Neurologists have a well-deserved reputation as staid and buttoned-down professionals who seldom venture to display their racy side. Known for their scholarly demeanor, blue blazers, and (we hope healthy) compulsiveness, neurologists are generally perceived as more likely to spend their free time at an art museum or concert hall than driving a Ferrari or sunning themselves in the Cayman Islands. But the author of Dick Swept, M.D.: Tomorrow, the World, neurologist-cum-novelist David B. Rosenfield, MD, Professor of Neurology at the Baylor College of Medicine, paints a somewhat different picture. Indeed, this book serves as an antidote to professional reserve, offering the reader a free-wheeling romp through a world of academic neurology and international intrigue, liberally embellished with Russian agents, beautiful women, drugs, sex, violence, and murder.
The protagonist of this mystery is Richard Michael Swept, MD, Assistant Professor of Neurology at a prestigious (and fictitiously named) Texas medical school. Here indeed is a neurologist for the ages. Endowed with high intelligence, good looks, athletic prowess, and tireless virility, he is not only irresistible to women but also possessed of the highest moral stature. He listens to Bob Dylan on his Walkman, jogs regularly to keep fit, fancies fine food and wine, and has a dog named Limbic. A caring doctor, a decorated teacher, and a gifted researcher, he is not afraid to confront his Chair openly when he has a disagreement because he knows he can raise the research dollars to support his position. Any practice or department of neurology would be lucky to have him, and indeed, most male neurologists would no doubt like to be him.
In addition to seeing a range of neurologic patients and teaching medical students about the subtleties of cognition, Swept does basic research on memory, and, in particular, on a pharmacologic agent for treating Alzheimer disease. He has a wet lab, a postdoctoral fellow, and substantial research funding. Safely ensconced in his academic position, he seems destined for a productive career. As his name unsubtly suggests, however, he becomes inadvertently drawn into a web of international espionage in which mysterious characters seek to exploit his work for their own ends. The story slowly builds as the intrepid neurologist and his associates gradually come to understand the nature of his involvement. We soon realize that there is much more in Swept's life than just neurology.
MIX OF CHARACTERS
The narrative devotes considerable space to the character development of many figures, including academicians, government agents, bureaucrats, spies, and women of all sorts. Along the way, the romantic life of our hero is not overlooked, and his ready access to attractive and willing women is ever apparent.
Descriptions of sexuality periodically enliven the text; some of these encounters are expected in the course of Swept's adventures, whereas others – far less appealing – contribute to the emerging plot as well as provide unexpectedly lurid interludes. There is a dramatically violent scene as well, during which Swept has the chance to demonstrate that his seemingly endless repertoire of skills includes proficiency with a variety of lethal weapons.
Primarily a book to be enjoyed for its pure entertainment value, some commendable, interesting literary features nevertheless deserves comment. As the story brings the reader from the white-coated environs of neurology to the covert domain of spying, so too does it describe Swept's own evolution as a character. We can sense that the thrill of working in a broader national and international context gradually compels him to reconsider his relatively secure and comfortable academic post.
At times rather unpolished, the writing is generally well paced and engaging. After a careful background with the obligatory introductions of characters and plot, the rapid crescendo toward an exciting climax undeniably engages the reader's attention. By the end, all threads of the plot are tied together in a tidy, if somewhat predictable, manner.
COLD WAR ACTION
Although the story takes place in the post-Soviet era, a distinct feel of the Cold War pervades the book. We are introduced to several sinister Russians whose interests in the use of neurologic research are as nefarious as Swept's are altruistic. It is almost as though Glasnost never happened, so great is the need to establish a cadre of villains. Yet somehow, beyond all the plotting and the secrets, these characters take on a life of their own, and the reader is not deterred. There is a certain playful exuberance about this adventure that allows one to look past the stark distinctions between those who are on the side of good and those who clearly are not. Some satisfaction can also be found in the ultimate fate of those characters that prove to be the most odious.
Many of the themes in this book will be familiar to neurologists, especially those who have experienced firsthand the often intensely competitive environment of modern academic medicine. First, there is the conflict between seeing patients and pursuing research; our hero is torn between attending to the needs of his patients and concentrating on the research that may ultimately cure the memory disorders he so often encounters but cannot reverse. He is keenly aware that in many cases the role of the neurologist is largely custodial, and he ruminates about the small percentage of his patients who seem never to respond to any intervention.
Then there is the autocratic Chair who insists on the steady acquisition of grants for basic science research as his paramount objective, all the while denigrating the value of clinical research studies. Gruff and curmudgeonly, the Chair respects Swept primarily because of the obvious talent he has for securing extramural funding. We witness the careful preparation for a research presentation to a panel of experts at the National Institutes of Health. Anyone who has presented clinical or research data to experts who know at least as much as the presenter will recognize the feelings generated by such an experience. Antivivisectionists also make several appearances; at first they seem to be introduced only as a familiar feature of the modern academic medicine landscape, but later they contribute to an intriguing twist of the plot that is deftly woven into the text.
This is primarily a book about a neurologist, and it will be most entertaining to those in or close to the field. The exploits of this clinician-researcher hero will doubtlessly lift the spirits of many neurologists who are laboring under the burdens of managed care, struggling to get their research programs off the ground, or attempting to deal with seemingly endless administrative demands. The book does, however, have a broader appeal as a thriller in its own right. Many general readers are likely to be drawn into this tale of espionage that begins in a medical center; how often can one find the neuroscience of Alzheimer disease and a character to rival James Bond in the same book? In brief, for anyone planning a relaxing summer vacation, Dick Swept, M.D.: Tomorrow, the World will serve nicely to adorn a reading list. And for neurologists who seek respite from the daily rigors of their work, a little fantasy can certainly do no harm.