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 ... David’s encounters, bracing as they are, made me wonder if there isn’t something oppressive about the insistence on majesty and wonder in modern science writing. Life can be awful, after all. Fiction, generally, is allowed to stun and depress but there is pressure on nonfiction to offer consolation or at least guidance. David leaves some big questions uncomfortably unresolved, and his stories are all the more haunting for it. Rarely have I read a book whose title is so true. Reading it was like standing on the edge of a great chasm and seeing how easily an unforeseen mishap could send any one of us tumbling in.

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 ... the compassionate, philosophical Dr. David can’t help second-guessing himself, and that’s only one reason his case histories are so compelling ... I wish he had provided more details about the state of our still-unfolding knowledge of the neurological and other channels through which mind and body communicate with each other. That may be for another book, however. In the meantime, he has given us a gripping overview of the dilemmas that the traditional binary medical mind-set has yet to fully explore or grasp.

Into the Abyss provides a strong argument for the restoration of a balance between physical, emotional, and neurochemical approaches to this complex situation ... a challenging, stimulating, and sometimes troubling look into the minds of some very complicated and very disturbed patients ... The cases described in this book are certainly not characteristic of the patient load for the average psychiatrist. They do illustrate the interplay between the emotional and physical that, to some degree, affects all of us. Into the Abyss paints a fascinating picture of the ties between mind and body and the complicated ways they interact.

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 is an academic as well as a clinician and I found myself wanting to hear more from the former side. Although he does discuss research relevant to each of his patients’ disorders, I wanted a final, resounding consideration of what it all means for science ... David’s case studies are illuminating and benefit considerably from his warm, self-deprecating style. He would be the first to admit, though, that his stories raise many more scientific questions than they answer.

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 ... Readers seeking a realistic approach to understanding the potential causes of mental illness will appreciate David's thought-provoking reflections, as will mental health professionals and fans of Oliver Sacks's The Man Who Mistook His Wife for a Hat.

... [a] fine debut memoir ... Displaying intellectual curiosity and pragmatic compassion, David focuses on cases in which the physiological and the psychological converge ... He also candidly addresses the challenges of being in the role of medical authority ... Readers will come away from this thoughtful work feeling a sense of connection to both the patients profiled and the practitioners who aim to understand them.

That psychiatric illness is at least partly brain disease still provokes skepticism in some circles, but these compelling case reports make a convincing argument ... David comes across as a compassionate physician and talented writer who works hard to demonstrate the biopsychosocial model and usually succeeds ... The cases are complex and sometimes so bizarre that it’s often difficult to apply their lessons to familiar disorders, but readers will be captivated. Fascinating stories from the practice of a skilled neuropsychiatrist.