View source for The Lazarus Effect by Sam Parnia

{{infobox1
|title=The Lazarus Effect
|sort=Lazarus Effect, The
|author=Sam Parnia
|reviewer=Zoe Morris
|genre=Popular Science
|rating=4
|buy=Yes
|borrow=Yes
|isbn=978-1846043079
|pages=352
|publisher=Rider
|date=March 2014
|summary=When is a dead patient no longer dead? When they're brought back to life and live happily ever after. This is a fascinating look at a specialist area of science that will have everyone talking.
|cover=1846043077
|aznuk=1846043077
|aznus=1846043077
}}
As part of my job, I assess junior doctors who want to specialise in General Practice at the end of their two foundation years, and this assessment takes the form of role plays where they play a doctor and respond to cues from an actor playing a patient/relative/staff member while I take notes and score them against competencies. Last year one of the scenarios included explaining DNAR (do not attempt resuscitation) to a ‘relative’ and one rather memorable candidate said ''It doesn’t mean we let your mother die, but if she does die, we won’t bring her back to life the way we might another patient''. The answer did not score well on what I was assessing (communication skills) but it stuck with me and I still tell it as a tale from time to time, along with the story of the patient who tripped and fell on a, erm, personal massage device, had to have it surgically removed…and then asked for it back. It’s relevant here, though, because what that wannabe GP was saying is that he had the power to bring people back from the dead. And that’s what this book is all about.

The first thing you learn from reading this is that death can mean different things and that just because your heart has stopped, you might not actually be totally, 100% dead yet. This is important. Also important is what has caused a cardiac arrest. Because while the technology exists to restart hearts in a lot of cases, it’s not always a wise thing to do. If you don’t know or cannot resolve the reason, the underlying problem, the patient will just arrest again and again. And at some point, it’s kinder to let them go, and every day I process DNAR forms that specifically state a patient has requested they not be resuscitated, even if a clinician (who may or may not be familiar with their case) thinks it viable.

This is a book of science, of analysis and of case studies. It’s technical in places but still accessible to the lay person. It examines, in no particular order, how long patients can go after cardiac arrest and still survive, what the medical processes involved are, and why the best place to collapse is probably right outside a well-equipped Emergency Department in a cold, wintery climate.

Every year we do Basic Life Support training at work, and since it happened, every year the name Fabrice Muamba has cropped up. As you would expect, he features in this book too. He is someone who came back from the dead. Other case studies are less well known but equally interesting, like the driver who was in the right place at the right time, the cancer patient who knew her time was up, and the scholar whose own research saved her life.

I learnt a lot from this book and it’s hard to summarise it all here, but one thing that really stands out is the idea that death is a process, not a split second in time, and that if you get there at the right moment, you can stop it before it terminates. Or before you do. That window of opportunity won’t be there for everyone, but comes together in the idea that anyone who dies of something that can be reversed (such as a clot in the heart which can be removed, or an infection which can be treated) should no longer die because of that. Of course it’s not enough to keep someone alive in body if their mind or brain are gone, and so timing can be crucial as the longer it takes to bring someone back, the greater the chance of brain damage through lack of oxygen.

Some have commented that this book does not contain enough Near Death Experiences, something so popular it has its own abbreviation (the admittedly slightly obvious NDE). This wasn’t a disappointment to me. I am not that interested in reading about people who have seen a light or had their life flash before their lives, I’m more intrigued by the science that surrounds it, and I quite liked his renaming of these as ADEs (actual death experiences) in light of the above comment about death being a process that takes time and allows you to be some way through the process but not finished.

This book covers lots of things but ultimately they fall under the heading of developments in the science of resuscitation, itself still an emerging discipline. You do not need to be working in a clinical field to be interested by it, so if it sounds intriguing I would recommend you pick up a copy. It certainly presented me with a lot of food for thought.

Thanks go to the publishers for supplying this book.

More medical missives that get the thumbs up include [[Diagnosis: Dispatches from the Frontlines of Medical Mysteries by Lisa Sanders]] and [[Taking the Medicine by Druin Burch]]

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