"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 acco

I walked onto the icu a little before 8:00 a.m. to find three third-year medical residents— Dr. Ella Andrews, Dr. James Shotinger, and Dr. Ian Trent-Johnson—waiting for me. Each had a big smile. They had arrived early to familiarize themselves with our patients and already knew a lot about them. Their smiles were not only welcoming but inquiring. We were all going to spend the next four weeks together, and they were curious to see how well I would help them handle the formidable problems that lay ahead of us: would I be an aid or an obstacle, a rabid interventionist or a do-nothing conservative, a stickler or a laissez-faire leader? Could I teach? Now in the last year of medical residency, they had learned that much of their training in internal medicine is subject to variations in attending physicians' style and competence.

While they were wondering about me, I was scrutinizing them. Depending on their clinical abilities and willingness to work hard, the four weeks I would spend in the units and my level of anxiety during our rotation together would be either manageable or exceedingly uncomfortable. I would be depending on them, and on a number of other personnel as well, to carry out the plans we had agreed on during rounds, to show good judgment in dealing with new patients and with matters we . . .