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George Bernard Shaw said “we have not lost faith, but we have transferred it from God to the medical profession.” Paediatric intensive care was born from the increasing technology and sophistication expected from medicine and is still a new and evolving speciality. A very small number of children will have the misfortune to need to be treated in a paediatric intensive care unit (PICU). It’s an expensive business and often a very emotional one; but very real paediatrics. There are few PICUs in the UK and only six centres that are fully recognised for formal PICU training. Trainees may feel that mercifully few of them will rotate through PICUs as part of their training and that perhaps a book like this might not be for them. If that describes you I would encourage you to think again. Most PICUs are staffed with juniors who are paediatricians in training. Even if they decide that other areas in paediatrics interest them more, I believe most find their time in PICU valuable, varied and exciting. You won’t forget it. You won’t regret it. This book might suit you and there are not that many like it in the bookshops.
Gale Pearson is undoubtedly well qualified to write this book as clinical director in one of the largest units in the UK. Some of his passion for the subject comes through the text even when discussing “developing a Bayesian approach to PICU”. In a slim textbook a great breadth of the subject is covered including respiratory physiology, audit, congenital heart disease, and nutrition for example. Despite the breadth this book appears to me to have some depth and may be less of a handbook and more of an introductory textbook to PICU. There are valuable management suggestions and algorithms but much of the book is carefully selected background to the problems encountered in clinical practice and requires time to read and take it in. From a personal point of view there were a few areas that perhaps needed more coverage. If the intention was a bias to include common causes of admission to PICU, I think bronchiolitis deserved more than the 10 lines it got but maybe that’s my bias.
The book ends with a concise but detailed chapter: “Issues surrounding death on the PICU”. Public expectation is very high. Despite the public’s faith we are not the deities they see on the television and certainly not as good looking (not in the units I’ve worked in). We do our best—sometimes we fail. Samuel Beckett said: “Ever tried. Ever failed. No matter. Try Again. Fail again. Fail better.”
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