Cherie Kephert’s “A Few Minor Adjustments” engages readers in her quest to discover the cause of an undiagnosed illness that plagues her for years. During her difficult journey, the reader feels Cherie’s pain as she searches for answers that will restore her to the quality of life she once knew. An honest story of determination and perseverance that gives others hope in the darkest times of their lives. ( )

This is one of the best books I've read in a long time. It is something many of us can all relate to, even at smaller levels. I found it touching and beyond interesting to read the author's journey and struggles to find a cause and cure for her ailments even as they got worse. This without a doubt is a testament to the enduring will of the human spirit and I would love to thank the author because it couldn't have come a better time in my life to lend me perspective pushing forward through my own struggles. Amazing work, well written, and captivating. ( )

Cherie Kephart’s memoir begins in 2004 in a bathroom shower stall. As the water rains down upon the then 33-year old, she experiences neck and arm pain so intense she drops to the floor. Willpower alone gets her to the phone. She summons her boyfriend who takes her to the emergency room of a local hospital—a place she had visited a mere two weeks before, afflicted with similar mysterious pain. The physician who had attended her then noted a highly irregular EKG—which would eventually lead to a diagnosis of SVT: supraventricular tachycardia—due to Wolff-Parkinson-White Syndrome. That first E.R. doctor had also recommended that she see her primary care doctor and be referred to a cardiologist and a neurologist. Now, two weeks later, with the referrals to specialists in the queue for approval by her health insurance company, the second E.R. doctor can only tell her she is in the wrong place: the emergency room is for trauma victims, not those with chronic illnesses. Rest and take ibuprofen, he tells her.

A Few Minor Adjustments documents the long and painful ordeal Cherie Kephart endured in order to get a diagnosis and treatment for her mysterious, debilitating condition. In crisp, often humorous chapters that travel back in time a decade or more (before 2004), Kephart tells stories of the adventurous life she lived before severe chronic illness took her hostage. She had studied in Hull, England during her college years, spent time in Zambia with the Peace Corps as a 23-year-old (where an atypical case of malaria took such intractable hold of her that she was forced to return to the U.S. to recover), and resided in Auckland, New Zealand to attend graduate school.

Kephart describes the illnesses and personal challenges she faced in each of these locations. With each detail she provides, the mystery of her “presenting complaints” in 2004 only deepens for the reader. Her story is a genuine medical mystery that had me perpetually revising my amateur differential diagnoses. Was this mysterious illness a lingering case of malaria or due to some unusual African virus or intestinal parasite? Could it be Hepatitis? H.I.V? A psychosomatic condition associated with the violent assault she had endured many years before but did not properly “process”? The residual physical effects of a serious car accident that had required a year of physical therapy, or some sort of autoimmune disorder like lupus or multiple sclerosis?

Kephart attended appointments with innumerable specialists (46 of them by October 2008)—among them: a neurologist, a cardiologist, a physiatrist, and an infectious disease expert. She’d been submitted to five CT scans, seven MRIs, and 10 ultrasounds, undergone a multitude of lab tests, and filled an abundance of prescriptions—to no effect. (She also dabbled in alternative medicine and had money siphoned away by a few quacks.) Some clinicians offered “catch-all” (or wastebasket) diagnoses like fibromyalgia or chronic fatigue syndrome. One physician told Kephart that she needed to face the fact that her illness might all be in her head. I was glad to read that Kephart did not return to this unfeeling and arrogant clinician.

It is an unfortunate truth that many results-oriented physicians grow impatient when confronted with difficult, ambiguous cases like Kephart’s, dismissing the patient as a malingerer, a basket case, or a time-waster. Pressed for time, burdened with heavy patient loads, or simply burned out from years of demanding work with sick people, they may lack the interest or stamina to investigate conditions that don’t yield to easy interpretations.

In addition to the physical and emotional costs of chronic illness, there are social ones. Friendships fray, and many are lost. The author marvels that her boyfriend, Alex, stays the course. She often feels tremendous guilt at how her condition limits his life, however.

Kephart generally writes in a lively manner, injecting humour to leaven the sometimes heavy subject matter. However, there is some unfortunate overblown figurative language. For example, a friend’s pale skin is said to be “adorned with a Milky Way of freckles”. There is also some problematic word choice. The author mentions “easement” of suffering (“easing” would be the better word). She says she feels “endearing gratitude” when what she really means is gratitude to an “endearing” friend or gratitude of an “enduring” kind. A sports bra is described as “enterprising”(!) when the author appears to mean it is of good quality, and the word “robust” is used incorrectly fairly consistently. A good editor should have assisted with these distracting infelicities.

Kephart also assigns her many doctors comical monickers based on their most salient physical or character traits. Along the way, readers meet “Dr. Perfect “, “Dr. Friendly“, “Dr. Nose Hair“, and “Dr. Godlike “—among others. I understand the author’s desire to inject some levity into a personal narrative made of many unfortunate events, but the snideness can interfere with tone at times. Sometimes it’s perfectly appropriate for an author to be serious! Moments of intense psychological distress also don’t come off quite right and read a bit too melodramatically. Recreated or remembered verbal exchanges, in particular, often sound mechanical and unconvincing. Less would have been more where dialogue is concerned.

My reservations aside, I enjoyed A Few Minor Adjustments . It is an engaging read that I would recommend to others who enjoy memoir and autobiography, travel narratives, or nonfiction on medical themes. The author does get a diagnosis and treatment eventually, but I’ll leave that to potential readers to discover on their own.

I thank the author, publisher, and Net Galley for providing me with an advance reading copy of this book. ( )

I usually don’t read memoirs, but this one completely blew me away! I was taken on a journey, and felt like I was there with Cherie every step of the way. Her writing reads much like fiction and I found myself lost in her world, and in the end, I was left inspired to find the beauty in life. And this isn’t a book that you read and forget, either. Even weeks after reading it, I remember Cherie’s story, and her ability to find the humor in the most dire situations. Oh, and anytime I see an egg in the grocery aisle, without fail, I smile and put my hand over my heart. If you want to know why, then I guess you have to read it! ( )