Review of "Nurse Florence, What is XYY Syndrome or Jacobs Syndrome?" by Michael Dow

Score: 89+/100 (8.9+ out of 10)

Nurse Florence, What is XYY Syndrome or Jacobs Syndrome? is an educational children’s book written by Michael Dow and illustrated by Sela Goldfarb.

The book is part of the Nurse Florence series, which aims to introduce medical concepts to young readers. Michael Dow's series has become a mainstay and frequent participant in our contests.

This particular installment focuses on XYY Syndrome (also known as Jacobs Syndrome), a genetic condition in which males have an extra Y chromosome.

The book follows a conversational format where the protagonist, Jean, consults Nurse Florence to understand her cousin’s XYY Syndrome diagnosis. The dialogue-driven narrative provides a step-by-step breakdown of the syndrome’s causes, symptoms, frequency, diagnosis, and management.

There is always a Jean and always a Nurse Florence in each installment of the series with Jean (and her friends) representing curious young people and Nurse Florence representing nurses who do tremendous work in healthcare around the world.

The book introduces children to DNA, chromosomes, and the genetic makeup of males and females. It explains how individuals typically inherit 46 chromosomes and how the addition of an extra Y chromosome results in XYY Syndrome. Nurse Florence explains that XYY Syndrome occurs due to an error during meiosis, affecting approximately 1 in 1,000 males, though many remain undiagnosed.

The book details common characteristics such as increased height, macrocephaly (large head size), weak muscle tone, clinodactyly (curved finger), and widely spaced eyes. The text covers conditions associated with XYY Syndrome, including a higher prevalence of autism, ADHD, asthma, seizures, dyslexia, and behavioral challenges. Diagnostic methods include genetic testing after birth or prenatal screening. The book emphasizes that while XYY Syndrome cannot be prevented, various supportive treatments like speech therapy, behavioral interventions, and occupational therapy can help affected individuals.

Nurse Florence mentions that individuals with XYY Syndrome tend to live about 10 years less than average but can still lead normal lives, including having children and going through puberty. The book successfully simplifies complex genetic and medical concepts for a young audience. It introduces children to medical terminology while reinforcing the importance of scientific literacy.

Books in this series have tended to have several glaring weaknesses. First and foremost, they tend to be incredibly wordy and expositional (for a children's book). That's usually made worse by how flat and lifeless the dialogue tends to be. This book is no exception. Keep in mind: Nurse Florence is supposed to be describing all of this to an adolescent or young teenage girl, but she information-dumps about things like testes and hormone imbalances with no regard for how a real conversation with a child might actually unfold.

There seems to be little effort to soften the language, add any warmth, or frame the information in a way that would make it more engaging or relatable for the intended audience. Instead of feeling like a natural discussion between a curious kid and a knowledgeable nurse, the dialogue reads a bit like a dry medical textbook awkwardly pasted into a script.

Exacerbating this, the book’s structure can also become repetitive to the point of monotony, like watching someone play Pong.

Jean asks a question, Nurse Florence responds with an overly detailed explanation, and then the cycle repeats. There seems to be no attempt at humor, no storytelling elements beyond the framing device, and no emotional engagement that might help kids connect with the material. It’s just a long, uninterrupted stream of facts with no real attempt to build tension, curiosity, or character dynamics.

At the same time, this book does have something that other books in the series were sorely missing: actual stakes and purpose. In previous books, the young characters would often randomly ask about a topic with no motivation or inciting incident. However, at least in this book, Jean is motivated by the fact that her cousin has recently been diagnosed with XXY Syndrome/Jacobs Syndrome, a rare disease that understandably causes alarm and concern for poor Jean. In fact, Jean seems to harbor the specifics of this disease from her friends (at least initially), resisting naming it and simply saying, "One of my cousins got diagnosed with something."

This actually shows some character as Jean, like a real person, doesn't want the world to know every single detail of her family problems, partly out of respect for privacy. She actually chooses to meet with Nurse Florence alone, which is also indicative of that.

And while the book deserves credit for its educational intent, it leans a bit too hard on simply dumping information without considering how kids might actually learn best. There are no interactive elements beyond the journal at the end, no analogies to make concepts more tangible, and very little effort to break up the dense exposition into manageable, engaging pieces.

While there is a story (Jean's cousin having XXY Syndrome), it really gets overshadowed and drowned out by Nurse Florence explaining so much.

The illustrations are sufficient. In fact, they are probably more pleasant than about half of the illustrations in the series. They are colorful and expressive, though not particularly detailed or intricate. There are times when it seems like the same illustrations and expressions are reused for the two core characters, so no bonus points for going above and beyond.

However, we are glad that there's clearly a brighter, more colorful presentation in this book. Jean wears bright lime green while Nurse Florence wears bright blue scrubs. Condi and Sonya, Jean's friends, wear bright pink and lavender respectively. It's a bit of a bummer that they're only in a panel or two.

We've said it before, and we'll reiterate: the concept of this series is incredible! This series could be a powerful tool for reaching kids and getting them interested in science, medicine, and healthcare. However, it has seemingly not met its full potential. It might be better handled by a publishing house or by hiring a ghost writer and professional illustrator to really bring these characters, stories, and concept to life. Right now, the presentation and writing seem really clunky and unnatural. This series leaves a lot of room for improvement.

Check it out on Lulu!