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Publisher's Summary

An ICU and palliative care specialist featured in the Oscar-nominated Netflix documentary Extremis 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.

©2017 Jessica Nutik Zitter (P)2017 Penguin Audio

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Brilliant & eye-opening

For anyone who wants to know what "the end" really looks like, this book is must reading. In fact, it should be mandatory reading for anyone who is - or is related to anyone who is - mortal. And I think that covers ALL of us. Spoken by the author with visceral compassion, Dr. Zitter compresses her 20+ years in the ICU with so many you-are-there stories of patients and family members in end of life crises, it truly becomes a rallying cry for us to Do Something Now, even beyond Advance Directives. Thank you for telling it like it really is, Dr. Zitter! m

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very good read

should be read but every family and family member important information on end-of-life care fantastic read this doctor knows her stuff

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Towering Contribution to Medicine and beyond

Thank you Dr. Zitter for taking us on your personal journey from the disease centered approach to medicine that you were trained in to the patient centered approach where people are viewed with respect and not simply a collection of organs that needs to be maintained. Your implicit humility that enabled the learning is in stark contrast to how some doctors fail to listen because they have stopped learning. The case of “Walter” demonstrates the contrast between the two approaches so forcefully. Thank you for the courage to take a stand against the many forces that would have us all remain on the conveyor belt of death. Your honesty and introspection along the way is a lesson to us all. I will recommend this work to everyone within medicine and anyone who has not thought deeply about end of life issues - which would be all of us, but especially to our youngest son, a 4th year med school student. So glad that I bought the audible version to hear you describe it in your own words - but this is one of the significant works where I will buy the Kindle version as well. Keep up the great work!

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A compelling new voice

Physician writers don't often accomplish what Nutik Zitter has with Extreme Measures. This was as informative as it was moving. I'm left with a deep sense of gratitude for the work she has done and will continue to do.

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thoughtful

I heard the author on a radio interview which prompted my purchase. the book was well organized with plenty of interesting case studies peppered throughout. thoughtful subject matter which was narrated well. a great albeit darker book. I recommend for sure

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Wonderful look into US ICU/palliative healthcare

very impressed learned so much from this book. From what is wrong with the current healthcare model when dealing with the critically ill to what the future hold for these patients if the expansion, understanding and prevalence of palliative care continues. Her 1st hand stories where captivating and allowed me understand how people as well as healthcare professionals views change thought practice and presence in the field. How so many things are needed to keep in mind towards end of life care for everyone including practitioners. So many things lay in the hand of providers and family to a critical ly I'll patient resulting in the two major extremes of death (the do everything method and the palliative approach)