Correspondence

Review of The Two-Headed Boy

N Engl J Med 2001; 344:1333April 26, 2001

Article

To the Editor:

The hostile review by Berkwits (Jan. 4 issue)1 of my book The Two-Headed Boy, and Other Medical Marvels contains several errors and gives potential readers a deeply misleading image of the book. For instance, Berkwits wrongly states that the patient in one of the historical cases of severe growth retardation, Nicolas Ferry, had progeria; the correct diagnosis, as is clearly stated in the book, is osteodysplastic primordial dwarfism.

The book is based on many years of original research, and versions of some of the chapters have been published in refereed journals of the history of medicine; it is thus wrong to represent it as being devoid of interest to this community. Berkwits ignores the clear statement in the preface that the book is a descriptive, multidisciplinary group of essays on the history of teratology, rather than a politically correct sociological treatise on the public's fascination with “freaks.” It is also misleading to say that the book “accepts contemporary provincial voices at face value,” as Berkwits laboriously expresses it. I challenge him to find a single chapter in which the medical discussion has not been brought fully up to date; this is something not easily found in the sociological tomes that he seems to like to read.

J. Bondeson, M.D., Ph.D.
Imperial College School of Medicine, London W6 8LH, United Kingdom

1 References

1. 1

   Berkwits M. Review of: The two-headed boy, and other medical marvels. N Engl J Med 2001;344:71-72
   Full Text

Author/Editor Response

Dr. Berkwits replies:

To the Editor: Dr. Bondeson writes in his book that “what particularly distinguishes [Nicolas Ferry] from the vast majority of individuals with primordial microcephalic dwarfism is his premature aging” and that given the similarities of his external features to those of persons with progeria, “it seems reasonable to suggest that there is a progeroid variant of osteodysplastic primordial dwarfism” with which he was afflicted. Both diagnoses are speculative, and in my review “progeria” seemed an accurate and richer, if less precise, description of the case, for purposes of conveying it to readers.

I decline to comment on Dr. Bondeson's other points, except to add that his undeniably original research falls short of the standards of cogency and scholarship the Journal asks of its authors and presumably would want for its readers. Those who are interested can read the book and judge for themselves.

Michael Berkwits, M.D.
University of Pennsylvania, Philadelphia, PA 19104