Neurologist Suzanne O’Sullivan’s excellent book reveals that medicine remains as much an art as a science
Suzanne O’Sullivan qualified as a doctor in 1991. She is now a consultant at the National Hospital of Neurology and Neurosurgery in London. This, her first book, is an account of her experience over 20 years of the many conditions that exist in that much disputed no man’s land between psychological and physical illness. The patients she examines in these pages often have dramatic symptoms – blindness, paralysis, seizures, intense pain and chronic fatigue – but they are symptoms related to no identified disease or physical cause. By the time these patients come to O’Sullivan they have generally exhausted every scan and endoscopy the NHS can provide, as well as the patience of doctors and specialists in different fields. She is often there to tell them the last words that they generally want to hear: that the very real agony that they may feel in head or gut or back or limb is all in their mind.
To O’Sullivan that is never a trivial diagnosis, no matter how it sounds. Psychosomatic illness, the experience of physical symptoms brought about by emotional states, is not a new phenomenon, though arguably it has reached pandemic proportions with the self-diagnostic possibilities offered by the internet. O’Sullivan traces it at least as far back as Hippocrates in 400BC, who noted, for example, that emotion alone could trigger sweating and cause the heart to beat double time. As a result of such observations Hippocrates believed that a physician must treat disturbances in the mind as well as the body. Two millennia before Freud he was analysing the dreams of his patients for signs of mental distress that might be causing physical illness.
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