Extreme Medicine

Anesthesiologist, intensive care expert, and NASA adviser Kevin Fong explores how physical extremes push human limits and spawn incredible medical breakthroughs Little more than one hundred years ago, maps of the world still boasted white space: places where no human had ever trod. Within a few short decades the most hostile of the world’s environments had all been conquered. Likewise, in the twentieth century, medicine transformed human life. Doctors took what was routinely fatal and made it survivable. As modernity brought us ever more into different kinds of extremis, doctors pushed the bounds of medical advances and human endurance. Extreme exploration challenged the body in ways that only the vanguard of science could answer. Doctors, scientists, and explorers all share a defining trait: they push on in the face of grim odds. Because of their extreme exploration we not only understand our physiology better; we have also made enormous strides in the science of healing. Drawing on his own experience as an anesthesiologist, intensive care expert, and NASA adviser, Dr. Kevin Fong examines how cuttingedge medicine pushes the envelope of human survival by studying the human body’s response when tested by physical extremes. Extreme Medicine explores different limits of endurance and the lens each offers on one of the systems of the body. The challenges of Arctic exploration created opportunities for breakthroughs in open heart surgery; battlefield doctors pioneered techniques for skin grafts, heart surgery, and trauma care; underwater and outer space exploration have revolutionized our understanding of breathing, gravity, and much more. Avant-garde medicine is fundamentally changing our ideas about the nature of life and death. Through astonishing accounts of extraordinary events and pioneering medicine, Fong illustrates the sheer audacity of medical practice at extreme limits, where human life is balanced on a knife’s edge. Extreme Medicine is a gripping debut about the science of healing, but also about exploration in its broadest sense—and about how, by probing the very limits of our biology, we may ultimately return with a better appreciation of how our bodies work, of what life is, and what it means to be human.

Deliver quality healthcare in the most challenging field conditions Full of practical clinical pearls and proven strategies, this indispensible guide shows you how to operate outside your comfort zone and devise effective treatment solutions when the traditional tools (medications, equipment, and staff) are unavailable—or when you need to provide care outside of your specialty. Improvised Medicine is a must for anyone who plans to work in global, disaster, or other resource-poor settings. FEATURES: Simple-to-follow directions, diagrams, and illustrations describe practical techniques and the improvised equipment necessary to provide quality care during crises. Contains improvisations in anesthesia and airway management, dentistry, gynecology/obstetrics, infectious disease/laboratory diagnosis, internal medicine, otolaryngology, pediatrics and malnutrition, orthopedics, psychiatry, and surgery. Also includes basic disaster communication techniques, post-disaster forensics, a model hospital disaster plan, and innovative patient-transport methods. LEARN HOW TO: Make an endotracheal tube in seconds Perform digital-oral and blind-nasotracheal intubations Make plaster bandages for splints/casts Give open-drop ether, ketamine drips, and halothane Use subcutaneous/intraperitoneal rehydration/transfusion Make ORS and standard nutrition formulas Clean, disinfect, and sterilize equipment for reuse Warm blood units in seconds inexpensively Take/view stereoscopic x-rays with standard equipment Quickly and easily stop postpartum hemorrhage Fashion surgical equipment from common items Evacuate patients easily for high-rise hospitals Make esophageal and precordial stethoscopes Quickly improvise a saline lock Make ECG electrode/defibrillator pads and ultrasound gel

This technically oriented book on medicine as applied to extreme sports offers broad coverage of the field extending well beyond the usual focus on major trauma and acute injuries. In addition to the injuries and diseases associated with individual extreme sports, this book also addresses the topics of psychology, dermatology, ophthalmology, infectious diseases, physiology, nutrition, training, injury prevention strategies, rehabilitation, doping, treatment in hostile environments, and legal aspects. Innovative and less frequently considered topics are also discussed, such as recent advances in protective equipment and materials, the effects of exposure on whole-body vibration, and cold exposure risk management. More than 60 of the most authoritative experts from across the world have contributed to this book, drawing on their personal experiences and including practical examples whenever relevant. Both subject matter and illustrations have been selected with the utmost care, the latter including photographs of world-class athletes.The book’s multidisciplinary approach to the subject ensures that it will be relevant to a wide readership.

For readers of Being Mortal and Modern Death, an ICU and Palliative Care specialist offers a framework for a better way to exit life that will change our medical culture at the deepest level In medical school, no one teaches you how to let a patient die. Jessica Zitter became a doctor because she wanted to be a hero. She elected to specialize in critical care—to become an ICU physician—and imagined herself swooping in to rescue patients from the brink of death. But then during her first code she found herself cracking the ribs of a patient so old and frail it was unimaginable he would ever come back to life. She began to question her choice. Extreme Measures charts Zitter’s journey from wanting to be one kind of hero to becoming another—a doctor who prioritizes the patient’s values and preferences in an environment where the default choice is the extreme use of technology. In our current medical culture, the old and the ill are put on what she terms the End-of-Life Conveyor belt. They are intubated, catheterized, and even shelved away in care facilities to suffer their final days alone, confused, and often in pain. In her work Zitter has learned what patients fear more than death itself: the prospect of dying badly. She builds bridges between patients and caregivers, formulates plans to allay patients’ pain and anxiety, and enlists the support of loved ones so that life can end well, even beautifully. Filled with rich patient stories that make a compelling medical narrative, Extreme Measures enlarges the national conversation as it thoughtfully and compassionately examines an experience that defines being human.

Human Physiology in Extreme Environments, Second Edition, offers evidence on how human biology and physiology is affected by extreme environments, also highlighting technological innovations that allow us to adapt and regulate environments. Covering a broad range of extreme environments, including high altitude, underwater, tropical climates, desert climates, arctic climates and space travel, the book also includes case studies that can be used to illustrate practical application. Graduate students, medical students and researchers will find this to be an interesting, informative and useful resource for human physiology, environmental physiology and medical studies. Includes coverage of current global challenges and their consequences on human physiology and performance Presents human physiological challenges in extreme environments Provides an excellent source of information on paleontological and anthropological aspects Offers practical medical and scientific uses of current concepts

An in-depth look at the mavericks, moments, and mistakes that sparked the greatest medical discoveries in modern times—plus the cures that will help us live longer and healthier lives in this century . . . and beyond. Human history hinges on the battle to confront our most dangerous enemies—the half-dozen diseases responsible for killing almost all of mankind. And while the story of our triumphs over these afflictions reveals an inspiring tapestry of human achievement, the journey was far from smooth. In The Masters of Medicine, Dr. Andrew Lam distills the long arc of medical progress down to the crucial moments that were responsible for the world’s greatest medical miracles. Discover fascinating true stories of scientists and doctors throughout history, including: Rival surgeons who killed patient after patient in their race to operate on beating hearts—and put us on the path toward the heart transplant A quartet of Canadians whose miraculous discovery of insulin was marred by jealousy and resentment The doctors who discovered penicillin, but were robbed of the credit The feud between two Americans in the quest for the polio vaccine A New York surgeon whose “heretical” idea to cure patients by deliberately infecting them has now inspired our next-best hope to defeat cancer A Hungarian doctor who solved the greatest mystery of maternal deaths in childbirth, only to be ostracized for his discovery The Masters of Medicine is a fascinating chronicle of human courage, audacity, error, and luck. This riveting ode to mankind reveals why the past is prelude to the game-changing breakthroughs of tomorrow.

Adventure and extreme sports are increasing in popularity and it is not surprising that commercial adventure tourism and the accompanying life style and fashion, have become increasingly important to world economy. These unique sports involve not only major physical endurance and mental challenges but interaction and bonding with nature. They also tend to attract and excite audiences, both at the event and in the media. They are exciting to watch and redraw the boundaries of human achievement with the accompanying risks of injury and death. Adventure sports are usually performed in beautiful, exciting and remote locations or in extreme environments far away from medical assistance. Extreme sports usually involve an element of increased risk. These risks are highlighted by the media, usually after a reported accident or fatality but may vary according to the involvement of the participant; the weekend recreational adventure sports athlete or the experienced professional. A wide variety of sports fall into the category of adventure and extreme sports and with an increasing number of disciplines, this field is ever expanding. Sports are performed in contact with the “ground”; mountain running and biking, rock climbing, ice climbing and mountaineering. In the air: skydiving and base jumping. On water: surfing, white water kayaking and rafting, board sailing and diving. And also involve mechanical vehicles and animals! Some sports may be performed as a combination of few disciplines, such as water and air, e.g. kite surfing, and as so involve very unique mechanisms of injury. Sports events can also be merged to form a multi-sport race comprising many disciplines lastly from single to multi day races. Sports may involve competition with others, against the environment or with oneself, frequently the most ferocious adversary. Adventure sports are becoming increasingly popular in the general public and a few take these sports to an extreme level with the accompanying risks. Those that do, bring such time and dedication that they become professional in terms of training, preparation and finance. More and more people are enjoying adventure sports and unfortunately increased numbers are becoming injured as a result. Future research is progressing alongside the sport development, to allow the sport mechanisms, injury patterns and predisposing factors to be better understood. It is the hope of all researchers to make the sports safer without detracting from their adventurous nature. The aim and scope of our book would be to bring the sports medicine involved ineach of these sports into one volume. We would explain each sport including subtle similarities and differences, the common injury mechanisms, patterns of injury and treatment options. Additional chapters would include the mental characteristics of adventure racers and extreme sports athletes, together with the complexities of competing in hot and cold extreme environments. The book will present chapters focussing on the sports listed below, concentrating on published literature and newly formed studies by experts in the fields of injury epidemiology, prevention, management and rehabilitation.

Read the book described by one reader as "Like Grimm With Paramedics." Follow the exploits of new paramedic Dean Flynn as he gets assigned to a backwater station no one has ever heard of, Station U. He soon learns that his unusual patients are far from normal. They are the creatures of myth and legend. His tough, experienced paramedic trainer Brynne is determined to teach him everything she knows. With vampires, werewolves, witches and fairies as patients, will he survive? Will they?