Life in the Balance: A Doctors Stories of Intensive Care

(Paperback)

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A moving, frank and unflinching-yet-witty account of the realities of intensive care medicine from Dr Jim Down, ICU consultant at one of London's top hospitals In these stories, Dr Jim Down brings us to the very heart of the intensive care unit - the hospital section where the sickest patients are brought for emergency care. With honesty, humility and a streak of dark humour, Dr Down describes the quietly heroic work of doctors and nurses on the ICU, a place which sits at the cutting edge of medical technology, and where a split-second decision can make the difference between life and death. From headline-grabbing cases like that of Alexander Litvinenko, who was admitted to Down's ward after his poisoning by Russian agents, to the appalling aftermath of a train crash, and the daily struggle to simply find enough beds, Jim Down provides a unique insight into life on The Unit, and the critical medicine doctors and nurses perform there. Life in the Balance offers the first real glimpse of intensive care medicine; its immense challenges, its deleterious effects on doctors' mental health and also its enormous rewards. This profound work reframes the fragility of life and shows what it really means to care.

Reviews

A remarkably honest memoir of a life spent pulling people back from death -- Adam Kay * author of This is Going to Hurt *
[Jim] describes with unflinching honesty the toll that working in intensive care can take on his own mental health
Jim Down is as remarkable a writer as he is a doctor. If I'm ever in ICU I hope he's my consultant * Medical Editor, BBC *
Whether treating famous Russian spies, the victims of terrorist attacks, or people taken close to death by Covid, he shows us what it's really like to care for those who are clinging to life, and describes with unflinching honesty the toll that working in intensive care can take on his own mental health -- Alastair Campbell
Spies, terror, personal crisis, resolution and redemption; Life in the Balance really has it all ... a hilarious, beautiful book, I was sincerely moved -- Dr Chris van Tulleken
Beautifully written, witty and heartbreaking -- Olivia Colman
If Jim Down is as good a doctor as he is a writer, I'd definitely want him treating me. * John O'Farrell *
Transport yourself into the angst ridden, terrifying, and at times hilarious world of the trainee doctor of the 1990s. A cross between This is Going to Hurt and Do No Harm ... highly recommended! -- Dr Andrew Jenkinson * author of Why We Eat too Much *
Jim's book is different. His ear is attuned, and his recounting conversations makes me live his scenes. And he made me think, weep and smile. He's a smart, wise and kind doctor in real life, and these characteristics shine through. Whoever you are, you should read this book. One in five of you will, at some point, need a Jim -- Hugh Montgomery * Professor of Intensive Care Medicine, University College London *
Life in the Balance brims with the wonder, trauma and magic of medicine. Jim Down is a consummate storyteller whose tales of life and death in the ICU are riveting. I loved this book! -- Dr Rachel Clarke * author of Breathtaking *
A beautifully written, brutally honest account of what life spent as an ICU doctor is like, how it feels and what it costs -- Dr Kevin Fong
Medical students should read this. Young doctors should read this. Patients should read this. Having read it, I have no idea how Dr Down found the time to write it! -- Sir Richard Stilgoe
Jim Down is as remarkable a writer as he is a doctor. It is like being by the patient's bedside in critical care, but more than that you are inside Jim's head as he struggles with ethical as well as medical dilemmas. What comes across most strongly is his humanity. If I'm ever in ICU I hope he's my consultant -- Fergus Walsh * Medical Editor, BBC *

Author Bio

Dr Jim Down is a consultant in critical care and anaesthesia based in London. He chairs the ICU consultants' group, the department of anaesthesia weekly scientific meetings and the UCLH Trust guideline committee. During the Covid-19 pandemic he worked on UCLH's busy ICU ward, and was interviewed by the BBC for a groundbreaking report depicting medics on the frontline. His account of that period, Life Support, was published in 2021 and his second book, Life in the Balance, was published in 2023.