The Patient from Hell: Getting the Best That Modern Medicine Can Offer

Schneider, a climate scientist at Stanford and a MacArthur fellow, brought skills rooted in the uncertainty of his own field to bear on the treatments he received for mantle cell lymphoma, a rare condition for which treatments were relatively new. With his wife, Terry, also a scientist, he learned as much as possible about the protocol he had been assigned and read up on his oncologist, a leader in this type of cancer, Dr. Sandra Horning. Schneider gives a detailed account of the painful and otherwise unpleasant side effects of the chemotherapy, radiation and bone-marrow transplant he endured in a determined effort to arrest the disease. From the beginning, the author researched probabilities and outcomes and sought to modify decisions made by his physicians. Most importantly, after some resistance, Dr. Horning agreed to use Rituxan for Schneider as maintenance therapy to prolong his remission. Although the author's scientific language can be daunting, patients will relate to his arguments for the importance of patient advocates, individualization of treatments and the negative role bottom-line accounting plays in medical judgments made by HMOs. (Oct.)