Review by Choice Review
Fong is a medical doctor with additional degrees in astrophysics and engineering, an occasional documentarian for the BBC, and an engaging, compelling storyteller. His eminently readable book relates how medical disasters, whether inflicted on Antarctic explorers or soldiers in battle, have provided medical researchers with valuable information that, in turn, has led to more-effective treatments for hypothermia, burns, heart conditions, etc. Fong, who has worked for NASA and is a founder of the Centre for Altitude, Space, and Extreme Environmental Medicine, is also very interested in the physiological aspects of space travel and discusses its effects on the human body. He experienced weightlessness while training with NASA and endured the infamous "vomit comet." Accordingly, he brings firsthand experience to his analyses. A futuristic section of Extreme Medicine deals with medical obstacles to human travel to Mars. A medical optimist, Fong believes that all can be overcome. This volume, which integrates links between geographical exploration, warfare, the human spirit, and medical innovation, deserves a wide readership and is of special value to general readers and academic students. Summing Up: Highly recommended. All academic and public libraries. I. Richman emeritus, Pennsylvania State University, Harrisburg Campus
Copyright American Library Association, used with permission.
Review by New York Times Review
IT IS EASY to forget how amazing modern medicine is. When my mother's grandmother was born, there were no antibiotics, no anti-sepsis and, except for smallpox, no vaccinations. There were no X-rays, no IVs or EKGs. There was no anesthesia. When the English novelist Fanny Burney underwent a mastectomy in 1811, she was awake. "I mounted, therefore, unbidden, the Bed stead," she wrote to her sister. "When the dreadful steel was plunged into the breast - cutting through veins - arteries - flesh - nerves - I needed no injunctions not to restrain my cries Oh Heaven! - I then felt the Knife rackling against the breast bone - scraping it!" Simple appendicitis was often fatal, and the average age of death in England in 1840 was 41, not because people aged more quickly but because so many died of disease and accidents first. Then, in the mid-19th century, discoveries and inventions began pouring into medicine. Today we have the medical care previous societies only dreamed of - painless surgery, treatments for infections, marvelous mechanical aids for the disabled. In "Extreme Medicine," Kevin Fong, an honorary lecturer in physiology at University College London who has worked with NASA and trained in anesthesiology and intensive care medicine, surveys how far medicine has come in the treatment of hypothermia, severe burns, heart disease, lung disease, complex trauma care, viral epidemics. This "is a book about life: its fragility, its fractal beauty and its resilience," he writes. "It is about a century during which our expectations of life transformed beyond all recognition, when we took what was routinely fatal and made it survivable ... this exploration of the human body was no less extreme than our forays in the physical world." In fact, his premise is that the cause of this transformation in medicine was exploration. Fong structures his book chronologically. He begins with the explorer Robert Falcon Scott's death by freezing in Antarctica in 1912 and ends with the medical issues presented by a future manned trip to Mars. Each chapter is made up of linked sections and stories told enthusiastically at a fast pace. It's a particular style - casual, choppy, visual. "Extreme Medicine" is fun to read, but it doesn't read like a book. It has episodes not chapters. It's broad not deep, and it doesn't develop so much as unroll. For example, the chapter on Mars begins with Fong's arrival as an intern at NASA. It cuts to the physiology of weightlessness, then back to his experience in an antigravity lab, on to the physiology of gravity, and concludes with NASA's decision to reduce the Mars budget ("Once again the Red Planet receded into the future"). I could almost see the animated Red Planet moving away from us in space and hear the voice-over. It felt more like watching a PBS documentary than reading a book, and I wondered if it had started out as a television show. In fact, Fong presents several of the book's stories, themes and expositions on a BBC series. This isn't necessarily a bad thing, but I did have to ratchet down my expectations. Rather than develop an argument, "Extreme Medicine" is a moving picture of dramatic historical moments, explanatory pauses and Fong's real-life experiences. I also had to change my expectations of the writing. Fong weaves much of the text out of clichés; for instance, in a few pages we read about "drug-fueled gang wars," a city that "jockeys for position," "shady characters" and "a thick Colombian accent." The language can be clumsy - "The absence of gravitational load takes on a new dimension, transforming from a novelty into a creeping threat" - sometimes so much so that meaning is lost. For instance: "The layers of epidermal cells, constantly being born and marching forward, are like a never-ending conveyor belt of foot soldiers throwing themselves at the wire." I had to read the sentence three times to understand that it was referring to the layer of cells that divide, grow and move up to the surface of the skin. Some of Fong's comparisons are odd, though vivid. The cell membrane is like the chief executive of a budget airline; the cell is like a walled city with power stations and industrial estates; the spleen is like a quality control officer monitoring a production line. Others are confusing: "The cells of the immune system roam the bloodstream and tissues, like policemen pacing the beat." Are they like British bobbies with billy clubs, then, keeping peace in our bloodstreams firmly but kindly? Or are they, perhaps, American boys in blue, with fierce expressions and guns, shooting holes in wayward bacteria? Nor was I won over by Fong's premise - that exploration transformed medicine. He doesn't provide much evidence; he mainly draws parallels between the two. So, medical researchers push against frontiers and cross "chasms." Doctors "conquer" the virgin territory of the heart, and a surgeon "narrates his exploration like a mountaineer describing a new route." Although exploring did lead to some technological advances, what caused the transformation of medicine in the 20th century was a powerful and complex interplay between machines, industrialization and war. It was the terrible disfigurements suffered by World War I pilots as they used the newly invented airplane that gave us plastic surgery. The revolution in the care of multiple trauma happened because of automobile accidents, helicopter accidents and industrial explosions. Echocardiography came out of using sonar to locate submarines; and chemotherapy started with our learning about the physiological effects of chemical weapons. Still, Fong tells a good story, and in this time of unrelenting criticism of our medical system, we need to be reminded of how much we've learned in the past hundred years, how much we know, how miraculous it all is, what a blessing. Our 'exploration of the human body was no less extreme than our forays in the physical world.' VICTORIA SWEET is a professor of medicine at the University of California, San Francisco, and the author of "God's Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine."
Copyright (c) The New York Times Company [March 23, 2014]
Review by Booklist Review
Inner space, outer space, and regions in between this is the sprawling subject matter of a book that celebrates the challenges of discovery. Fong, a physician with a background in astrophysics, engineering, and aerospace medicine, ably identifies the correlations and convergence of exploring extreme environments and predicaments and the human body. For example, he tethers an expedition to the South Pole with forthcoming medical applications of hypothermia. He links the disfiguring burns suffered by WWII aircraft pilots with the development of reconstructive plastic surgery. Fong focuses on the fragility of human physiology and efforts to protect it with advanced life-support systems. Along the way, readers learn about the rise of intensive-care units, human spaceflight, iron lungs and polio, a complete face transplant, and SARS. Exploration of any kind is risky business and at times seems irrational. It requires curiosity, innovation, and resiliency, and it pushes the limits of knowledge, territory, and biology. Fong makes the point that human survival has been and will continue to be closely connected to our compulsion to explore.--Miksanek, Tony Copyright 2010 Booklist
From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review
British doctor and space enthusiast Fong launches a gripping "exploration of the extreme tolerances of the human body" in this eloquent history of how 20th-century science and medicine moved us toward "improved survival"-and with it a better understanding of life and death. He begins with a tale of a young Norwegian woman's incredible survival after deep hypothermia and moves on to describe the remarkable strides in burn care built on reconstructive surgery during WWII. Further along in his journey, Fong details the daring operations that opened "the continent of the heart," and how the polio epidemic-which touched Fong's own family-begat the fields of anesthesiology and intensive care. From the heart-pounding tale of how a fatal accident helped a grieving doctor develop life-saving trauma care to a moving depiction of the end of human life, these are thrilling stories that describe the limits of human physiology. But they have a more profound meaning as well, Fong finds. Whether it's the 1912 South Pole expedition that claimed the life of Robert Falcon Scott or the obstacles that await our species as we prepare for outer space travel, Fong concludes, "We explore simply because we must." (Feb.) (c) Copyright PWxyz, LLC. All rights reserved.
(c) Copyright PWxyz, LLC. All rights reserved
Review by Library Journal Review
A woman dies of hypothermia and is revived two hours later. A doctor and his family are in plane crash and a simple, life--saving mnemonic is developed. Fong, a doctor and codirector of the Aviation Space and Extreme Environment Medicine at University College London, links the history of medicine to extremes. The author draws from history and his own experience to craft an engaging narrative of early burn wards, the destructive and curative promise of hypothermia, crushing pressures of diving, high-altitude sickness, expected health issues of missions to Mars, and the future of elder care. This inspiring read shows how far medicine has advanced the use of ambulances and helicopters, intensive care units, and the other technologies that vastly improve the likelihood of surviving trauma and diseases that otherwise would be fatal. The narrative feels disjointed at times as the author jumps from one story to another but ties together nicely at the conclusion of each chapter. VERDICT Fans of history, medicine, space exploration, and sf will find this book difficult to put down.--Susanne Caro, Univ. of Montana Lib., Missoula (c) Copyright 2014. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
(c) Copyright Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Review by Kirkus Book Review
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.]] Copyright Kirkus Reviews, used with permission.
Copyright (c) Kirkus Reviews, used with permission.
