BOOK REVIEWS

tables and graphs useful in summarizing information. lated a mental dialogue with the author, stimulating him
Adequate references through 1978 are provided at the to "go one on one with the author in just one more case."
end of most chapters. JOHN J. HERBST, MD
The editors state that this text is to "help prepare the Professor of Pediatrics
pharmacy student . . . to assume a patient-oriented role University of Utah School of Medicine
Salt Lake City
in health care." Clinzical Pharmacy and Therapeutics pro-
vides sufficient information to the student to approach
this goal. I recommend it as an acceptable text for in- THE OSTOMY BOOK-Living Comfortably With Colostomies, lie-
struction of pharmacy and nursing students in applied ostomies, and Urostomies-Barbara, Dorr Mullen and Kerry Anne
McGinn, RN. Bull Publishing Company, P.O. Box 208, Palo Alto,
therapeutics, recognizing its limitations. It would also CA (94302), 1980. 236 pages, $7.95 (paperback).
be an appropriate addition to the library of most hospital In the general field of ostomies, this is the most in-
pharmacies. It has little to offer practicing physicians or formative book to reach the public. The authors present,
clinical pharmacists. in a well-organized, easily readable form, material that
THOMAS C. HARDIN, PharmD
Assistant Professor should prove valuable to both patients with ostomies
School of Pharmacy and health care professionals.
University of Colorado Health Sciences Center For the patient, although the realities of living with
Denver
an ostomy are clearly spelled out, the general tone of the
* * * book is optimistic and encouraging. The illustrations are
PEDIATRIC GASTROENTEROLOGY-Case Studies-William Lieb- well done so that even a medically unsophisticated reader
man, MD, Assistant Professor of Pediatrics, Pediatric Gastroen- can recognize the anatomical arrangement of various
terology Unit, University of California, San Francisco, School of
Medicine. Medical Examination Publishing Co, Inc., 969 Stewart types of ostomies. Anecdotal experiences, which would
Avenue, Garden City, NY (11530), 1980. 496 pages, $18.00 (paper- have no place in a scientific treatise, are often cited, but
back).
these stories only add to the solid flow of facts and in-
As the title indicates the book consists of 58 case structions in a book aimed primarily at laymen.
studies of 57 different disorders of the gastrointestinal Medical professionals will also find considerable merit
tract in children. Each case study consisted of a one- or in The Ostomy Book. The comprehensive coverage, not
two-page presentation of history, physical examination only of the technical details of ileostomies, urostomies
and pertinent laboratory data. Next comes a series of and colostomies but of the practical problems of day-
multiple choice questions about the case. The heart of to-day care, will undoubtedly add to the education of
the book is the next section; the correct answer to each most physicians and allied health workers, for this is an
question followed by a discussion or commentary. This area of medicine usually skimmed over superficially
commentary is referenced, usually 15 to 20 references during their training. Indeed, the focus of the book on
per case study. Finally, there is an index so that readers the practical aspects of ostomy care is its most important
can proceed directly to the pages where specific problems, contribution.
diseases or drugs are discussed. The conditions covered Several of the chapters could unnecessarily alarm pa-
in the case studies include functional bowel disease with tients entering a hospital for a major operation. Despite
inflammatory bowel disease, celiac disease, parasitic in- the current malpractice scene, I do not believe that pa-
fections, shigella and intractable diarrhea, and the like, tients are well-served by reciting a litany of possible
and represent a broad cross section of gastrointestinal surgical complications. This criticism reflects a personal
illness. bias, and I fully realize that other surgeons may be more
The author states in the preface that he hopes the concerned about informed consent and only stop short
material presented will serve as a catalyst for further of warning patients that upon returning from the operat-
study in pediatric gastroenterology. If further study in- ing room a chunk of plaster may drop off the ceiling and
cludes a careful perusal of the book he has succeeded hit them on the head.
very well. The book is not intended as a textbook, but Certainly the chapters covering the preoperative and
for more experienced practitioners serves as a stimulating postoperative periods are not conducive to a patient
review using a format a practitioner is most familiar "living comfortably"-a goal mentioned in the subtitle
with, the individual patient. For the less experienced of the book. In these pages, hospital discomfitures and
student it presents a wealth of information in the com- operative complications are agonizingly described and
ment section that is related to a real patient as presented can only add to the prospective surgical patient's jitters.
in the case study. The book is very readable and one Thus we find the following:
quickly finds oneself reading "one more case" in a one * ". . . first visit was almnost before the cock crowed
on one match with the author until one finds oneself at in the morning;"
the 58th case and disappointed that it is the last. * ". . . write up another three dozen orders for tests;"
As with any single author text, there is considerable * '"1 was introduced to new forms of misery;"
time lag between manuscript and publication, and few
references are more recent than 1976, but this does not * "blood . . . may form small clots;"
detract from the information in the commentaries. As in * "We crowded into a cold and tiny bathroom, I didn't
any situation where one tries to simulate progressive like any part of it," and
actions in the real world in print, at times the situation * "If only they'd stop nagging and leave me alone."
is contrived. Occasionally in the question section we are
expected to request a test, the results of which are given Such comments continue on and on, discussing bladder
in the laboratory data section, or we are left wondering infections, painful wounds that may take a year to heal
until the commentary section how frequent is often-S and stitches that may pop open.
to 10 or 20 or 50 percent? Some questions are obviously Not very reassuring. 1 see no reason for a patient to
included to serve as a springboard for a lively, succinct worry before an x-ray examination about a "fiery heat
discussion in the commentary section. Rather than detract flash following the injection." I prefer the technician's
from enjoyment of the book the reviewer found it stimu- calmly informing the patient before the injection that it

THE WESTERN JOURNAL OF MEDICINE 83