The founder of the Centre for Altitude, Space, and Extreme Environment Medicine examines the connections between extraordinary advances in modern medicine and the experiences of explorers, mountaineers, soldiers and others who face extreme conditions.
An intensive-care physician who also studied astrophysics and engineering, Guardian contributor Fong shares a unique point of view on the development of intensive care as a medical discipline. “Much of the [modern] advance [in saving life]…has come through wrapping fragile human physiology in concentric layers of artificial life support and allowing it to be projected into extremes that we were never before able to survive,” writes the author, who provides many fascinating examples—e.g., in 1999, the miraculous recovery of a Norwegian doctor who almost died after a skiing accident. When rescued after being submerged in icy water for more than 40 minutes after a fall, she was not breathing and had no discernible pulse. Her medical colleagues used heroic methods to save her, calling upon the skills of a surgical anesthesiologist and applying techniques pioneered in open-heart surgery. This prompted the recognition that deliberately inducing “hypothermic arrest” and bringing a patient to the point of death extended the time available for complex, life-threatening surgical operations. Similarly, the treatment of wartime casualties during World War II led to major advances in the treatment of severe burns—and the first successful face transplant in 2009. The key was to artificially maintain blood circulation in skin grafts to the affected areas. Fong believes that the demands of manned space flights to Mars will drive new frontiers of medicine. Today, we are only beginning to deal with medical problems (e.g., loss of calcium in bones, inner-ear problems with balance) faced by astronauts who spend time in zero-gravity environments and then return to Earth.
A medical thriller of the first order.