Intensive Care: A Doctor's Journal

"[Intensive Care] faces the raw edge of urban living. It is in the daily detail of an ICU at work that Murray wonderfully depicts a place of function and dysfunction. Murray shows that the ICU is a place of small successes rather than triumphant victories."-Richard Horton, New York Review of Books; "Dr. Murray is an evenhanded guide to the real world of intensive care medicine. His book is informative, a necessary counterweight to the medical fiction of popular entertainment. It may not be something to read for entertainment, but it is important to read if we are to know what crisis medicine can and cannot do for us."-San Francisco Chronicle Book Review; "Takes the reader on his daily rounds at the intensive care unit (ICU) of the San Francisco General Hospital. Between realistic scenes of bedside medical diagnoses and analyses, we also encounter the ethical dilemmas confronting today's medical establishment and society. Recommended for its naturalistic picture of inner-city hospital medicine."-James Swanton, Library Journal

"Intensive Care" is an affecting view from the trenches, a seasoned doctor's minute-by-minute and day-by-day account of life in the Intensive Care Unit (ICU) of a major inner-city hospital, San Francisco. General. John F. Murray, for many years Chief of the Pulmonary and Critical Care Division of the hospital and a Professor at the University of California, San Francisco, takes readers on his daily ward rounds, introducing them to the desperately ill patients he treats as well as to the young physicians and medical students who accompany him.Writing with compassion and knowledge accumulated over a long career, Murray presents the true stories of patients who show up with myriad disorders: asthma, cardiac failure, gastrointestinal diseases, complications due to AIDS, the effects of drug and alcohol abuse, and, emphysema. Readers will come away from this book with a comprehensive understanding of what an ICU is, what it does, who gets admitted, and how doctors and nurses make decisions concerning life-threatening medical problems. Intensive care for critically ill patients is a new but well-established and growing branch of medicine.Estimates suggest that 15 to 20 percent of all hospitalized patients in the United States are treated in an intensive or coronary care unit during each hospital stay, so there is a real possibility that the reader will either be admitted to an ICU himself or herself or knows someone who will be. Murray not only offers a real-time account of the diagnosis, treatment, and progress of his patients over the course of one month but also conveys a wealth of information about various diseases and medical procedures in succinct and easy-to-understand terms. In addition, he elaborates on ethical dilemmas that he confronts on an almost daily basis: the extent of patient autonomy, the denial of ICU care, the withdrawal of life support, and physician-assisted suicide. Murray concludes that ICUs are doing their job, but they could be even better, cheaper, and - most important - more humane. His chronicle brings substance to a world known to most of us only through the fiction of television.