Unconscious

A neurocritical care physician’s revelatory exploration of coma, consciousness, and the fragile border between life and death

What happens when consciousness disappears?

A healthy bride collapses on the dance floor at her wedding. A father of two suffers a cardiac arrest at home. A young man found on the street is declared brain dead. In hospitals every day, families are suddenly confronted with an enormous but urgent question: What is happening inside the mind of someone who cannot respond?

In this pressing and deeply humane book, neurocritical care physician Dr. David Fischer draws on cutting-edge science and unforgettable patient stories to explore one of medicine’s greatest mysteries: unconsciousness. From fainting and anesthesia to coma and severe brain injury, he reveals how consciousness is created, how it can be disrupted, and how, sometimes, it can return.

Guided by real cases, Dr. Fischer takes readers inside the ICU and the laboratory, showing how doctors assess awareness in unresponsive patients, why predictions about recovery are often wrong, and how new technologies are transforming our understanding of the injured brain, giving us new insights into what patients can experience and even forcing us to reconsider the boundaries between life and death.

He also confronts the most wrenching questions families and clinicians face:

When is someone still “in there”?
How should decisions about life support be made?
What does brain death really mean?
And what makes life worth living after catastrophic injury?

At once gripping, compassionate, and revelatory, this book is both a scientific journey into the nature of consciousness and a practical, profoundly moving guide for anyone who may one day face a loss of consciousness in themselves or someone they love.