Casebook of Psychosomatic Medicine

The Casebook of Psychosomatic Medicine is a well-written collection of fascinating case reports derived from the authors’ years of experience as psychosomatic medicine clinicians. The wide variety and number of compelling stories are a testament to their collective wisdom and skill. This is an enlightening, entertaining, and informative textbook that would be well suited for trainees as well as those who already practice psychosomatic medicine. The book begins with cases illustrating both the challenges and the satisfaction inherent in evaluations in psychosomatic medicine; it then proceeds through 17 chapters, organized by major systems of illness (e.g., heart disease, gastrointestinal disorders) or subspecialty (e.g., surgery, dermatology), similar to the organization of other textbooks in psychosomatic medicine. What is particularly appealing about the cases presented here is that they are reflective of “real” consultations. The final diagnosis may not be entirely clear, or the patient may not be a “textbook” example of a disorder, and “the answer” may never truly be known. The course of treatment in the hospital might be difficult, and an unsatisfying outcome, or death, remains a possibility. The patient histories are only the beginning of the process of reflection and inquiry, because the authors then direct the reader through useful and thought-provoking discussions after a case or series of cases. The material is not an exhaustive exploration of each subsection topic (which would be unwarranted), but the authors sufficiently cover key aspects of practice, offer new insights, and invite the reader to address further research questions raised by these intriguing histories and dilemmas. The chapter on heart disease is very informative; it exemplifies the educational value of the discussion sections, where the “triple-D triangle” of dementia, delirium, and depression is explored, and the reader is guided through expert, comprehensive management of complicated consultations. The chapter on gastrointestinal disorders is also particularly well written, with concrete examples of questions to explore with patients that can help build resiliency in the face of what appears to be overwhelming difficulty. In the oncology chapter, one receives sage advice, and the art of the consultation of a psychosomatic-medicine practitioner is meticulously displayed in poignant case histories. The chapters on surgery and psychosis in the general-medical setting have fascinating and enjoyable case examples that will be remembered long after the reader has finished the book. There are only a few instances where it seemed as though the authors may have been able to omit a redundant example from a series of cases. There are also only a few case examples that seemed so rare (albeit fascinating) that they might not be relevant for most trainees or practitioners. The combined chapter on obstetrics/gynecology and pediatrics is disappointingly brief, given the wide range of possible topics and issues inherent to this aspect of psychosomatic medicine. In future editions, an expansion of this chapter (or possibly division into two separate chapters) would enhance the educational breadth, such as that demonstrated in the rest of the textbook. There may also be a consideration given to developing a chapter devoted to somatoform disorders or medically unexplained symptoms. Although they were touched upon in some of the chapters, this topic seemed to be somewhat overlooked. Otherwise, the reader should find this to be a very satisfying text that can be incorporated into coursework for medical students, a general-residency training program, or a psychosomaticmedicine fellowship. I would also recommend this book to the seasoned psychosomatic-medicine specialist, because the cases and discussions presented are thoroughly enjoyable, as well as educational.