelf Indulgence

Today’s Shelf Indulgence subject is truly extraordinary. Allan Ropper is a professor at Harvard Medical School. Credited with founding the field of neurological intensive care, he knows a thing or two about the brain. Taking the form of a series of case studies, it provides fascinating insights into a neurologist’s work and the often bewildering behaviours caused by the malfunctioning brain.

His style is straight-talking and sometimes wise-cracking – you won’t find the gentle, almost contemplative studies typical of Professor Oliver Sacks’s work in this book – but it is every bit as informative. A caveat: Ropper pulls no punches and, since this text discusses terminal diseases including Parkinson’s and Motor Neurone Disease, the outcomes for some of his patients can be searingly painful to read.

Ropper emphasises the importance of really listening to the patient, and in one astonishing chapter, describes how a student’s misdiagnosed ‘drug psychosis’ was actually caused by an ovarian cyst. While the understanding of the human brain has progressed with new techniques and equipment, some phenomena remain a complete mystery – such as the peculiar condition named Transient Global Amnesia. It led to one patient being admitted having driven almost 200 miles but with no memory of the journey. Intriguingly, TGA spikes on the first warm day of spring in Boston. Ropper explains the correlation, if not the cause, so I won’t spoil it for you, and, thankfully, patients suffering TGA quickly make a full recovery, so that’s at least one case study with a happy ending.

Ropper credits his collaborator, Burrell – a mathematician and statistician – with having the ‘lyrical talent to make true stories sing’, and for bringing the disparate stories into a cohesive whole, as well as gently steering Ropper away from his occasional rants against the system.

Reaching Down the Rabbit Hole was shortlisted for the BMA Medical Book Awards in 2016. I clearly missed it back then – but that’s the joy of writing this column – it doesn’t have to be on the lists of publishers’ new releases to be reviewed here.

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