Book Review: Struck by Orca, subsequent encounter


Struck by Orca: ICD-10 Illustrated
Ed. by Niko Skievaski
November 2013

As most of you know, my husband is an ICU doctor at the University of Chicago. He’s also got a wicked sense of humor. So when Niko Skievaski released his collection of illustrated ICD-10 codes, it was inevitable that at least one copy would make its way into our house.

For those of you who don’t spend your lives navigating the US healthcare system, ICD-10 is an internationally used system to describe tens of thousands of medical diseases, symptoms, and illnesses. It’s astoundingly specific, with codes for conditions like “V91.07xD: Burn due to water-skis on fire, subsequent encounter” (not again!) and “W56.49: Other contact with shark.”

It’s also been used in Europe for years. What prompted this particular book is the introduction of ICD-10 into the United States.

In Struck by Orca, Skievaski showcases the illustrations of several artists with varying backgrounds in the medical field. Each has chosen one or more ICD-10 codes to illustrate.

Some of the illustrations are remarkably entertaining. The illustration for V61.6xxD “Passenger in heavy transport vehicle injured in collision with pedal cycle in traffic accident, subsequent encounter” shows a grinning five-year-old on a big wheel tricycle peddling away from an overturned 18-wheeler truck that is burning merrily half a block behind her.

I’m also a huge fan of “Z89.419: Acquired absences of unspecified great toe,” which reads “After years of toe-tal bliss, Mr. Hallux put on his best pants and left to discover the world.”

In other cases, the illustrations are fine, but it’s the idea of the code existing at all that prompts the laughter. As long as you don’t think too hard about the details, that is. In retrospect, it may be a very good thing that the illustration for “W61.62: Struck by duck, sequela” is a bit on the pedestrian side.

All told, this is a highly entertaining book that would make a great stocking stuffer for any hospitalist on your holiday gift list. Sadly for me, my resident hospitalist already has two copies.

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About Shala Howell

I spent two decades helping companies like Bell Labs, Juniper Networks, and a genetic testing company that was later acquired by CVS translate some of the world’s most complicated concepts into actionable, understandable English. Now I'm working on a much harder problem -- fostering children’s curiosity and engagement in the scientific, artistic, and linguistic world that surrounds them. The first book in my Caterpickles Parenting Series, What’s That, Mom?, focuses on how to use public art to nurture children’s curiosity in the world around them. My next book, Did Dinosaurs Have Belly Buttons?, is currently planned for release in 2018. In the meantime, you can find me blogging about life with a very curious Ten-Year-Old at, chatting about books and the writing life at, and tweeting about books, writing, science, & things that make me smile at @shalahowell.
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