Published On February 23, 2023
Diagnosis is a series about the past, present and future of a medical cornerstone. It examines all aspects of diagnosis, how it happens, how it can be shaped by history or human bias, and how a diagnosis can itself affect a patient’s health. In this episode:
Walter B. Cannon was a Harvard Medical School student in 1898. His lessons about the human body consisted of four-hour daily lectures that he found “dreary and benumbing.” Cannon envied his roommate, a student at Harvard Law School, whose classes were taught through real legal cases provided by his teachers. At Cannon’s urging one professor at the medical school, Dr. Richard C. Cabot, adopted what came to be known as the case method, in which students did discuss “actual cases of disease”. The practice soon broadened beyond the school and before long Cabot and his colleagues were mailing four so-called case records per week to more than 800 subscribers. These records of patients would eventually become a fixture of the New England Journal of Medicine, where they have appeared consistently since 1923.
A main feature of the Case Records then and now is their focus on the act of diagnosis and the curious turns it can take. Each of these articles begins with a patient and their symptoms. Step by step the records tease out information in the manner of a mystery novel, challenging the reader to piece together the disease at the root of the problem. Eric Rosenberg, who has been the editor of the Case Records since 2014, discusses their continued relevance.
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