Good overall.
Ch 1. Ice Doctors. Discovering that drowning victims pulled within about an hour from in icy waters can be revived, medicine has turned to induced hypothermia to slow down metabolism and all the body's processes to help the severely injured or deeply invasive surgery patients survive and recover better. One of the principle concepts that keeps recurring in Cheating Death is "reperfusion injury". This occurs when oxygen is reintroduced quickly to tissues that have been oxygen starved long enough to go anaerobic (shifting metabolism from oxygen dependent normal- to non-oxygen dependent energy sources). It apparently causes all sorts of havoc, including significant oxidizing damage, and can lead to rapid cell death. If cell metabolism is significantly slowed down by hypothermia, reperfusion injury can be mitigated. Examples include a Norwegian physician who fell into an icy stream while skiing. Submerged for 45 minutes, she was eventually revived.
Ch 2. A Heart-Stopping Moment. My favorite chapter, because it partially explains the success we had in reviving the Southwest passenger using compressions and an AED in 2/09 at SAN. CPR changes - no longer administer breaths, now do chest compressions only. Discusses the history of getting the medical community to change a simple procedure from saving 2% of victims to more like 30% of victims.
The single most important thing in a heart attack is to keep the blood moving. If an AED applies shock to a stopped heart without having had compressions, the pooled blood in the heart is oxygen depleted, and the heart muscle can't get going again. If 200 compressions are given first, the depleted blood is replace with relatively fresh (oxygenated) blood, and is available to the heart muscle when it needs it as the heart starts firing in synchrony after the shock.
Disccuses the 3-phase model of cardiac arrest (Dr. Lance Becker at Penn):
1. Electrical. 4 minutes. Heart still pulsates with electrical energy, but not in synchrony. VFib, or ventricular fibrillation.
2. Circulatory. 4-10 minutes. Blood stays in heart due to VFib (no coherent beats), and consumes all oxygen necessary for good contractions; electrical activity is unable to continue without oxygen.
3. Metabolic. 10 minutes. "The cascade of cell-killing chemical reactions reaches a crescendo. . . It's during this time that cell death begins in earnest." p. 44.
The remainder of the book deals with NDE (Near Death Experiences), the idea of miracles, pre-natal intervention, and PVS (Persistent Vegetative States). All dealt with better in other books.
One comment - he (mostly in the endnotes) refers to all interviews as being "interview with the author's team." This indicated Gupta, as a CNN reporter and Neurosurgeon is too busy to do what most authors do - the interview work themselves, so he's farmed it out to his staff. Doesn't really take away from the read, but it made me wonder how much of it he wrote.
Good, quick read.
