"The Woman with the Worm in Her Head & Other True Stories of Infectious Disease" Pamela Nagami, M. D.

Andy's red blood cells lay like a field of a thousand flattened jelly donuts.  There should have been throngs of blue cell fragments, the platelets, but there were almost none to be seen.  At first glance the red cells seemed OK; they were neither abnormally large or small.  And then we saw them:  tiny blue rings inside the red cells, each ring set with two red dots.  Some of the red cells were parasitized by two of these rings.

I looked up at the technician.  "This is falciparum malaria, right?"

I have read several books on medicine, including books on medical mysteries, but no other book made me feel so hypocondriacal as this one.  That is not a negative recommendation, quite the contrary.  This is a book for anyone who wants the medicine on the TV show "House" is real and who watch it because of the medical mystery and not for the soap opera of the doctors' lives, Hugh Laurie's sexiness notwithstanding.  Dr. Nagami talks about real medical mysteries, her emotions throughout her medical career (something you won't get from House), and the care and prognosis of the real patients she treats.

As opposed the episodes of House, the mystery in "Worm" does not end with a final diagnosis but rather with how the patient responds to treatment and therapy, and so these are more complete and more satisfying stories.  Nagami kept a journal of what was happening with her patients and with her family, and so she is able to mesh her family life with her professional life, something I particularly enjoyed.  She is not able to compartmentalize as well as some people in medicine, and I think she is the kind of doctor I would want if I were as seriously ill as the patients she describes in this book.

Nagami tells her journey from learning how to catch earthworms as a child to specializing in Infectious Diseases.  As an ID specialist, she worked on cases with worms of all sizes, tapeworms, bacteria and viruses.  "Worm" has 11 chapters on stories from her career, sharing details about her patients that show how she connected with them.  I appreciated the humility and humanity she shows, and my negative opinions about doctors were softened a little.

The book did frighten me a little since I had just returned from South America.  One of the stories is about a man who visits the Ivory Coast and contracts malaria even though he only stays in five-star hotels.  Another is of a woman who visits Chile and gets a hookworm from eating a salad.  So, I am sure I am overreacting a little when I worry that the salads I ate in Argentina and Uruguay were contaminated or that the mosquitoes that bit me along the Párana river were carrying malaria, but be assured that if I develop any of the symptoms of the two patients described by Dr. Nagami I will be a little worried.


I enjoyed the read, Nagami's voice and the stories.  Another recommendation of the book is that it could have been longer - I wasn't ready to be done with it at the end.  It is also good that it includes a medical terms glossary, an index and a selected bibliography.