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Intensive Care: A Doctor's Journal [Hardcover]

John F. Murray (Author)
4.2 out of 5 stars  See all reviews (4 customer reviews)


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Book Description

July 17, 2000 0520220897 978-0520220898 1
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, 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.

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Editorial Reviews

From Publishers Weekly

"What this book is about," explains Murray (professor emeritus at U.C.-San Francisco) in his prologue to this journal, is "how doctors and nurses make decisions concerning... urgent medical problems." As an attending physician on the Intensive Care Unit at San Francisco General Hospital--a unit that sees a large number of poor patients--Murray believes the processes guiding those decisions deserve strenuous review. In 28 chapters he does just that: using a daily journal format, he leads readers through 28 typical days on the ICU, describing the patients who come through the unit's doors and reproducing the medical notes he writes in their files. It is not long before his point becomes clear: although he believes that an ICU should give all patients care that will restore them to a good life regardless of why they came to the unit (including alcohol or drug abuse), he is convinced that patients who will die within a period of days or weeks should be denied ICU admission. It's a controversial point, but one that Murray defends with case examples and analysis. According to the author, patients who are unable to make decisions and have not instructed their families about end-of-life care are sometimes kept in the ICU when they are close to death, painfully prolonging their dying. Although the dry presentation of chart notes is occasionally either repetitive or confusing, Murray's narrative indicates that he is a dedicated physician who debates with himself about the patient care decisions he has to make on a daily basis. His book is likely to spark a heated debate. (May)
Copyright 2000 Reed Business Information, Inc.

From Library Journal

Murray (medicine, Univ. of California, San Francisco; coeditor of The Textbook of Respiratory Medicine) takes the reader on his daily rounds at the intensive care unit (ICU) of the San Francisco General Hospital. Over the course of a month, 60 critically ill patients are treated there under his supervision. We discover how the best of modern medical technology is applied, with expert efficiency, compassion, and at colossal financial cost, to the treatment of the patients in this major inner-city hospital ICU. 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.DJames Swanton, Harlem Hosp. Lib., New York
Copyright 2000 Reed Business Information, Inc.

Product Details

  • Hardcover: 311 pages
  • Publisher: University of California Press; 1 edition (July 17, 2000)
  • Language: English
  • ISBN-10: 0520220897
  • ISBN-13: 978-0520220898
  • Product Dimensions: 9.4 x 6.5 x 1.2 inches
  • Shipping Weight: 1.3 pounds
  • Average Customer Review: 4.2 out of 5 stars  See all reviews (4 customer reviews)
  • Amazon Best Sellers Rank: #1,209,638 in Books (See Top 100 in Books)

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Average Customer Review
4.2 out of 5 stars (4 customer reviews)
 
 
 
 
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13 of 13 people found the following review helpful:
4.0 out of 5 stars Intensive Care A Doctor's Journal, August 21, 2000
By A Customer
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This review is from: Intensive Care: A Doctor's Journal (Hardcover)
This is a clear, honest look inside the world of ICU. Concise, well-written, without the glitz and exaggeration served up by commercial TV in shows such as ER. This gifted physician shares his world view and realistically portrays the complexity and stresses of the day to day operation of an urban intensive care unit. Don't look for sentimentality here, this is more in the realm of science. Good job.
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11 of 11 people found the following review helpful:
5.0 out of 5 stars An honest look at life in the ICU, February 20, 2001
By 
"jenniferstuart" (Pittsburg, CA USA) - See all my reviews
This review is from: Intensive Care: A Doctor's Journal (Hardcover)
As an ICU nurse, I am often disturbed by the average person's expectations when a family member is treated in our intensive care unit. Too often, we are expected to perform miracles when at best all we can do is delay the course of nature for a few days or weeks while the family adjusts to the concept that their loved one is dying. This is frequently at the expense of the patient who is subjected to a long and uncomfortable death. Dr. Murray paints a true to life picture of what happens in the ICU by providing a day by day journal covering four weeks at San Francisco General Hospital. He provides an enlightening view of critical care that is both compassionate and accurate. His writing style is easy to understand, and the stories he tells of each patient he meets are compelling. He covers all; the successes, the failures, and those in between. Dr. Murray also addresses the ethical dilemmas facing us today regarding self determination and the allocation of scarce resources. A must read if you really want to know what happens to your loved ones in the ICU.
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5.0 out of 5 stars Time in the ICU, November 2, 2009
By 
Michael B (Columbia, MO) - See all my reviews
This book was great! Especially for anyone interested in a medical career. The book provides an overview of what took place during Dr. Murray's month as the attending doctor at a Medical ICU. It provides very detailed accounts of a number of cases. Some cases ended on a positive note, while others not so much. I would recommend this book. In fact, Dr. Murray is still practicing one month a year at this hospital!
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