Student review: Pathophysiology of Disease: An Introduction to Clinical Medicine
Authors: Stephen J. McPhee and Gary D. Hammer
Edition: Sixth revised
When I first started medical school, the course co-ordinator informed us that medicine is not "difficult" in the way that quantum physics or mathematics is "difficult", but that the challenge of medicine is the speed at which we would have to assimilate, recall and logically apply a vast quantity of information.
So in order to facilitate such speedy learning, the medical textbooks that underpin our studies need to be accessible and comprehensive, balancing breadth and depth.
In many ways, Pathophysiology of Disease is an ambitious book that falls at the last hurdle by trying to do too many things. It has the breadth, but it is at the expense of the requisite depth found in subject-specific textbooks.
By trying to squeeze in introductory anatomy, physiology and pathophysiology, the authors attempt an insurmountable task and produce a book that is admirable in scope but frustrating in its limitations.
It is marketed as an introductory textbook, but anyone approaching the chapter "Disorders of the Immune System" without some background knowledge will end up drowning in the densely written text; conversely, the chapter on "Cardiovascular Disorders: Heart Disease" starts with a generalised overview of the heart that would not be out of place in high school.
One of the biggest sins of omission, however, has to be the glaring absence of any discussion of lung cancer in the sections on respiratory diseases and neoplasia; a major oversight, surely, given the continued prevalence of smoking worldwide.
Eschewing the heavy use of computer-generated "cartoons", this book relies instead on presenting information in tables and graphs, which is quite refreshing and provides a high yield of information.
I found myself preferring the physiological analysis of heart function in this book over the one found in Vander's Human Physiology: The Mechanisms of Body Function (Eric P. Widmaier et al). As in Vander's, and as is de rigueur for the medical textbooks we study, each chapter is littered with review questions and ends with case studies, some of which are moderately challenging.
Incidentally, the lack of gory pictures makes it quite suitable for studying in public, a bonus for those who work on the move, or sit reading in coffee shops.
Ultimately, however, this book is insufficient as a core textbook. While it has many things to offer, it would necessarily remain a supplementary text to Kumar and Clark's Clinical Medicine, Gray's Anatomy and Vander's Human Physiology.
Given the price of medical textbooks, money would have to be no object in order for this one to become a worthwhile purchase.
Who is it for? Undergraduate medical students.
Presentation: Conservative, minimalist and well designed.
Would you recommend it? Only as a supplement/revision tool to more specialised textbooks.
Clinical Medicine (Oxford Assess and Progress)
Editors: Alex Liakos and Martin Hill
Publisher: Oxford University Press
Ewen Millar is a second-year medical student, University of Aberdeen.