“Passionately and poignantly, Dr. Zitter reminds us that ‘conveyor belts, regardless of their destination, are not meant for human beings.’”

Lucy Kalanithi, MD

“Part memoir, part exposé, this book is an insider’s view of intensive care in America and its impact on how we die. Dr. Zitter’s wisdom derives from a career whose trajectory models a rethinking of care for the dying. 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


Zitter’s book shows how knowing when to do nothing is as vital to being a good doctor as knowing when to do everything.

~ The New York Times

“In Extreme Measures: Finding a Better Path to the End of Life, palliative care physician Jessica Nutik Zitter suggests ways to change the culture of medicine and empower patients so that they can avoid overly mechanized and painful deaths.– Spirituality and Health Magazine

Jessica Zitter became a doctor because she wanted to be a hero. She elected to specialize in Pulmonary and Critical Care Medicine, intent on rescuing patients from the brink of death.

Extreme Measures charts her two-decade journey through intensive care units across the country.  Over that time, Dr. Zitter was dismayed to see how the dying are treated in our current medical culture, where mechanization and protocol override patient-centered care. The resulting moral distress led her to the burgeoning Palliative Care movement, which focuses on the overall well-being of the patient, rather than just the disease.  And over time, she came to a new understanding of what heroism is really all about.

Extreme Measures shares the stories of patients, families, and healthcare providers on the frontlines of this issue.  It offers an insider’s perspective on a public health crisis that will touch us all. Bringing the reader into a world that most will only enter during crisis, the book offers guidance to help us  navigate this rocky terrain, and live the best life we can right up until the last moments.

The Four Things

A good death means different things to different people. In this video, Dr. Jessica Zitter shares one of the central themes of Extreme Measures: the four things patients can do to help themselves and their loved ones prepare for dying well. 




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