A Toss of the Dice is an
absorbing collection of anecdotal stories, crafted beautifully by practicing
pediatrician Dr. Natasha Hays.  As explicated by Hays, the "patients"
described in the book are mainly composite characters, drawn from several 
different patients presenting with similar problems.  Additionally, quite a bit
of information, about Hays’  professional and family life, is woven, artfully,
into the textual fabric.  The tapestry of engrossing, if emotionally
drenching,  anecdotes, recounted by Hays, is enshrouded, unmistakably,  by an
aura of real life experiences.

   Interestingly, and somewhat
unusually, the writing style employed, by Hays, commingles great sensitivity
and compassion, with blunt frankness, unadulterated candor, and, at times, even
harsh social commentary.  With this brush skillfully in hand, Hays very revealingly
paints a picture of clinical pediatric medicine that is both sobering and
fascinating, and which will likely enthrall the rapt attention of parents as
well as health care professionals  entrusted with treating children.

   A very important lesson imparted
by this wonderful book, indeed, perhaps the most important lesson of all, is
that compassion is an indispensable part of the bond connecting health care
provider and patient.  The steadfast belief of Hays, in fact, is that a doctor
simply cannot be a very good doctor, in the absence of compassion.  This overarching
message reverberates distinctly through the pages of the book.  Hays obviously
derives great personal and professional satisfaction, from caring for children
in a very sensitive manner.  And her passion for sensitively helping her
pediatric patients permeates text.

   Structurally, Hays very
frequently recounts fragments of conversations with patients.  These
conversational snippets comprise an integral component of the substance of the various
stories, and unequivocally, and rather poignantly, help reveal that, although
pediatric medicine has a sort of mechanistic clinical side, it also very
importantly has an emotionally wrenching side, frequently immersed in pain,
suffering, and even death.  In a manner stylistically bereft of academic
formalness, and tailored quite adroitly to finely fit lay readers, Hays
illumines some of the mechanics, of the clinical part of pediatric medicine. 
Concomitantly, Hays cuts deeply to the core of the humanistic side of pediatric
medicine, drenched in the emotions of health care providers and their patients.

   Hays, resolutely wielding a pen
exhibiting unabashed forthrightness fused, inseparably, with sensitivity,
composes sundry stories in twenty three chapters.  In the first chapter, Hays
very frankly opines that having children is actually akin to a toss of the
dice.  Because, all persons carry seeds for genetic disorders.  The many
tentacles, of Hays’ probing interest, extend to pithy commentary concerning her
medical school and pediatric residency experiences, and her planting of professional
roots, in the soil of a developmental evaluation clinic, in North Carolina.

   Mostly, however, Hays expounds,
in a gentle, insightful, and informative way on multifarious developmental and
behavioral problems affecting children.   Her far flung net ensnarls child
abuse, mental retardation, Down syndrome, fetal alcohol syndrome, attention
deficit hyperactivity disorder, depression, bipolar illness, cerebral palsy, autism,
seizures, elective mutism, and cyclic vomiting.  The expansive gamut, of Hays’
wide ranging focus, encompasses further:  the rather lurid mental illness
called Munchausen by proxy, hearing impairment, bullying, and terminal illness
in children.

   The anecdotal observations, and accompanying
discourse, proffered by Hays, although enlighteningly suffused with luminous
insightfulness, informativeness, and sensitivity, may, however, be overdiluted,
in a substantive sense, for researchers.  The academically inclined may further
carp that, although Hays may effectually convey observations and information
that is anecdotal in nature, nonetheless, the "truth", in the
tradition bound medical research world, must properly be anchored, securely, to
data emanating from double blind, placebo controlled, peer reviewed  academic
studies.  The relative sparseness of detail, regarding many of the anecdotes,
may be disquieting, as well.

   With proper weight affixed to
the foregoing caveats, Hays’ riveting descriptions, of the real life trenches
of clinical pediatric medicine, should be immensely interesting and edifying
for all parents, as well as health care professionals involved in some capacity
with the care of children, including pediatricians, geneticists, psychologists,
psychiatrists, child psychiatrists, neurologists, endocrinologists, physical
therapists, speech therapists, and genetic counselors.

© 2006 Leo Uzych

Leo Uzych (based in Wallingford, PA) earned a law degree, from Temple University;  and a master of public
health degree, from Columbia University.  His area of special professional
interest is healthcare.

Categories: ChildhoodDisorders