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So much of neurology exists only “in use”. This is the neurology that is practiced in the clinics, wards, and offices of seasoned clinicians and cannot be found in large encyclopedic textbooks of neurology or smaller monographs intended for medical students. The accumulated experience of the neurologist can be distilled to a number of action items and thought processes that are challenging to articulate.

Dr. Aaron Berkowitz has written a book that occupies just this position. He has taken the transactional daily work of neurology and produced a wonderfully readable, concise, but by no means superficial book that fits well in the current pedagogic environment. One might ask whether any book on neurology is needed now that disembodied information is so easily available on the web and algorithms for various signs, symptoms, and diseases abound. But between information that is as often misleading as it is useful, and the storehouse of wisdom accumulated over a long career, sits a great body of neurological knowledge. It is this assembled knowledge that allows us to efficiently move through the workday and can be taught to students and residents during their rotations. Berkowitz’s book is more than a compendium or teaching guide and is far superior to existing books of its size and scope because of the thoughtfulness with which the knowledge about diseases and neurological conditions has been assembled. He gets right down to business, addressing almost every major point that is encountered on the wards and in the clinic.

A book such as this one is more suitable for neurology than for any other branch of medicine. We still depend on the interface between our own refined clinical skills and our decisions regarding diagnosis and treatment. The pearls contained here about the meaning of particulars of the history and examination cannot be found elsewhere. The book makes a seamless transit from these data to practical wisdom about their application. The material is clear and avoids the ambiguity that clutters most other books. In doing so, it also incorporates the latest thinking from clinical trials and together, these features provide one of the best modern outlooks on the pragmatic practice of neurology.

It takes a certain outlook on pedagogy and practice to produce such a book. Dr. Berkowitz has more than succeeded, and I find myself looking at a number of the chapters over and over to reorient myself to solid teaching and practice.

Allan H. Ropper, MD
Professor of Neurology
Harvard Medical School
Boston, Massachusetts

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