Dr Jim Down, a consultant in critical care and anaesthesia at University College London Hospitals, brings us to the very heart of the intensive care unit with stories about patients including a poisoned Russian spy and the victims of a terrorist bomb, a major rail crash, Covid and an Ebola-like virus. Delving into ethical conundrums such as what gives life meaning, how much suffering is too much and, in a cash-strapped NHS, who should get to decide, he describes the quietly heroic work of doctors and nurses on the ICU, and explains with unflinching honesty the toll working there eventually took on his own mental health.