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Chapter 6 shines the spotlight on how specialists can also run into problems. The chapter has some good stuff but also runs into issues of complex writing.

For instance, Groopman is once again does a good job of delving into medical behind-the-scenes to stop you cold.

"Most of what we do in pediatric cardiology, we make up. In fact, a fraction of what is routinely done today in my specialty, I made up," Lock said with a grin. That is because children often have such unique problems with their hearts that there is little precedent. But, Lock continued, "you simply have to do something. The big problem is that most people assume that once it's made up, it's actually real. Especially the people who make it up themselves. Then they think it came straight from God."

And this little tidbit

One of the most common congenital abnormalities of the heart is a hole between the two upper chambers, between the right atrium and the left atrium. Since the pressure in the left side of the heart is higher than in the right, blood will flow from the left atrium through the hole into the right atrium.This aberrant blood flow is called a shunt and can overload the right side of the heart, leading to heart failure and other complications. Lock told me that doctors send children for surgery to close these holes if there is a two-to-one shunt, meaning that twice as much blood flows through the right side of the heart than the left.

"Do you know where that two-to-one number came from?" Lock asked. I imagined it was from careful clinical studies of children with the hole. "You would think so. But you'd be wrong. At a medical meeting in the 1960s, a pediatrician presented the question 'When should the hole be closed?' to a group of cardiologists. There was a heated debate about how much shunting required a surgical fix. So the meeting organizers, out of desperation, took a vote. Some voted for a lower number, some for a higher number. The median ended up being two-to-one. ... Children can have two-to-one shunt and still have a good chance of being healthy and never needing any specific treatment. Many children with two-to-one shunts undergo surgery and probably don't need the operation."

But sometimes things just get to cluttered with clinical terms and too-technical explainations

Lock took a blank sheet of paper and began to rapidly sketch the outlines of the heart, its chambers and valves. There was a disorder called "common AV canal," he said, where the wall between the left and right sides of the heart does not fully form. This most often occurs in children with Down yndrome. "The central part of the heart is missing, and this can include the lower wall between the atria, part of the mitral valve and part of the tricuspid valve, and the upper wall between the ventricles -- all don't form." Some of these children also have aortic stenosis, Lock explained, meaning partial closure of the aortic valve, or co-arctation of the aorta, meaning that the large vessel is narrowed "When this happens, the left ventricle can be very small."

What it boils down to is making sure you consult as many specialists as possible to overcome their tendencies to overvalue their treatments while dismissing others. Not a bad idea, just one that gets hard to see through some of the writing.