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Review of Sixth Edition of Forfar and Arneil's Textbook of Pediatrics
Early Human Development 80 (2004) 77 – 78 www.elsevier.com/locate/earlhumdev
Book review Review of Sixth Edition of Forfar and Arneil’s Textbook of Pediatrics A review of such a ‘magnum opus’ has to formulate basic questions about its purpose. I cannot imagine anyone reading this from cover to cover, but these monsters are still produced and bought. Are they just talismans to protect us from ignorance? In truth we keep these books accessible in clinics or by our telephone so that we are not caught out by intrusions into our ‘blind spots’. We also trudge through them for ideas when we are puzzled. We revise our rusty knowledge of mechanisms of unusual disorders. We look for a broader understanding when we are due to make presentations. The alternatives are lonely hours in the library or on the computer. Books like this are our friend. Friends are not expected to be perfect—even though the eminent editors have striven valiantly. The examples I give of the variability is not to criticise individuals, but to show alternative approaches (and that I have read a reasonable amount of the book!). The section on constipation is accurate and readable—but it is not practical enough to help me in out-patients—should it be? The account of osteogenesis imperfecta is brief and out of date compared with up to the minute reviews in Current Paediatrics or Archives or this Journal. This is inevitable. In the short section on E.C.M.O. one is advised to discuss each individual case with the specialist centre, which is excellent advice and saves paper. Broader issues like prevention are well covered. Topics like breaking bad news highlight the twin elements of our art—knowledge and skill. The multi-author volume can provide much knowledge and a gateway to more. There are thousands of references; details of key reviews which provide all these would save paper and the readers time. Individual authors do not need to support their views by evidence of their many papers. How much space should be devoted to clinical skills, techniques and investigations? The chapter on developmental assessment is practical as well as fact packed. Should an account of the ECG give a structured plan for interpretation, or is that now left to the machines? Balance is difficult. The balance between fundamental science and clinical information is excellent in the sections on immunodeficiency, infections and respiratory disorders as one would expect. Many pages on the embryology and cellular development of the brain seemed relevant if I were due to meet an examiner with these interests, but not as enjoyable as the discussion on birth asphyxia. That is a personal view. Some topics such as the eye I found fascinating because of my ignorance. I was also grateful that the account of oncology was clearly written for the non-expert reader. The contrast between providing knowledge and increasing skill arose again in the chapter on ethics and the law which is a gold mine of factual information. One of the authors, a professor of medical law, has also written a series of books which demonstrate
doi:10.1016/j.earlhumdev.2004.04.006
78
Book review
skill ‘in the application of normal psychology’. Our patients will be grateful if we learn to use our knowledge to help them as individuals allowing them dignity and choice. Much can be learnt from Ms. Precious Ramotswe, and ‘The Number 1 Ladies Detective Agency’, as well as from Forfar and Arneil. If you need a tome—and most of us do—use this one, use it frequently, and take the CD-ROM wherever you go. R. Wilson Department of Child Health, Kingston Hospital, Hanover House, Galsworthy Road, KT2 7QB, Surrey, UK Tel.: +44-20-8934-3413; fax: +44-20-8934-3415
Book review Review of Sixth Edition of Forfar and Arneil’s Textbook of Pediatrics A review of such a ‘magnum opus’ has to formulate basic questions about its purpose. I cannot imagine anyone reading this from cover to cover, but these monsters are still produced and bought. Are they just talismans to protect us from ignorance? In truth we keep these books accessible in clinics or by our telephone so that we are not caught out by intrusions into our ‘blind spots’. We also trudge through them for ideas when we are puzzled. We revise our rusty knowledge of mechanisms of unusual disorders. We look for a broader understanding when we are due to make presentations. The alternatives are lonely hours in the library or on the computer. Books like this are our friend. Friends are not expected to be perfect—even though the eminent editors have striven valiantly. The examples I give of the variability is not to criticise individuals, but to show alternative approaches (and that I have read a reasonable amount of the book!). The section on constipation is accurate and readable—but it is not practical enough to help me in out-patients—should it be? The account of osteogenesis imperfecta is brief and out of date compared with up to the minute reviews in Current Paediatrics or Archives or this Journal. This is inevitable. In the short section on E.C.M.O. one is advised to discuss each individual case with the specialist centre, which is excellent advice and saves paper. Broader issues like prevention are well covered. Topics like breaking bad news highlight the twin elements of our art—knowledge and skill. The multi-author volume can provide much knowledge and a gateway to more. There are thousands of references; details of key reviews which provide all these would save paper and the readers time. Individual authors do not need to support their views by evidence of their many papers. How much space should be devoted to clinical skills, techniques and investigations? The chapter on developmental assessment is practical as well as fact packed. Should an account of the ECG give a structured plan for interpretation, or is that now left to the machines? Balance is difficult. The balance between fundamental science and clinical information is excellent in the sections on immunodeficiency, infections and respiratory disorders as one would expect. Many pages on the embryology and cellular development of the brain seemed relevant if I were due to meet an examiner with these interests, but not as enjoyable as the discussion on birth asphyxia. That is a personal view. Some topics such as the eye I found fascinating because of my ignorance. I was also grateful that the account of oncology was clearly written for the non-expert reader. The contrast between providing knowledge and increasing skill arose again in the chapter on ethics and the law which is a gold mine of factual information. One of the authors, a professor of medical law, has also written a series of books which demonstrate
doi:10.1016/j.earlhumdev.2004.04.006
78
Book review
skill ‘in the application of normal psychology’. Our patients will be grateful if we learn to use our knowledge to help them as individuals allowing them dignity and choice. Much can be learnt from Ms. Precious Ramotswe, and ‘The Number 1 Ladies Detective Agency’, as well as from Forfar and Arneil. If you need a tome—and most of us do—use this one, use it frequently, and take the CD-ROM wherever you go. R. Wilson Department of Child Health, Kingston Hospital, Hanover House, Galsworthy Road, KT2 7QB, Surrey, UK Tel.: +44-20-8934-3413; fax: +44-20-8934-3415