Wednesday, December 9, 2009

Book Review of Cheating Death: The Doctors and Medical Miracles that Are Saving Lives Against All Odds by Sanjay Gupta

I'm going to let you in on a little secret: When the heart stops beating, it's not the end. In fact, you might say that your troubles have only just begun. As it turns out, life and death is not a black-and-white issue. There is a gray zone - a faint no-man's land where you are neither truly dead nor actually alive. In order to control it, in order to cheat death, we have to first better understand it.
-Cheating Death: The Doctors and Medical Miracles that Are Saving Lives Against All Odds by Sanjay Gupta

Cheating Death: The Doctors and Medical Miracles that Are Saving Lives Against All Odds
The blurb:
An unborn baby with a fatal heart disease. . .a skier submerged for an hour in a frozen Norwegian lake. . . a comatose brain surgery patient whom doctors have declared a "vegetable."

Twenty years ago all of them would have been given up for dead, with no realistic hope for survival. But today, thanks to incredible new medical advances, each of these individuals is alive and well. . .Cheating Death.

In this riveting book, Dr. Sanjay Gupta - neurosurgeon, chief medical correspondent for CNN, and bestselling author - chronicles the almost unbelievable science that has made these seemingly miraculous recoveries possible. A bold new breed of doctors has achieved amazing rescues by refusing to accept that any life is irretrievably lost. Extended cardiac arrest, "brain death," not breathing for over an hour - all these conditions used to be considered inevitably fatal, but they no longer are. Today, revolutionary advances are blurring the traditional line between life and death in fascinating ways.

Drawing on real-life stories and using his unprecedented access to the latest medical research, Dr. Gupta dramatically presents exciting accounts of how pioneering physicians and researches are altering our understanding of how the human body functions when it comes to survival - and why more and more patients who once would have died are now alive. From experiments with therapeutic hypothermia to save comatose stroke or heart attach victims to lifesaving operations in utero to the study of animal hibernation to help wounded soldiers on far-off battlefields, these remarkable case histories transform and enrich all our assumptions about the true nature of life and death.

Sanjay Gupta shares stories of patients that had fallen within that gray zone where they are "neither truly dead or actually alive," and have subsequently benefited from good luck and medical expertise and recovered to lead productive lives.

I found the book fascinating. The clear and detailed descriptions of the medical cases and discoveries were riveting in and of themselves. For instance, learning how hypothermia can slow down the effect of lack of oxygen caused by a stroke or a heart attack is helpful, but it made a difference to learn that "next step." The use of hypothermia only became practicable when doctors discovered that it is essential to minimize the use of liquids when raising the body's temperature. By keeping the use of liquids to a minimum, the doctors are able to prevent the brain from expanding and avoid subsequent brain damage.

I hadn't known much about CPR and did not know that that survival rate from cardiac arrest outside of a hospital is rare. Did you know that only about 2% of the victims survive without long term damage? In certain parts of Arizona, people have a substantially better survival rate because of the use of a modified CPR technique and a public health effort to train more people in CPR. The number one thing that can save your life if you have a heart attack is to have a bystander who is trained in CPR and is willing to help.

The bystander rate of CPR is 20%, in large part because many people are hesitant about performing mouth-to-mouth resuscitation. Through training and education programs, places like Seattle have a 50% rate of bystander CPR assistance and this has meant that the cardiac arrest survival rate in Seattle is much better than in other parts of the country.

Doctors studied the role of artificial respiration in emergency resuscitation and analyzed the three-phase model of cardiac arrest (electrical, circulatory and metabolic). I won't go into a technical explanation here, but the in the first 4 minutes, the heart has its own energy and has oxygen. The heart needs assistance in getting its beat back. Defibrillation works during this phase because it reinserts the heart's rhythm. From the 4 to 10 minute mark is the circulatory phase, the heart needs assistance to circulate oxygen. It is critical to have someone pump the heart artificially. If there is a delay pumping the heart because the rescuer is performing mouth-to-mouth,then the heart isn't receiving the oxygen that it needs. Sanjay Gupta and the doctors that he cites point out that the most important thing is to get the blood and oxygen moving by compressing the chest.

Those are just two examples of practical and revolutionary advances in medicine that Sanjay Gupta covers in Cheating Death. I found Cheating Death to be a fascinating read and recommend it to both laypersons and medical professionals both for the scientific innovations that it chronicles and for its clear writing style.

Publisher: Wellness Central; 1 edition (October 12, 2009), 304 pages.
Review copy provided by the publisher.

About the Author:
Sanjay Gupta, MD, is a practicing neurosurgeon and associate chief of neurosurgery at Grady Memorial Hospital and assistant professor at Emory University Hospital in Atlanta. He is a columnist for TIME magazine and chief medical correspondent at CNN. He lives in Atlanta, Georgia.

Thanks so much to Anna and Hatchette Book Group for this review opportunity!

1 comment:

  1. Very nice and thorough review. I did a briefer one and also enjoyed the stories of survival.