Book Review: The Woman with a Worm in Her Head
The Woman with a Worm in Her Head: And Other True Stories of Infectious Disease is a memoir-cum-medical-journal by Dr. Pamela Nagami, a Clinical Associate Professor of Medicine at UCLA. Containing 11 different chapters, each dealing with a different disease, Dr. Nagami discusses interesting cases from her career and offers insights into what goes into finding and saving a patient from infectious diseases.
The book opens with the story of a patient who picked up a worm while eating raw snake meat in Vietnam, While this sounds like a recipe for disaster - there are also stories where the mundane turns into the mystery. Stories of tiny bacteria picked up from breathing valley air, an injection received 2 decades ago, or a mosquito bite in an air-conditioned hotel room - that turn a normal person's life into a struggle for survival.
Some of the really interesting cases to me were those of Valley Fever (which you can seemingly pick up from inhaling valley air that contains these bacteria), a strain of chicken pox (that can cause multiple organ failure and eventually death), and a vaccination gone wrong - injecting an imperfect virus, a ticking time bomb.
From her practice in the 1970s, Nagami has been through not only medical advancements but also changes in our attitudes towards various diseases. She reminds us of a time when HIV was rampant, HIV-positive patients were discriminated against (as being primarily known as a disease that infects the LGBT community), and the government was complacent in trying to find a cure. A time when even doctors would avoid treating these patients or be afraid to shake hands.
Nagami does not shy away from her failures either. In fact, most of her stories deal with how despite all our advancements, we're still helpless against these tiny micro-organisms and their ever-growing resistance. The chapters on Aids and Manju were especially heart-wrenching. A lot of our fights with infectious diseases are still based on surviving as opposed to curing.
What works best for a book like this is Dr. Pamela Nagami's humanity. She speaks early on, of the clinical detachment she had to develop to be able to witness all the pain and suffering passing through the ICU, and the toll it took on every intern. However, the book does not feel clinical at all! The insights into her mind, the way her personal and professional life intertwined, and the quick calculated decisions of dealing with family members of patients that doctors know are gone far beyond, offer a humane look into how much doctors deal with.
Nagami describes her role much like that of a detective. A sore throat could mean anything from early onset of coccidioidomycosis to the common flu. Does one wait for things to get worse to take things seriously? Doctors are human, not heroes, and more often than not filled with as much hope as the patients they are struggling to save. In fact, Nagami suffers from panic attacks, and shys away from medical procedures - not the ideal self-effacing image movies would have one believe of doctors. It is not a comforting thought, to know that the doctor you have visited is also unsure if the next procedure is the cure, or simply a wild goose chase - but it is what it is.
Throughout the book, I found many instances where it's clear that Nagami herself still struggles to give meaning and purpose to everything she witnesses. Early on, she asks - what is the purpose of all this suffering she was made to witness? The scenes in the ICU were enough to drive the young intern away from the gates of medicine. And she was not the only one, many found the harrowing scenes far beyond their wish to save the world.
But she finds the answer (or at least a will) in a graphic scene while looking through the translucent hands of a half-formed baby:
I still don't understand the purpose of the suffering I've seen, but I have come to believe that I'm supposed to witness it so I can help the next patient.
Years later, after losing a patient, she asks her husband Glenn the meaning of life - if any, if it fizzles out so soon. And he replies with:
The meaning of life is life itself. Life fighting to stay alive in a cold, dark universe.
It's interesting to find a medical, non-fiction that mediates deeply on these aspects while retaining the gory details of the disease without sacrificing the patients' identity as individuals. But Nagami did it very well.
On the whole, the book is quite graphic with descriptions of flesh-eating bacteria (and the damage they cause) to patients suffering from extreme chicken pox. If you're a hypochondriac, I'd suggest staying miles away from this book.
But of course, Nagami's aim, as she mentions in the end, is not to scare one with all the possibilities of infections - but to simply make people more aware.
Hopefully now if you haven't had chickenpox, you will get the vaccine, and if you live in cocci hot spots, you'll think twice before hiking on a windy day.
The cases are interesting and so is the race against time to find its causes. It's not something I would read again, nor is it something exemplary from this field, but it was a good read while it lasted!
Overall rating: ✰✰✰/5
Let me know how you found this book!