Life in the Balance
A Doctor’s Stories of Intensive Care
Jim Down
Having read it
★★★★☆
A good read – insightful and with plenty of informative (and a few funny) footnotes – about an integral part of hospital: ICUs (intensive care units).
It all makes for a well-balanced memoir that has some good moments and humour all supported by plenty of reality that the author (a consultant of critical care and anaesthesia) has seen and been through.
A good passage
The ICU occupies a space both at the cutting edge of medical technology and at the cusp of life and death. But while the machines can postpone dying, they can’t make people better. The patients themselves have to do that. They must have the potential to progress from this ‘existence’ to a ‘meaningful life’ – except that no one has defined what that is. So the invasive, technical medicine rubs shoulders with profound ethical dilemmas, and it is these dilemmas that we the clinicians discuss, debate and argue about every day.
[...]
All of life is in ICU, but stripped back to the bare essentials. Wealth, power, status and dignity are all gone. There is no judgement, no deference, no hierarchy and no favouritism. Each patient is treated on their merits and our own prejudices and beliefs are pushed to the back of our minds. If there is a reasonable chance that the patient in front of us might return to a meaningful quality of life and they want to take that chance, then we offer it.
A second good passage
[Footnote] Moral luck describes the impact of luck on our moral status. The drunk driver who hits a wheelie bin is an idiot whereas the one who hits a child is a monster – despite the fact that their intention and action may well have been identical. Some philosophers argue that luck has no place in moral status, but in practice we see its place all too clearly every day.