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A Final Arc of Sky: A Memoir of Critical Care
 
 
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A Final Arc of Sky: A Memoir of Critical Care [Hardcover]

Jennifer Culkin (Author)
3.9 out of 5 stars  See all reviews (14 customer reviews)

Price: $24.95 & eligible for FREE Super Saver Shipping on orders over $25. Details
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Book Description

April 1, 2009
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.

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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.

Review

This book gives us so much more than the details of Jennifer Culkin's experiences as an intensive care nurse; it lifts us into the world of the helicopter and into some of life's highest dramas. A Final Arc of Sky carries its 'mortal freight' with candid honesty as it addresses how we choose to live our lives, and sometimes how we end them. 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

"In this powerful, beautifully written memoir, Jennifer Culkin seems constitutionally incapable of sentimentality as a nurse and as a writer. Instead, she wields an irreverent sensibility like a scalpel and applies lyrical insights like a balm, unveiling a fierce and tender passion for her work and her family as she celebrates the 'accidental sacraments' that emerge from love and loss." —Sherry Simpson, author of The Accidental Explorer

"Rarely have we heard from such an eloquent yet urgent voice from the frontlines of mortality. Jennifer Culkin, a writer of enormous talents, brings us too close for comfort to a variety of intense locales: the wreckage of a highway pileup, the inside of a pediatric intensive care unit, her father's deathbed. She writes with elegiac grace and unblinking honesty of our collective determination to sustain life, limb, and, above all, dignity."—Robin Hemley, author of Invented Eden: The Elusive, Disputed History of the Tasaday

"A Final Arc of Sky is one of the very few books I've read that is simultaneously 'I-can't-stop-turning-pages' riveting and profoundly meditative. 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. A remarkable debut."—Ann Pancake, author of Strange as This Weather Has Been

"Jennifer Culkin initiates her readers into the high-stress world of critical care medicine, and as she shows us her profession with all its costs and rewards she also reveals the way such work both hardens and opens us to the things of this earth. A Final Arc of Sky is an unstinting inquiry into life-and death-accomplished in lean, graceful prose."—Jane Brox, author of Clearing Land: Legacies of the American Farm

Product Details

  • Hardcover: 248 pages
  • Publisher: Beacon Press (April 1, 2009)
  • Language: English
  • ISBN-10: 0807072850
  • ISBN-13: 978-0807072851
  • Product Dimensions: 5.6 x 1 x 8.8 inches
  • Shipping Weight: 1 pounds (View shipping rates and policies)
  • Average Customer Review: 3.9 out of 5 stars  See all reviews (14 customer reviews)
  • Amazon Best Sellers Rank: #994,623 in Books (See Top 100 in Books)

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Customer Reviews

14 Reviews
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Average Customer Review
3.9 out of 5 stars (14 customer reviews)
 
 
 
 
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Most Helpful Customer Reviews

9 of 9 people found the following review helpful:
4.0 out of 5 stars Interesting and compelling, April 11, 2009
This review is from: A Final Arc of Sky: A Memoir of Critical Care (Hardcover)
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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5 of 5 people found the following review helpful:
4.0 out of 5 stars Grim but moving, April 21, 2009
This review is from: A Final Arc of Sky: A Memoir of Critical Care (Hardcover)
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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3 of 3 people found the following review helpful:
5.0 out of 5 stars The Book I Couldn't Put Down - My Highest Recommendation, June 8, 2009
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This review is from: A Final Arc of Sky: A Memoir of Critical Care (Hardcover)
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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Inside This Book (learn more)
Key Phrases - Statistically Improbable Phrases (SIPs): (learn more)
medic rig, final arc, flutter valve, flight nurse
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Final Arc of Sky, Jennifer Culkin, San Francisco, Sister Therese, New York, Puget Sound, Pacific Northwest, Revere Beach, Little League, Port Madison, Day Road, Grand Canyon, New Hampshire, Turk Street
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