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When Dr. Lisa Sanders saw an early version of the forthcoming Netflix documentary series about her efforts to help diagnose the mysterious ailments of eight patients, she delivered what she now readily admits was “badly designed feedback.”
“Stop! Stop! This is awful!” Dr. Sanders recalls saying. “Oh, my God, this is terrible! You can’t do it like that! You can’t say things like that!”
Granted, the producers were trying to create an innovative show, for the first time asking the global audience of the popular column Dr. Sanders has written for The New York Times Magazine since 2002 to help diagnose seemingly impossible medical cases.
But Dr. Sanders, an internist, felt that subtle and important things were off in the way that early cut portrayed the stakes of a diagnosis, the overwhelming doubt patients can feel, doctors’ talks with patients and, in short, her life’s work.
The final cut of the show “Diagnosis,” which Netflix will release on Aug. 16, fixed all that, capturing her beliefs about diagnosis and the lessons she’s learned over her career — like when, years ago, she used a then-common phrase of hers with a patient.
“You know, diagnosis is just a word,” Dr. Sanders said.
“No!” the patient sharply corrected. “It’s everything.”
In the show, a diagnosis means parents don’t have to let doctors cleave their music-loving daughter’s brain, possibly making her mute. It means a nearly bankrupt young woman can stop paying for stumped doctors and know she can have a child without fear of passing on crippling muscle pain.
In one of her earliest pieces for The Times, Dr. Sanders wrote about her own grief-filled efforts to diagnose her alcoholic sister’s cause of death, to get an answer.
“It’s not ‘just a word.’ It’s actually a word that carries a lot of meaning — social meaning and medical meaning,” she now says.
Dr. Sanders, who’d grown up in South Carolina loving Arthur Conan Doyle’s works and the satisfying “clunk” of the once disconnected pieces of a mystery story coming together, started her professional life as a journalist. She won an Emmy Award for her 1989 CBS News coverage of Hurricane Hugo’s impact on Charleston.
But she decided to switch careers after an assignment about white-water rafting in North Carolina, during which a fellow reporter, who was also a doctor, leapt into a fast-moving river to pull out a woman who had been floating face down.
“I watched him change from a journalist who watches things to a doctor who does things,” Dr. Sanders told The Times in a 1992 article about people’s unusual paths to medical school. “It made me realize I’m not a person who wants to just sit around and watch.”
She still vividly remembers the reporter doing chest compressions on the woman, who then turned her head and coughed up “a ton of water” and vomited.
At Yale University, where Dr. Sanders got her medical degree and did her residency, she was quickly captivated by the Sherlock Holmesian nature of diagnostic work.
Shortly afterward, a longtime friend who had just started as an editor at The Times Magazine called her and asked, “What can doctors write?” Dr. Sanders thought about the reports she did for all new patients.
“I write little mysteries every single day,” she said.
For the column that sprang from that conversation, Dr. Sanders pulled from unusual and already solved cases that had brought up unexpected questions for the doctors who told her about them around the proverbial water cooler. She also began to look out for unique cases among her own patients at Yale New Haven Hospital.
“This column helps me remember that most people have what other people have had, but not everybody,” she says. “It opens me up to the possibility of ‘weird.’”
In 2010, she introduced the idea of crowdsourcing in her column by sharing the case of a feverish academic who had let the readers of a popular medical website help diagnose his illness.
Then, the following year, she let her own readers get in on the detective work with a Well column, Think Like a Doctor, that invited them to speculate about symptoms of an ailment she would reveal the following day.
“Because I saw how good they were with these solved cases, I knew for sure that they would be good with unsolved cases,” Dr. Sanders recalls.
She didn’t build on that idea until the Academy Award-winning producer Scott Rudin approached The Times about making a documentary series with the production company Lightbox.
Last April, the magazine published the first in a series of unsolved cases that Dr. Sanders and producers had spent months collecting. For the first time, they invited readers to share their best guesses about what the patients were suffering from.
Thousands of readers from around the globe responded. Many were members of the medical community.
But others were just people who recognized their own suffering in someone else a world away and wanted to help, like a California mother who saw one young “Diagnosis” patient’s behavior as a symptom of the same untreatable genetic condition her son has.
“I feel like it’s a diagnosis,” she said through tears. “But it’s a diagnosis to nowhere. I think that our kids are going to help future kids, and future parents, not go through what we went through.”
This is what Dr. Sanders hoped to capture. Where many medical dramas use odd cases to show a doctor’s deductive brilliance in the third act, she wanted to show something else.
“It’s so much more than that,” she counters. “The patients are not the backdrop. They are the show.”
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