In this memoir, Suzanne Crowe, paediatric intensivist and head of the Medical Council, takes the reader from the complex reality of medical training to her work in the paediatric ICU, where split-second decisions mean life or death for the most vulnerable children.
Crowe is powerful in her exactitude about the fear and uncertainty a career in medicine creates and the many times she wanted to quit. In one particularly harrowing moment of training, she is forced to intubate a child in a small hospital without adequate supervision. When handing over the patient - whose life she saved - she is scolded by the paediatric team for placing such a small intubation tube into the child’s swollen trachea. This stays with Crowe as a directive: when she inhabits a senior role, this kind of criticism can wait until later. A kinder connective tissue for a future training narrative.
Early on, the writer states a healthcare professional’s job is to narrate by “creating ... from what the patient is saying, because the patient doesn’t know what the doctor is looking for”. But what kind of narrative is sought? Despite detailed accounts of children dying and living, the book states, “any resemblance to actual persons, living or dead, is purely coincidental”. There is a missed opportunity to use the campaigning voice of Crowe’s columns to illuminate how adequate services could have changed these stories.
What is clear is the deep human commitment this work takes. When the writer grapples with the tragic death of her fourth child, just born, a “new narrative” emerges. She is left “almost mute.. at night I woke screaming because I couldn’t find the baby”. This grief and the exorcism of it charts the complexity of inhabiting two roles at once - both mother and physician. This dual perspective propels the story into something powerful. “I no longer knew who I was, I had no identity, and no connection to who I had been before Beatrice and no ability to connect to the future,“ she writes.
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Somehow, dedicated to paediatrics, she re-emerges. Gone is the softer boundary-less edge from the early days, replaced by lines such as “we must take our work to the best possible conclusion”. It’s the gruelling truth of what it takes to save the lives of all involved.
