By Dr. Christopher M. Johnson; 212 pages. Subtitle: Life and Death Choices Parents Must Face.
For parents accompanying a critically ill child into a Pediatric Intensive Care Unit (PICU), it can be hard to know what to expect, and what to make of all the tending and treating and tweeting of scary machinery. Dr. Johnson, former director of the Mayo Clinic's PICU, introduces readers to his specialty, pediatric critical care, and to the expertise and guesswork and dumb luck that goes into reversing the progress of devastating illness and injury.
- Writing is engaging and compelling
- Reads like the synopsis of a really good medical TV series
- Stories point up specific areas that parents need to be aware of in critical care
- Summary at the end of each chapter gives specific advice
- Nice to get a compassionate doctor's point of view on the process
- This is less a how-to than a memoir with useful observations
- You may not agree with the doctor's stated or implied opinions on vaccinations and "futile care"
- Reading about a thoughtful and involved doctor may make the doctors you're stuck with look bad
- Chapter 1: Parent's Challenge: Running the PICU Marathon
- Chapter 2: How the PICU Works
- Chapter 3: Understanding Supportive Care's Limits and Advantages
- Chapter 4: Doing the Right Thing
- Chapter 5: Whom Shall We Cure?
- Chapter 6: Knowing When to Quit
- Chapter 7: Medical Uncertainty
- Chapter 8: When Ethics and Costs Collide
- Chapter 9: Carrying On
- Chapter 10: Miracles Do Happen
Someone turn this book into a TV show! It's perfect, kind of a "House, Jr." Each chapter presents a case history of one or two children who are brought to the PICU with life-threatening and mysterious ailments. One boy is found unconscious on a hiking trail; did he fall from a rock and have a seizure, or have a seizure and fall from a rock, or suffer from something altogether different? A little girl starts out with a bad case of diaper rash and ends up having multiple surgeries to clean out skin ravaged by flesh-eating bacteria. A baby struggles to survive whooping cough, a girl with no insurance suffers repeated attacks of lupus, a girl's brain bleeds and a boy's brain seizes for reasons not immediately apparent.
This is the world of the pediatric critical care specialist, and Dr. Johnson shares both the battles of doctors and nurses to contain cascading medical crises and of parents to understand what is going on around them and make good decisions for their children and themselves. He is admirably respectful of parents and appreciative of the extreme stress they undergo as their children struggle for life. Although his opinions on issues like vaccinations and futile care do sometimes slip through, he generally tries hard not to make judgments -- harder than a lot of medical professionals seem to, anyway.
The text does contain some good suggestions for parents who may one day have to deal with these life and death issues -- which, I suppose, could be anybody, since most of the kids in this book were the pictures of health right up until the point when they weren't. Yet this is really less of a how-to on caring for your critically ill child than a memoir of medical crises told from the doctor's point of view. A pretty good read, at that.
