“Part memoir, part exposé, this book is an insider’s view of intensive care in America and its impact on how we die, written by a physician uniquely positioned to examine end-of-life care. Dr. Jessica Zitter’s wisdom derives from a career whose trajectory – she specializes in both ICU and palliative medicine – models a rethinking of care for the dying. Her book is a trenchant critique and a clarion call for end-of-life care that aligns with what each patient values most.”

~ Lucy Kalanithi, MD, co-author of When Breath Becomes Air

“Jessica here reveals a fuller truth of how the end-of-life plays out within our healthcare system. There’s nothing easy in these pages, but plenty to learn from, cautions to absorb, and material for creating a better way.”

~ BJ Miller, MD, Assistant Clinical Professor of Medicine at UCSF

“Clarity and compassion unite in this touching and convincing new conversation on comfortable, patient-centered end-of-life care.”

~ Kirkus Reviews


“It is my greatest hope that Extreme Measures will serve as an empowering and practical guide for engaging in the radical honesty, authentic communication, and vibrant collaboration needed to improve end-of-life care for all.”


Jessica Zitter became a doctor because she wanted to be a hero. She elected to specialize in critical care, becoming an ICU physician who imagined herself rescuing patients from the brink of death.

Extreme Measures charts Jessica’s two-decade journey through intensive care units across the country and her discovery of an approach to medicine that transformed her vision of what it means to be a hero.

Over that time, she saw the reality of how end-of-life plays out in our current medical culture, where mechanization and protocol override personal preference and collaborative decision-making.

Again and again, she saw how the same medical technology that saves lives can increase suffering for those who are truly dying. And far too often, patients and families accepting treatment by “extreme measures” without understanding the complete picture of what they can expect and whether it will change the prognosis.

Told through the heroic stories of everyday people, Extreme Measures shares an insider’s perspective on the front lines of the public health crisis that touches us all: people dying badly.

It brings the reader into a world that most will only venture into during crisis, and extends a guiding hand to help patients, family members, and health care providers alike navigate this harrowing terrain with radical honesty, authentic communication, and vibrant collaboration. What Dr. Zitter calls: a new kind of heroism.

















Please contact csorders@penguinrandomhouse.com
to place an order of 25 copies or more.


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My newsletters come out about once a month and share stories, resources, and invitations to participate in the growing movement to improve end-of-life care in America.


“Dr. Zitter has pulled back the curtain on the needless suffering undergone by the dying in Intensive Care. Honest about her own uncertainties, mistakes and limitations, she spares no one, not even herself. The average person will learn much about the pitfalls of navigating the strange subculture of medicine close to the end of life.”

~ Katy Butler, author of Knocking on Heaven’s Door: The Path to a Better Way of Death and A Good End of Life: a Practical Guide


“America’s healthcare system inadvertently makes things worse for dying patients and their families. This situation calls for Extreme Measures – and this book is the remedy we need. Dr. Zitter’s guidance is an elixir of medical sophistication, practical savvy, and timeless soulfulness. She writes with the clinical mastery of an intensivist and the personal sensitivity of a trusted friend.”

~ Ira Byock, MD, author of The Best Care Possible

“A stunning portrait of the ways decisions in the intensive care unit shape the way we live—and die—now. Whether we live with illness, love someone who is facing these decisions, or care for them professionally, Dr. Zitter has written a call to action that none of us can ignore.”

~ Anthony Back, MD, author of Mastering Communication with Seriously Ill Patients: Balancing Honesty with Empathy and Hope

“With compassion, intelligence, and a rare expertise, Jessica Zitter shines a light on some of the most difficult issues we face in our lives.”

~ Angelo Volandes, MD, author of The Conversation: A Revolutionary Plan for End-of-Life Care

“You wouldn’t take a trip to a foreign country without learning as much as you could about its rituals, its culture, and its landscape. The ICU, a place many of us will pass through at least once in our lives, is as foreign as it gets. Thus Dr. Zitter provides an essential illumination for her fellow humans.”

~ Diane E. Meier, MD. Director, Center to Advance Palliative Care

“Required reading for every young medical student and every family member wondering how to help the people they love live well to the end.”

~ Ellen Goodman, founder of The Conversation Project

I know: death is scary and hard.

But through honest communication and vibrant collaboration we can make it the best it can be. By following along through Facebook or Twitter, you’ll join the growing tribe of people embracing the mission to improve end-of-life care in America.