{"id":45957,"date":"2019-10-29T11:27:56","date_gmt":"2019-10-29T10:27:56","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=45957"},"modified":"2019-11-04T18:58:45","modified_gmt":"2019-11-04T17:58:45","slug":"jack-brindley-critical-conversations","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2019\/10\/29\/jack-brindley-critical-conversations\/","title":{"rendered":"Jack Brindley: Critical conversations"},"content":{"rendered":"<p class=\"standfirst\"><span style=\"font-weight: 400\">New books Critical and Seven Signs of Life are worthy additions to the growing collection of doctor memoires, says Jack Brindley<\/span><\/p>\n<p><!--more--><span style=\"font-weight: 400\">The odds are that you or someone you know will be a patient in intensive care at some point. The intensive care unit (ICU) is a world in which patients and their families (and sometimes the healthcare professionals too) can easily feel lost, confused, and alienated. In separate new books, Matt Morgan and Aoife Abbey have endeavoured to explain what intensivists actually do. In so doing, they have shown that \u201c\u2018doctoring\u201d\u2019 extends beyond working hours and into the lives of each patient and family that passes through.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Matt Morgan with his book <\/span><i><span style=\"font-weight: 400\">Critical <\/span><\/i><span style=\"font-weight: 400\">and Aoife Abbey with <\/span><i><span style=\"font-weight: 400\">Seven Signs of Life<\/span><\/i><span style=\"font-weight: 400\"> set out to share the world of intensive care through compelling storytelling. Both books contextualise and humanise intensive care through the stories of patients. Morgan and Abbey describe death, dying, suffering, and the occasional joy in the ICU without the dull rigour of a textbook or the dramatic prose of a novel. For this, they should both be commended. This pre-med student found these stories touching, educational, and encouraging. They are stories worth telling, and for the doctor and non-doctor alike, stories worth reading.\u00a0<\/span><\/p>\n<p><i><span style=\"font-weight: 400\">Critical<\/span><\/i><span style=\"font-weight: 400\"> by Dr Matt Morgan spans nine chapters and each includes patient stories related to a specific type of ailment. Chapter one follows Vivian, a woman with polio; chapter two focuses on the immune system; chapter three on skin and bones, and so on. For those without the technical knowledge to understand how and why Dr Morgan\u2019s patients ended up in the ICU, each chapter also includes an explanation of medical practice and biology. In particular, chapter four, entitled <\/span><i><span style=\"font-weight: 400\">The Heart<\/span><\/i><span style=\"font-weight: 400\">, teaches the reader how to perform CPR.\u00a0<\/span><\/p>\n<p><i><span style=\"font-weight: 400\">Critical <\/span><\/i><span style=\"font-weight: 400\">is an enjoyable and informative read from start to finish. Matt Morgan discusses life and death in the ICU in an insightful, humble, and moving way. Whether one of Dr Morgan\u2019s stories ends in full recovery, death, or disability, one is left with a sense of resolution; that one understands why each treatment has been done, and why (if need be) treatment has stopped. Not only does <\/span><i><span style=\"font-weight: 400\">Critical <\/span><\/i><span style=\"font-weight: 400\">delve deep into medicine from the doctor\u2019s perspective, it reinvigorates a sense for the public and intensivists that intensive care is worthwhile.<\/span><\/p>\n<p><i><span style=\"font-weight: 400\">Seven Signs of Life <\/span><\/i><span style=\"font-weight: 400\">is written on a similar principle: stories of intensive care centered around patients and as a means to explain the ICU to the non-clinician. However, Aoife Abbey organises her book by emotion, not by body system. This clever structure of seven feelings (fear, grief, joy, distraction, anger, disgust, and hope) as the \u201cseven signs of life\u201d adds immensely to this book. Each emotion is the subject of one of seven chapters with several patient stories.\u00a0<\/span><\/p>\n<p><i><span style=\"font-weight: 400\">Seven Signs <\/span><\/i><span style=\"font-weight: 400\">guides the reader through the experiences of an intensivist and their patients one by one. The separation of experience by associated feeling goes a long way towards not overwhelming the reader, and Abbey is similarly adept at explaining complex medical procedures to the non-clinician. She leaves the reader with a strong sense of understanding, not only of medical procedures, but of the thoughts and feelings of doctors, which are so often invisible to patients.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">These things are hard to talk about. We all struggle to find the right words at times, but discussing with someone what will or should happen when they or their loved one\u2019s die is a scenario beyond most people\u2019s experience. Doctors, particularly intensive care doctors, have these conversations every day. Both of these books highlight how sometimes, when dealing with death, the right words are still lacking. By translating closed door conversations into stories, we get a glimpse into that which goes unsaid.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">It is not easy to tread the line between storyteller and narcissist. Especially when telling stories about intensive care, it is all too easy to create the narrative of hero doctor and helpless patient. Is it self-aggrandising for doctors to insert themselves into the narratives of these patients\u2019 lives? I don\u2019t think so. Morgan and Abbey tell their stories respectfully and keep the patient at the centre of the narrative. Neither makes themselves a savior. This is what really makes these books worthwhile and a worthy addition to the growing collection of doctor memoires.\u00a0<\/span><\/p>\n<p><i><span style=\"font-weight: 400\">Seven Signs of Life <\/span><\/i><span style=\"font-weight: 400\">and <\/span><i><span style=\"font-weight: 400\">Critical <\/span><\/i><span style=\"font-weight: 400\">tackle a similar topic<\/span><span style=\"font-weight: 400\"> and are equally rewarding. They should be shared, highlighted, dog-eared, and quoted. Matt Morgan and Aoife Abbey both add valuable experience to the niche and often misunderstood specialty of critical care and the inner workings of the staff that keep it going. Whether the reader works in an ICU, a lab, or at McDonalds, they will find something valuable in these books. I certainly did.\u00a0<\/span><\/p>\n<p><em><strong>Jack Brindley <\/strong>is an undergraduate at the University of Alberta, Canada.<\/em><\/p>\n<p><strong>Competing interests:<\/strong> None declared.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>New books Critical and Seven Signs of Life are worthy additions to the growing collection of doctor memoires, says Jack Brindley [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/10\/29\/jack-brindley-critical-conversations\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":45959,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[],"class_list":["post-45957","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guest-bloggers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Jack Brindley: Critical conversations - 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