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A Final Arc of Sky: A Memoir of Critical Care [Kindle Edition]

Jennifer Culkin
4.1 out of 5 stars  See all reviews (18 customer reviews)

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Book Description

Buckling herself into the rear of an Agusta A109A, Jennifer Culkin prepares for the moment of lift. The deafening thrum of the helicopter announces the unknown perils and potential havoc that await. A critical care and emergency flight nurse, Culkin treats patients who are most often in mortal danger. Aboard the Agusta, she is entrusted with the life of a seventeenyearold pulled from the wreckage of a headon collision as his father calls out a wrenching plea from below; she cares for a middleaged man who is bleeding to death internally, remembering the four daughters who have kissed him goodbye, possibly for the last time. It is the arduous and acute struggle to keep her patients alive en route to the hospital that is Jennifer Culkin's most profound duty.

Culkin is no stranger to death and its dramas, or the urgency that accompanies them. Her memoir pulls us into the neonatal intensive care unit, where she labors to ventilate an elevenounce preemie, the smallest human she has ever cared for. The tenuous lines between life and death lead us to the pediatric intensive care unit, where she looks after children seemingly too small to contain their devastating illnesses.

As her personal life begins to mirror the intensity of her work, Culkin writes poignantly of attending her dying mother, who refuses to decide whether to prolong her life. She recounts with tenderness and exasperation the experience of looking after her widowed father, who faces death with dramatic stubbornness, ignoring medical advice and rejecting even basic treatment. Tempering her profound insights with humor, Culkin relates her taste for the edge, her own risky gambles, and her ongoing battle with multiple sclerosis. Finally, Culkin takes us back to flying, with the dramatic and redemptive stories of her colleagues who have perished in helicopter crashes in their very exceptional line of duty.

A Final Arc of Sky does more than plunge readers into the chaos of emergency medicine; it is also a masterful reflection on the pivotal moments of our lives, on the beautiful fragility of our mortality.

Editorial Reviews

From Publishers Weekly

Over three decades, more than 4,000 patients and their loved ones have shared their most wrenching ultimate experiences with Culkin, a critical care nurse living near Seattle. In this compelling memoir, her moving reflections on life and death interweave clinical encounters with her own life. She looks back at the clockwork of hormones as she began her relationship with her future husband while working 12-hour shifts in a San Francisco intensive-care nursery, moving on to become a traveling nurse in Anchorage, then living in the Alaskan wilderness, completely alone at the edge of the civilized universe. Her marriage, sons, problems with her parents and family dynamics intertwine with memories of patients extricated from wreckage and an impromptu procedure in a helicopter on a patient who couldn't breathe. Culkin details the sisterhood of nursing, with its risks and stress and sharing cups of 0900 coffee, and her own bouts with multiple sclerosis. Describing her life as a flight nurse in the final chapters, Culkin sees herself and others clearly, and poetic juxtapositions make her sentences soar. (Apr.)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.


In this compelling memoir, her moving reflections on life and death interweave clinical encounters with her own life. . . . Culkin sees herself and others clearly, and poetic juxtapositions make her sentences soar.—Publishers Weekly

"A marvelous writer, mixing tragedy and reflection with luminous prose . . . We are privileged to share her passion and heartbreak."—Marilyn Dahl, Shelf Talker

""With its perfect capture of the fragility of life and our vulnerable human bodies and bonds, A Final Arc of Sky . . . is a disturbing, powerful read."—Lynda V. Mapes, Seattle Times

"Rarely have we heard from such an eloquent yet urgent voice from the front lines of mortality. . . . Culkin writes with elegiac grace and unblinking honesty."—Robin Hemley, author of Invented Eden

"Absorbing . . . This former neonatal and pediatric intensive-care nurse has vivid memories of the tiny patients whose lives were in her hands, and she writes of them with warmth and clarity. . . . Powerful and lucid . . . The risks of being an emergency flight nurse-night flights, bad weather, human error-come fully alive. . . . Enthralling."—Kirkus Reviews

"With her electrifying scenes, her gorgeous sentences, and her provocative explorations of the borderland between life and death, Culkin engaged my heart, my intellect, my artistic sensibility, and my adrenaline."—Ann Pancake, author of Strange as This Weather Has Been

"I loved the stories, the language, the point of view, but what I loved most was the way this book was able to break my heart—then mend it."—Judith Kitchen, author of Distance and Direction

Product Details

  • File Size: 1551 KB
  • Print Length: 248 pages
  • Publisher: Beacon Press (April 1, 2009)
  • Sold by: Amazon Digital Services, Inc.
  • Language: English
  • ASIN: B002AKJBD0
  • Text-to-Speech: Enabled
  • X-Ray:
  • Word Wise: Not Enabled
  • Lending: Not Enabled
  • Amazon Best Sellers Rank: #782,558 Paid in Kindle Store (See Top 100 Paid in Kindle Store)
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Customer Reviews

Most Helpful Customer Reviews
10 of 10 people found the following review helpful
4.0 out of 5 stars Interesting and compelling April 11, 2009
This book has only one failing as far as I am concerned. It is far too short.

The episodes related in this book range from critical care for infants in PICU units, to lifesaving measures applied while being bounced around in a helicopter. Each of the stories told by the author of her experiences on the job are mirrored by other stories about her personal life. This serves to make a very compelling read.

The style of this author is informal and down to earth. This is a style I enjoy when reading a memoir. It provides a sort of intimacy that is not to be found by a more formal approach.

I will indeed recommend this book to my friends, and I will also hope for a volume II by Jennifer Culkin.
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6 of 6 people found the following review helpful
4.0 out of 5 stars Grim but moving April 21, 2009
After working as a NICU and PICU nurse, Culkin becomes a flight nurse. She describes harrowing life and death scenes, scenes whose outcome is known only if it is bad. If the patient dies in the air, she knows it. If the patient recovers... well, that happens on someone else's watch. Telling her story in a thematic, rather than linear, arrangement, Culkin juxtaposes particular flights with more or less loosely related fragments of her own life: the growing up of her sons, especially the younger; her daredevil bike rides, surprising in someone who works with trauma patients; her parents' aging, illness, and descent into selfishness; her own struggle with multiple sclerosis. For me, the hardest parts of the book to read were those about her parents' final illnesses. Both become querulous, irrational, and self-centered, wanting those they love to perform backbreaking labor to care for them and refusing to accept outside help. None of the book is exactly easy to read--Culkin isn't the kind of memoir writer who carefully balances the grim with the hopeful, and there's a dark edge even to her beloved bike rides--but these sections are just plain ugly. The last chapter, in which she details some of the colleagues she's lost to helicopter crashes, had me almost in tears. Again, she starts not with the first time this happens to her, but the most recent, looping back and forth through the connections. The nonlinear format, which is sometimes disorienting in other places, works particularly well in this last chapter.
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4 of 4 people found the following review helpful
While I love memoirs and creative non-fiction essays, what I don't love is the world of medicine, doctors, and nurses, so I was surprised to find myself unable to stop reading Jennifer Culkin's first book. I read it in 2 days and it was one of my favorite reads of the year.

What I loved about it was the author's honesty and ability to weave her life as a flight nurse in with stories of her childhood and her family life. She speaks to the difficulty of caring for elderly parents (in this case, two who feel they are doing quite well on their own), the family struggles with siblings, and she does it with honestly, not trying to hide that everything is less than perfect, she makes no excuses for herself, but speaks to the reader as a friend--this is how it was.

And throughout the book, there is the author's wit. While the book does deal with difficult subjects, she is able to guide the reader through her book with her incredible forward-moving narrative as well as her ability to see the humor in unfunny situations.

The book is moving, dark, funny, honest, and gives the reader the inside scoop on what life is like for a flight nurse. I know how many times I've seen the medic helicopters go by my house with no idea what these people do and how they do it. It's an interesting look into a side of the medical world that isn't included on Grey's Anatomy or really, anywhere. And while I am not someone who reads medical memoirs, I connected with this one in many ways. And as I said, I couldn't put it down and I was interested in Culkin's thoughts and stories.

What a treat to have such a strong new voice in the creative non-fiction/memoir world. I can now only hope I don't have too long to wait until her next book.
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2 of 2 people found the following review helpful
By Lex
Format:Hardcover|Verified Purchase
I read this book in less than 2 days. I don't know the author but work with flight nurses on a daily basis.

Every chapter has a different feel. Some are extremely personal about dealing with her parents, her siblings, feelings about her children and parenting and especially touching is the one about her struggles with multiple sclerosis. Other terrific chapters trace why and how her parents came to their own, very different, conclusions about end-of-life issues.

As a health care provider as well, I especially appreciated her insights about how people who work with critically ill patients have quite different approach to dealing with illness when people we love get sick.

Chapters on aging parents should be required reading for anyone over 60!

Finally, her writing style is lovely -- I re-read multiple sentences just because they were so thoughtful.
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2 of 2 people found the following review helpful
5.0 out of 5 stars Parallel Life June 22, 2009
As someone who has experienced life similarities, minus the diagnosis of MS, I find Ms. Culkin's memoir eerily accurate in facts, feelings, and experiences. She clearly vasillates between the searing emotion of her own dying parents, (as the only child with medical knowledge) and the connections made with parents of dying children. The flight team memories touched my heart. Please keep writing.
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Most Recent Customer Reviews
5.0 out of 5 stars Five Stars
Published 3 months ago by i order alot
5.0 out of 5 stars Good read for a nursing student.
I bought this book for my ICU class. It shined some light on the nursing in the critica care dept from infants to elderly.
Published on December 11, 2012 by Jerri
4.0 out of 5 stars A moving, well written memoir
I didn't expect to like this book as much as I did, and I was unsure in the first chapter if I'd be able to read it at all. Read more
Published on November 5, 2012 by M. Carroll
5.0 out of 5 stars Stimulating memoir!
This book was engaging and kept me turning the pages. Jennifer's accounts of her experiences as a Critical Care Flight Nurse allows one to step inside this elite role. Read more
Published on September 7, 2012 by rw
2.0 out of 5 stars A Waste of Money
I was expecting this book to be exciting and full of heroic life saving efforts that the author encountered in her career but easily 2/3 of the book is about her family. Read more
Published on January 16, 2011 by Kindle Customer
4.0 out of 5 stars A bit disappointed, but nevertheless a well-told story
Jennifer Culkin became a flight nurse in Washington State after experience in many critical care settings elsewhere. Read more
Published on July 29, 2010 by Maudeen Wachsmith
3.0 out of 5 stars more a "literary" book than one about a flight nurse
A few years back I read the book "Trauma Junkie: Memoirs of an Emergency Flight Nurse" and enjoyed it. Read more
Published on November 19, 2009 by mikemac9
5.0 out of 5 stars There is one thing wrong with this book -- it ended!
Review of A Final Arc of Sky: A Memoir of Critical Care
Jennifer Culkin, Boston: Beacon Press, 2009.

By Judy Schaefer

Couldn't put it down! Read more
Published on September 13, 2009 by Judy Schaefer
2.0 out of 5 stars very disappointing
I completely agree with the reviewer who said that this book was disappointed, disjointed, and lacked emotional warmth. Read more
Published on July 25, 2009 by J. Hughes
2.0 out of 5 stars Lacking flow and warmth
I sat down to read A Final Arc of Sky expecting to read about the adventures of a nurse in the unusual setting of a helicopter on "flight for life" missions. Read more
Published on July 10, 2009 by Jean Kelso
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