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Doody's Review Service Reviewer: Vincent F Carr, DO, MSA, FACC, FACP (Uniformed Services University of the Health Sciences) Description: This is a compendium of pearls or "nuggets of accumulated wisdom" in internal medicine. Purpose: The purpose is to gather in one place some concepts that, while not applicable in every case, are a good starting point in thinking about a disease. Books such as this have elicited some derision as potentially inaccurate and unworthy, but the author presents the material as thoughts for consideration and not written in stone, which makes the reading thought-provoking and interesting. Audience: The audience is broad and includes those in residency training programs, primary care providers, and specialists of every type can be challenged to look at their own experience and compare it with what the author presents. Features: The book starts by describing the history and physical examination process and provides a number of pertinent thoughts on how important performing these services diligently is the basis for success. The author then moves through some organ systems and discusses the pearls that have developed over time related to each. The format is engaging with the pearl statement followed by a short discussion about the concept. The pearl is not taken literally, and the discussion clarifies the concept and highlights shortcomings of a literal acceptance. Assessment: As far as books of clinical pearls go, this is one of the best as it works to objectively look at the concept in light of the known physiology. As such, it invites readers to reflect on their own thoughts on the matter. It is also a tremendous teaching tool to help students in training programs develop critical thinking skills.

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