REACHING DOWN THE RABBIT HOLE . by Allan Ropper & B. D. Burrell . ( Atlantic £17.99 ) Some years ago a policeman stopped a driver who had been circling a roundabout for nearly an hour . When he asked him if there was anything wrong , the man replied : ‘ I don ’ t know how I got here. ’ Ropper gives a fascinating account of his work as a neurologist in Boston ( stock image ) The confused driver , a salesman , was taken to hospital , where a junior doctor found nothing wrong with him , apart from memory loss . He concluded that it was an episode of transient global amnesia ( TGA ) , a dramatic , but harmless condition . The junior doctor asked Dr Allan Ropper , then the hospital ’ s senior resident in neurology , to authorise the patient ’ s discharge , expecting that his memory loss would , as usual in incidents of TGA , return within hours . Ropper examined the man himself . Together , they worked out that the roundabout incident had come at the end of a 12-hour drive . The patient recalled only getting in his car that morning and heading for somewhere completely different . He couldn ’ t retain the names of the doctors examining him or what he ’ d just eaten . Unconvinced by the TGA diagnosis , Ropper decided to keep him in overnight , suspecting a stroke . The following morning , the salesman ’ s memory had returned , but with huge gaps : had he been suffering only an episode of temporary amnesia , it would have returned completely . After 23 hours , the patient ’ s speech became slurred and Ropper knew instantly he was suffering a stroke . An arterial blockage was restricting blood flow to part of his brain . Treated with anticoagulants and other drugs , the man quickly recovered with only minimal memory difficulties . Ropper ’ s fascinating and gripping account of his work as a neurologist at Boston ’ s Brigham and Women ’ s Hospital in Massachusetts reveals what a mysterious and little understood organ the brain is , not least in the list of all the things that can go wrong with it . Sometimes it simply seizes up because of psychological pressure , as in the case of a 23-year-old woman who was admitted after suddenly losing the power of speech . Extensive testing showed no evidence of brain damage , seizure or stroke . But questioning of her family revealed she ’ d broken up with her boyfriend that day . Next day , she ’ d recovered . So-called hysterical symptoms that have no basis in disease often present like neurological diseases . They include paralysis , the inability to walk or talk , blindness , deafness and weakness . Spotting genuinely serious malfunctions and distinguishing them from merely harmless tics and tremors is far from easy , but there are some symptoms a neurologist doesn ’ t want to see . In the case of a young mother admitted with what appeared to be a severe asthma attack , Ropper ’ s heart sank when he spotted the muscle between her thumb and forefinger twitching . He knew he was looking at ALS or Lou Gehrig ’ s disease , a fatal illness that would see her body begin to shut down until it was kept alive solely by machines . At some point this woman would have to decide when her life became so unbearable she would ask for the machines to be switched off . Quite how someone works with that kind of trauma almost every day is unimaginable to the layman . What comes over in this remarkable book is Ropper ’ s humanity and his unremitting sympathy for his patients . If only all doctors were like him .
Ropper gives a fascinating account of his work as a neurologist in Boston . He treated a man who lost his memory and spent 12 hours driving his car . Unconvinced by the original diagnosis he kept him in for further testing . He found an arterial blockage was restricting blood flow to his brain .