The Seven Signs of Life by Aoife Abbey

A review by Julie Cahill

Aoife Abbey’s memoir is an insightful journey through the emotions that an intensive care doctor, or indeed any medical professional, must deal with on a daily basis. The seven signs of life, the feelings that make us human – fear, grief, joy, distraction, anger, disgust, hope. All very natural feelings, each experienced by every person alive at some point, however for those on the front line of critical care, these are the daily hallmarks of their job. It is easy as a patient or relative to consider doctors void of emotions. We all understand – ‘they must have to protect themselves, they cannot possibly care about every patient or they would never be able to do the job’ – yet perhaps the truth is that the doctors cannot show their emotions, it would be considered unprofessional, this doesn’t mean they are not feeling them. 

In her beautifully written book, Aoife analyses her feelings towards her job and her patients. She relates anecdotes from her time as a trainee and critical care registrar, each chosen as a demonstration of one of the seven emotions that she believes prove to her that she is still capable of feeling. Many are stories of grief and despair, her own or that of the patients and relatives that she comes into contact with. She questions how she handles the most difficult conversations, expresses her frustration with a system which doesn’t allow her the time to dedicate to the more pastoral aspect of her role, and wonders at the strength that some people show in extremis. 

There is also joy – the patients who pull through when all seemed lost, the times she is able to ease someone’s suffering at the very end and be certain that she has indeed fulfilled their wishes. Yet that certainty is so elusive. 

The author is almost tentative in her approach to her subject – what makes a good intensive care doctor? Am I doing the right thing? How can I be sure? Questions are posed about how best to approach end of life discussions, and how difficult it is to truly know the will of a patient who lies immobile and unconscious. How does one see beyond a patient’s physical signs of life to the truly human signs of the emotional life beneath?