Your Critically Ill Child

Your Critically Ill Child:  Life and Death Choices Parents Must Face

by Christopher M. Johnson, M.D.

Your Critically Ill Child is about children. It is a collection of stories describing children whom I have cared for in the course of over two decades practicing pediatric critical care medicine. The stories tell of the many challenges and decisions that these children and their families faced when severe illness or injury unexpectedly entered their lives. None of us are ready for events like these when they suddenly happen. As you will learn from these stories, however, most of us are wiser and stronger than we often think that we are; we usually do find a way to meet these challenges and make these decisions, sometimes against very tall odds. It has been my privilege to watch that happen time and again.

Why do we need a book about pediatric intensivists and PICUs? For one thing, the PICU is an exciting and fascinating place. As you will read, no television program or movie does justice to the reality of what happens there. That reality is far more complex and multi-faceted, more intriguing and fascinating, than Hollywood script writers can imagine. The complexity of the PICU world makes it fascinating, but that complexity also presents challenges to children, their parents, and those of us who work in the PICU. Some of these challenges are great, some small, but few families are ready to meet them when their child needs the PICU. This book tells you the stories of a few children, among the thousands whom I have cared for in the PICU, and how they and their families met and surmounted these challenges. It is a book of parables. It will show you how life-and-death decisions are made and who makes them.

Spending time in a PICU is to see ordinary people performing in extraordinary ways when they confront, often suddenly and unexpectedly, sick or injured children who vividly personify issues that previously seemed distant and abstract. The PICU is not a place for those with a special moral or philosophical agenda. Highly dogmatic persons do not last long in the PICU environment because what you see there every day challenges your preconceived notions of right, wrong, life, and death. On the other hand, if you pay attention to what goes on there, you can emerge from the encounter a wiser person, with stronger personal convictions. This is because in the PICU, not only is the care intensive, but so too is the lived experience. This book will take you there to share in that experience.

Table Of Contents

  1. Chapter One: Parents’ Challenge: Running the PICU Marathon – First Chapter Available Online
  2. Chapter Two: How the PICU Works
  3. Chapter Three: Understanding Supportive Care’s Limits and Advantages
  4. Chapter Four: Doing the Right Thing
  5. Chapter Five: Whom Shall We Cure?
  6. Chapter Six: Knowing When to Quit
  7. Chapter Seven: Medical Uncertainty
  8. Chapter Eight: When Ethics and Costs Collide
  9. Chapter Nine: Carrying On
  10. Chapter Ten: Miracles Do Happen