Book Review: Extremes, By Dr Kevin Fong

Fong’s first book is intelligent and informative, and is illustrated by stories of human endeavour that make it entirely grounded and personal. His descriptions are vivid, the stories are gripping, and the science is simply explained.

Extremes explores the physiological limits of the body, and how advances in medicine have pushed these limits further and further, paving the way for exploration in extreme environments and saving lives in ways that would have been impossible only a few short decades ago.

Fong spoke of what motivated him to write this book.

“I had a very strange route to and through medical school and an even stranger career as a junior doctor,” he said.

“I studied astrophysics before I went to medical school and because of that I later got a chance to work with some of NASA’s medical research teams.

“I found myself leading a double life as a junior doctor, oscillating between hospital work in the UK and space work with NASA in Houston. I think I used to feel guilty about that.

Exploration

“The former felt like the important Down-to-Earth job I was trained to do and the latter felt like a childhood fascination that I couldn’t put aside. But as I read about the history of 20th century exploration and learnt more about how we advanced in the field of medicine I think I reconciled the two halves of my life.

“In the end I think it’s all exploration; the exploration that took us out across the globe and on into space is the same exploration that took us inward to probe the corners of our biology and physiology. One is no less important than the other. I wanted to write a book about that.”

Extremes is incredibly wide ranging, and Fong has devoted a chapter to each varied topic, including everything from ‘Intensive Care’ to ‘Orbit’, explaining how these extreme situations affect the human body.

He admitted: “It was a difficult book to craft as I was aware I had to make some hard editing decisions. The challenge was not what to put in but how much to leave out. Writing a book is a bit like having children. Before you do it, you hear people talk about it and you think you know roughly what it’s all about. But until you do it yourself you really don’t.

Creative

“I really enjoyed it in the end. Most of all I enjoyed the chance to have a go at being creative; something there isn’t much scope for in medicine. But it’s a pretty lonely thing. In the hospital, no matter how bad the day is going, there are always other people around you sharing the experience and hauling you through it. At the end of a bad day’s writing it’s just you and your laptop and that was much more unpleasant than I thought.”

Highlights of the book include the description of the ground breaking work of the pioneers of plastic surgery who reconstructed the faces of airmen disfigured by devastating burns. Another noteworthy chapter is the truly remarkable story of the successful resuscitation of junior doctor Anna Bagenholm.

Having been trapped under ice, with no heartbeat for two hours, she survived and recovered against staggering odds. This book demonstrates that human beings are capable of incredible feats of both resilience and ingenuity. It is truly inspirational as it documents how science and medicine have allowed us to continually push the boundaries of our physical limitations.

The book is peppered with Fong’s own experiences as a doctor and member of NASA. This takes the science and makes it personal and accessible. The stories are gripping, moving, and, at times, darkly funny.

Engagement

He said: “I think we really do need to be more open to engagement in healthcare.

“The days of the old patriarchy are gone I think. We can’t just go around doing stuff to patients without really explaining why, what and how we’re doing it.

“And that’s about more than informed consent; it’s about demythologising the profession, making people understand how grey it is and involving the wider pubic in the way we shape its future. As doctors we should do that any which way we can: blogs, workshops, written articles, focus groups, books, broadcast - it all helps.”

Chapters about Fong’s work with NASA and the effects of zero gravity on the human body bring a whole new dimension of space exploration to the book.

Looking forward to the future of manned space flight he describes the research and development that will one day allow us to ‘boldly go’.

He defended the benefits of this kind of research in a resource challenged climate, saying: “Today’s esoteric challenge may be tomorrow’s routine survival.

“People can have a conceit that they know what the fight is, where we should be focussing our resources, but you never know what tomorrows’ challenge will be.

Discoveries

“Science for curiosity’s sake can lead to developments that can’t be predicted. You might argue that exploring Antarctica and racing to the pole in 1912 was folly, but the work done in Antarctica has led to great discoveries in the field of climate change that could have huge benefits.”

In the tradition of a good scientist, Fong has included his references as suggested further reading. While unusual in a popular read, this is in fact extremely helpful.

As each chapter explores a topic that could happily give rise to a book of its own, so further reading is ideal for those whose interest is captured by the chapter and are hungry for more. This epitomises the tone of the book, which is accessible and straightforward, and yet has depth of knowledge for the reader to explore further if they wish.

You don’t have to have a degree in astrophysics or medicine to enjoy this book, just an interest in humanity and the human body. Since we all have one, that would be just about everyone.