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“..a true gem, for once taken up it’s hard to put down.”
– Dr Andrew Goh. Editor-in-chief, Impact Magazine Asia. Emeritus chairman, World Vision (Singapore) & Halogen Foundation Singapore.

“…for those keen to discover the true cost of survival, and live in light of such knowledge.”
– Dr Wes Ely. Professor of Medicine & Critical Care, Vanderbilt University Medical Center. Author: Every Deep Drawn Breath (Winner of the 2022 Christopher award)

“I highly recommend this book for anyone interested in getting behind the closed curtains of intensive care.”
– Dr Steve Taylor. GP and spokesperson, Doctors’ Assocation UK

“…conviction and compassion in a way that shows the humanity of intensive care medicine.”
– Alan Taman. Communications manager, Doctors for the NHS.

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Synopsis

In Scars & Stains, intensive care doctor, and award-winning writer Dr Mark ZY Tan, lays bare the clinical, ethical, and moral dilemmas facing intensive care professionals in today’s complex world. The book takes readers into the world of intensive care, where split-second decisions and expert skills can forever impact the lives of patients and their families. It is a journey that crosses continents, communities, and cultures – from the slums of Thailand and jungles of Papua New Guinea to the wealthiest districts of London and largest hospitals in the UK. Caring for some of the most unwell patients, with the help of high-tech machinery, and often in emotionally volatile situations, Mark provides moving – and often eye-opening – insights into this fascinating frontier of medicine. He brings together the science underpinning this high-stakes specialty with the humanity required to navigate life and death decisions.

Written for anyone interested in life on the frontline, the book challenges preconceived notions of the ICU, sheds light on the often-misunderstood realities faced by patients, their loved ones, and healthcare professionals in the most challenging of environments, and guides readers in considering their own preferences and priorities when faced with life-limiting illnesses.

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Reviews

“Sometimes invigorating and buoyant, sometimes raw and confronting, this deeply moving insight into the life of an intensive care doctor will stay with readers long after they have put their copy down. Reflecting on a series of patient encounters in anaesthetics and ICU settings, Dr Mark ZY Tan writes with literary eloquence, disarming frankness, but above all with spellbinding humanity. Scars and Stains highlights the constant decisions, gambles, successes and failures of ICU life, while also embedding each very human story against Mark’s personal perspectives and, particularly, his broader sense of history and culture.  Despite this work highlighting the limitations of modern medicine, and its oftentimes stressful effects on its practitioners and patients, this is ultimately a book which is always vivified by the author’s astonishing ability to never lose sight of joy and hope.”

Dr Anna Greenwood
Professor of Health History, University of Nottingham.
Co-author: Florence Nightingale at Home (Palgrave Macmillan, 2020), winner of the National People’s Book Prize, ‘Best Achievement’ 2021-2022.

“An honest and insightful book into the unknown world of intensive care. Mark accurately describes the travails and jubilations of a UK resident intensive care doctor on the shop floor. Both joyful and sad at the same time and beautifully written.”

Dr Shondipon Laha
Intensive Care Society (UK) President (24-26).
Consultant in Critical Care Medicine & Anaesthesia, Lancashire Teaching Hospitals.
Honorary Clinical Professor, University of Central Lancashire.

“Mark Tan has crafted a collection of stories that exposes the fragility of human life but also the skill with which emergency doctors treat and care for patients. Mark is that rarest of doctors: a multi-specialism specialist. He is adept, amongst other skills, at medicine, philosophy, and music, all of which he combines to excellent effect in this readable book. He has an ear and an eye for homologies – those Venn diagrams that are attuned to the overlapping similarities between disparate concepts. These have extraordinary explanative power, and Mark deploys them with enviable dexterity. He does this with humanity and humility. At a time when the NHS is faltering, it is reassuring to know that committed doctors like Mark are treating and caring for us at those critical moments when we’re poised between life and death. Those moments are eloquently explained and explored in these pages.”

Giskin Day
Principal teaching fellow, Imperial College London

“I enjoyed reading this book. It is well written and readily accessible. The human stories make this book compelling. Most are patient-related, but some are highly personal to the author – with one or two making the reader feel that perhaps too much has been revealed. However, it does reinforce the openness and self-awareness of the approach and strengthens the reader’s confidence in the authenticity of the account. The discussions in the book around futile care and the withdrawal of treatment are sensitively covered and are important features within the dialogue.

This book is very timely given the ongoing COVID inquiry in the UK. The distress of those working to salvage those so critically ill has been graphically displayed in the testimony of those who were there. Whilst COVID is also covered in this book, the author reminds us that such stresses, dilemmas, and commitment were there before COVID and will continue afterwards.”

Dr Tony Redmond
Professor Emeritus of International Emergency Medicine, University of Manchester.
Author: Frontline – Stories of Care and Courage in Emergency Medicine (HarperNorth, 2021).

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Table of contents

1. Front matter
   • Note on confidentiality
   • Foreword – Dr Matt Morgan
   • Preface
   • Warm-up
2. Airway
   • A is for Airway
   • The Perfect Storm
   • As Water to the Thirsty
3. Breathing
   • Blues and Trouble (part of an anthology)
   • 85%
   • The Three Sisters
4. Circulation
   • See One, Do One, Teach One
   • AAA: Abdominal Aortic Aneurysm
   • Tiny Oars
   • An Ear on the Hive
   • Do You Hear the People Sing?
5. Disability
   • 万箭穿心
   • Spice
   • Flaccidity
   • The Worst Scars are in the Mind
   • Gymnopédie (extract aimed at medical readers)
6. Exposure
   • 求签 (Qiú Qiān) Chinese Fortune Sticks
   • Grace
   • Silence is Not Golden
   • Painting an ICU
   • Beyond Bach
   • Curtain call
7. The Covid19 supplement
   • Telephone Lament for Coronavirus (taster chapter)
   • Critical but Stable (extract aimed at medical readers)
   • A Letter to Lydia