An introduction from
Professor Julian Bion OBE FRCP FRCA FFICM MD
My first experience of intensive care was in 1976 as a newly qualified house officer, delivering to the ICU a patient we had resuscitated from a cardiac arrest. As an aspiring general practitioner, it seemed to me to be a forbidding place: a physiology laboratory from which bedside medicine had been banished. Later on, as a cardiology registrar, I found my interest in intensive care stimulated by the uncomfortable fact that I lacked the skills required to care for my sickest patients: I was obliged to surrender them to the anaesthetists – who were clearly far more competent than I. So, I decided to change direction, to become ‘an intensivist’, and discovered that I could indeed become a general practitioner after all, but with added skills to provide quality holistic care to the most severely ill patients in the hospital, in the safest place in the hospital.
Critical illness challenges our existence as patients, our courage as relatives, and our capacities as clinicians. From a professional perspective we must integrate the multidisciplinary care of patients with complex diseases and comorbidities. We must master practical technical skills, and temper these with non-technical skills to minimise distress to our patients and provide compassionate support to their families. We must support each other in the ICU and our colleagues outside, so that patients get the best care. And we must recognise our limitations, and the fact that it is easy to make things worse, not so easy to make them better.
This course provides an excellent foundation for acquiring these skills and then mastering them through a life-time of practice in our new speciality of intensive care medicine. The authors and tutors are all front-line, high-quality clinicians. From them you will gain scientific knowledge, learn team-based decision making, and become high-reliability practitioners. And above all, you will appreciate the true meaning of placing the patient at the centre of care.
Foundation Dean of the Faculty of Intensive Care Medicine 2010-13