Through the Valley of Shadows
Living Wills, Intensive Care, and Making Medicine Human
Samuel Morris Brown
Reviews and Awards
"The critically ill in America survive more often than before, but not without trauma to themselves and their loved ones. What do we want done for us when we are at the end of our lives, or afflicted by terrible disease? Our attempts to discuss these questions with our families and doctors have foundered despite the best of intentions. To tell us how we got here, and point a way forward, we need a wise clinician-scientist, fluid writer, and careful thinker. Sam Brown is that person, and his book is a clear-eyed testimony to the weakness of checkboxes and the primacy of humane care." --Zackary Berger, MD, PhD, Johns Hopkins School of Medicine and author of Making Sense of Medicine
"Not everyone will agree with all of Dr. Brown's moral and clinical positions. But nobody will argue with the depth of his moral and emotional engagement with the profound question of reducing unnecessary suffering during serious illness. This is a valuable and groundbreaking contribution to the necessary debate about how we live, heal, and die-in hospitals and at home-and how medicine can do better to reduce unnecessary suffering." --Katy Butler, Author of Knocking on Heaven's Door
"In this compelling book, Dr. Brown vividly presents the urgent need to "re-humanize" all medical care, stressing that each patient is a unique person, whose humanity needs as much attention and understanding, and skilled care, as the patient's physical body. When one day our Intensive Care Units (ICUs) reliably provide caring-in which Respect and Dignity are as central as physical survival-it will be thanks to pioneers like Dr. Brown, and to those of us who heed his call to action in this book."--Lachlan Forrow, MD, Harvard Medical School
"It is hard to find a physician as comfortable quoting the latest ICU studies as discussing life and death in the Bible, the Crimean War and The Island of Dr. Moreau but Samuel Brown is that doctor. Through the Valley of Shadows is a remarkably comprehensive, thoughtful and moving guide to practicing compassionate care in a place-the ICU-where humanity often disappears." --Barron H. Lerner, MD, PhD and author of The Good Doctor: A Father, A Son and the Evolution of Medical Ethics
"By bringing life, history, and cognitive psychology to our ongoing conversation about advance directives, Brown highlights the limitations to our current approach to end of life care and offers a path forward. In a tone that is at once pragmatic, and deeply compassionate, Brown moves beyond legalese and overly-simple conceptualizations toward a vision of critical care that accounts for the lived experiences of patients and their families, as well as the doctors struggling to help them. I suspect this book will provide tremendous comfort, to all those struggling with these end of life decisions, while also providing a framework for a system of care that, by better serving the values of its patients, will ultimately relieve some of the unnecessary struggle." --Lisa Rosenbaum, MD, Harvard Medical School and Brigham and Women's Hospital