skip menus and go right to content



LifeWatch Employee Assistance Program




Topic Home · Related:  
Book Review - A Toss Of The Dice
A Toss Of The Dice
by Natasha T. Hays
Jessica Kingsley Publishers, 2005
Review by Leo Uzych, J.D., M.P.H.
Sep 5th 2006

   A Toss of the Dice is an absorbing collection of anecdotal stories, crafted beautifully by practicing pediatrician Dr. Natasha Hays.  As explicated by Hays, the "patients" described in the book are mainly composite characters, drawn from several  different patients presenting with similar problems.  Additionally, quite a bit of information, about Hays'  professional and family life, is woven, artfully, into the textual fabric.  The tapestry of engrossing, if emotionally drenching,  anecdotes, recounted by Hays, is enshrouded, unmistakably,  by an aura of real life experiences.

   Interestingly, and somewhat unusually, the writing style employed, by Hays, commingles great sensitivity and compassion, with blunt frankness, unadulterated candor, and, at times, even harsh social commentary.  With this brush skillfully in hand, Hays very revealingly paints a picture of clinical pediatric medicine that is both sobering and fascinating, and which will likely enthrall the rapt attention of parents as well as health care professionals  entrusted with treating children.

   A very important lesson imparted by this wonderful book, indeed, perhaps the most important lesson of all, is that compassion is an indispensable part of the bond connecting health care provider and patient.  The steadfast belief of Hays, in fact, is that a doctor simply cannot be a very good doctor, in the absence of compassion.  This overarching message reverberates distinctly through the pages of the book.  Hays obviously derives great personal and professional satisfaction, from caring for children in a very sensitive manner.  And her passion for sensitively helping her pediatric patients permeates text.

   Structurally, Hays very frequently recounts fragments of conversations with patients.  These conversational snippets comprise an integral component of the substance of the various stories, and unequivocally, and rather poignantly, help reveal that, although pediatric medicine has a sort of mechanistic clinical side, it also very importantly has an emotionally wrenching side, frequently immersed in pain, suffering, and even death.  In a manner stylistically bereft of academic formalness, and tailored quite adroitly to finely fit lay readers, Hays illumines some of the mechanics, of the clinical part of pediatric medicine.  Concomitantly, Hays cuts deeply to the core of the humanistic side of pediatric medicine, drenched in the emotions of health care providers and their patients.

   Hays, resolutely wielding a pen exhibiting unabashed forthrightness fused, inseparably, with sensitivity, composes sundry stories in twenty three chapters.  In the first chapter, Hays very frankly opines that having children is actually akin to a toss of the dice.  Because, all persons carry seeds for genetic disorders.  The many tentacles, of Hays' probing interest, extend to pithy commentary concerning her medical school and pediatric residency experiences, and her planting of professional roots, in the soil of a developmental evaluation clinic, in North Carolina.

   Mostly, however, Hays expounds, in a gentle, insightful, and informative way on multifarious developmental and behavioral problems affecting children.   Her far flung net ensnarls child abuse, mental retardation, Down syndrome, fetal alcohol syndrome, attention deficit hyperactivity disorder, depression, bipolar illness, cerebral palsy, autism, seizures, elective mutism, and cyclic vomiting.  The expansive gamut, of Hays' wide ranging focus, encompasses further:  the rather lurid mental illness called Munchausen by proxy, hearing impairment, bullying, and terminal illness in children.

   The anecdotal observations, and accompanying discourse, proffered by Hays, although enlighteningly suffused with luminous insightfulness, informativeness, and sensitivity, may, however, be overdiluted, in a substantive sense, for researchers.  The academically inclined may further carp that, although Hays may effectually convey observations and information that is anecdotal in nature, nonetheless, the "truth", in the tradition bound medical research world, must properly be anchored, securely, to data emanating from double blind, placebo controlled, peer reviewed  academic studies.  The relative sparseness of detail, regarding many of the anecdotes, may be disquieting, as well.

   With proper weight affixed to the foregoing caveats, Hays' riveting descriptions, of the real life trenches of clinical pediatric medicine, should be immensely interesting and edifying for all parents, as well as health care professionals involved in some capacity with the care of children, including pediatricians, geneticists, psychologists, psychiatrists, child psychiatrists, neurologists, endocrinologists, physical therapists, speech therapists, and genetic counselors.


© 2006 Leo Uzych


Leo Uzych (based in Wallingford, PA) earned a law degree, from Temple University;  and a master of public health degree, from Columbia University.  His area of special professional interest is healthcare.