Color Atlas of Physiology

I found it the way you used to find books: browsing a medical bookshop as a resident, with no particular plan, and pulling something off a shelf because the spine looked interesting. I have bought a great many books more systematically since and remember almost none of them as well.

It is a small book, and the format is the whole idea. One concept, one double page. Text on the left, and on the right a full-colour plate that carries the argument rather than decorating it. Turn to countercurrent multiplication and there it is, entire, in front of you. Turn to the cardiac cycle and the same. Nothing is continued overleaf.

That is not a loose comparison. The plates do exactly what a mind map does — a central idea, its branches laid out spatially, the relationships carried by position and colour rather than by prose — and they were doing it in 1979, long before the technique had a name or a following. When I build the mind maps for this site I am, consciously, borrowing from a book I bought as a resident.

And the illustrations are a genuine delight. Not merely clear: handsome. Somebody cared what they looked like, in a field where the usual ambition is to be unambiguous and stop there.

Who it is for

Nearly everybody, which is an unusual thing to be able to say about a physiology text.

It suits structured thinkers, and those of us who would like to be. It suits people who are short of time, which is all of us, because a double page is a complete unit you can finish. It suits visual thinkers particularly well. And it works for a medical student meeting the material, a fellowship candidate revising it under pressure, and an established clinician who wants a refresher without committing to six hundred pages of Guyton.

It also suits the reader who simply likes physiology, which I make no apology for being.

The preface

Now the part I did not expect, and the reason I still think about this book.

The name on the cover is Agamemnon Despopoulos. To an Australian eye that reads as a name out of Homer, which says more about the Australian eye than about the name: Αγαμέμνων is a living Greek given name, borne by a Greek ambassador to Washington and by a physician of the War of Independence. It is uncommon even in Greece — the choice of families with a classical turn of mind — but it is a name, not a curiosity. To a Greek family in New York in 1924 it was simply what you called your son.

Despopoulos was born there that year, was professor of physiology at the University of New Mexico until 1971, and then went to Basel as a scientific adviser to CIBA-GEIGY.

A small puzzle sits in the publication history. The book came out in German first, and the English editions are formally translations — yet Despopoulos was an American physiologist writing from Basel, and on the title page of the first edition his name came first. It is quite possible the material was drafted in English and published in German, which is a more interesting sentence than it looks.

The preface to the third edition explains, quietly and in a few sentences, that the first German edition was already at the printer when, on 2 November 1979, Despopoulos and his wife Sarah Jones-Despopoulos sailed from Bizerta in Tunisia, intending to cross the Atlantic. Nothing was ever heard from them again. Silbernagl writes that hope had to be given up, thanks his co-author for the creative enthusiasm without which the book would not exist, says plainly that continuing it alone was not easy — and signs off from Würzburg.

Beside that paragraph is a photograph of Despopoulos at the wheel of the boat in an orange foul-weather jacket, grinning broadly. It is the least funereal image imaginable, which is what makes it land.

I do not want to make more of that than it will bear. But there is something in it about what we leave and how little control we have over which part of us lasts. He was fifty-five. The book has now taught physiology to two generations of doctors who have no idea what happened to the man whose name is on it.

Worth knowing before you buy it

The seventh English edition is from 2015, so the newest material is a decade old and the recent editions are Silbernagl's work. For core physiology that matters very little — countercurrent multiplication has not changed — but it is not where you go for anything current.

It is also not a reference and not a textbook. It will not teach you a subject from nothing and it has no room for argument or uncertainty; the format forbids both. Use it for structure, for revision, and for the pleasure of seeing something complicated made to fit on one page.

Which it does better than anything else I own.