David’s stories are fascinating, and he does something quite remarkable with his tone. Here the obvious comparison is to the neurologist and prolific writer Oliver Sacks, often described as the poet laureate of medicine. Even when Sacks wrote about tragedy, his narratives were imbued with meaning, and if not positivity, then at least a sad beauty. David appears not to be driven by the same impulses. Even when his case studies have positive endings, a rather thick vein of gray runs through them.

Fans of the medical-mystery television series House will find arresting parallels—and striking differences—in the absorbing collection of real-life psychiatric case histories the distinguished British neuropsychiatrist Anthony David recounts.

Into the Abyss provides a strong argument for the restoration of a balance between physical, emotional, and neurochemical approaches to this complex situation.

The first thing that comes across from the stories is David’s obvious compassion for his patients. This is typified not just by his thoughtful medical interventions and the doctor-patient conversations he recounts in vivid detail, but also by his willingness to raise hell with the relevant bureaucrats when pointless rules get in the way of his charges receiving the treatment they need. The second thing, though, is an uncomfortable sense of uncertainty—that abyss again. More than one patient is described as feeling like a human guinea pig as their treatments and medications are shuffled around in (often vain) attempts to pinpoint what might work.

David creates a work that reads like a memoir. The cases are distinct, the diagnoses elusive, and the personality of each patient comes through with warmth and care. The author doesn't gloss over the reality that sometimes there are no definitive answers or perfectly happy endings, but he maintains a spark of hope that keeps the narrative from becoming bleak.

... [a] fine debut memoir.

That psychiatric illness is at least partly brain disease still provokes skepticism in some circles, but these compelling case reports make a convincing argument.