playing basketball. She describes an incident in high school where she experienced a syncopal episode while watching a rat being injected in the lab. Chapter 2 deals with life as a chemistry major at Vassar( the college for women only until 1969) in Poughkeepsie, New York. She describes her experience with alcohol and“ dope” and a mood disorder, for which she was seen by a psychiatrist.
To prepare for a future medical career, she started working at local hospitals to get a taste of how the art and science of medicine works. She also describes interesting details of taking the MCAT exam. She came to Louisville, the home of one of her classmates, with the twin goals of going to the Derby and taking the MCAT; the examination was apparently difficult as she suffered from dyslexia. Nevertheless, she did get into the MD / PhD program at Johns Hopkins. Chapter 3 deals with her experience as a medical student,“ one of 10 women in a class of 110.” She was greatly impressed by two great women: Prof. Helen Taussig, pediatric cardiologist( portrayed in the fabulous 2004 movie, Something the Lord Made) and Bernadine Healy, who became the first female director of the NIH. For her PhD program, she worked on identifying chemicals that could be potential neurotransmitters.
Dr. Young had no uncertainty about picking a specialty. She was fascinated with the brain and writes,“ Neurology seemed to be a subspecialty of wonderful people who dealt with little blood, studied a beautiful brain and approached patient diagnoses as an opportunity to solve the puzzle of the patient’ s disease.” She did her neurology residency at the University of California, San Francisco. She describes several anecdotes of patients she saw, experiences that most neurology residents can relate to. She joined the University of Michigan neurology department as faculty, pursuing both research and patient care. She and her husband started a Movement Disorders Clinic, which piqued her interest in Huntington’ s disease( HD).
Chapter 9 titled“ Neuros in the Lagoon” deals with her experience as a visiting neurologist, part of a team studying Huntington’ s disease in Lagunetas, a village in Venezuela, which apparently had the largest cluster of families with HD. The author introduces the famous Dr. Nancy Wexler, who organized those expeditions to Venezuela for several years. Dr. Wexler, while a psychology student, was confronted with the diagnosis of HD in her mother. She elected to study HD as her thesis; her father, Milton Wexler established The Hereditary Disease Foundation in 1968. Later Nancy Wexler organized the U. S.-Venezuela Huntington’ s Disease Collaborative Research Project, arranging several trips to Venezuela to study HD. Researchers were starting to use recombinant DNA technology and needed blood samples from many HD patients, especially those who inherited the responsible genes from both parents, to locate the genetic mutation. The remote village in Venezuela had such families and the teams led by Dr. Wexler documented clinical details and collected blood samples from these patients. This effort led to the identification of gene mutation with expanded CAG repeats( HTT gene in chromosome 4) in 1993, paving the way for development of a diagnostic blood test and potential treatment.
The next several chapters deal with her move to Boston to be chief of neurology at MGH and professor of neurology at Harward Medical School and how she was able to manage as the first female to be in that role. She describes the situation as“ When it came to neurology, Mass General was a Boston star. The Mass General Neurology Service was renowned for its extraordinary triumvirate of senior leaders in the field: Raymond D. Adams, C. Miller Fisher and E. P. Richardson. In their eighties, they still came to work daily, taught students and saw patients. They were very welcoming and supportive of me. Their work was their life.” The department she headed had 200 faculty and trainees. During her long career at MGH spanning 21 years, she was successful in elevating the clinical and research status even more and was instrumental in establishing the Mass General Institute for Neurodegenerative Diseases.
The last chapter deals with her retirement in 2012. She writes“ I had been chief of service for 21 years. I felt strongly that leaders shouldn’ t stay too long in their positions. I don’ t want to go past my prime. A new leader would bring a new financial package for the department, new recruits, new ideas and new expertise.” She concludes her memoirs with an optimistic statement.“ I have learned so much about disorderly movements and disorderly thinking. Hopefully these diseases will become things of the past in the next generation.” I strongly recommend Dr. Young’ s book to medical students, interns, residents and physicians of all specialties.
Dr. Iyer practices at the Neurodiagnostic Center of Louisville and is a retired professor of neurology at the University of Louisville School of Medicine.
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