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Fatal Sequence: The Killer Within Hardcover – March 15, 2005

by Kevin J. Tracey (Author)
4.3 4.3 out of 5 stars 15 ratings
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The human body is capable of killing itself for little apparent reason, and it happens often enough to rank as the third most common cause of death in the United States today. Kevin Tracey, a neurosurgeon, immunologist, and highly regarded scientist, offers in Fatal Sequence an easily understandable account of the medical and scientific "perfect storm" that is severe sepsis, the medical crisis that can descend on patients fighting off even seemingly nonfatal illness or injury. Severe sepsis killed "Muppets" creator Jim Henson, who had been hospitalized for pneumonia, and took the life of Christopher Reeve, who was being treated for pressure sores of the skin.

Fatal Sequence tells the story of Janice, a one-year-old who arrives in the emergency room, burned by boiling water after she crawled behind her unsuspecting grandmother as she turned from the stove. She survives the night, but the following morning is only the beginning of her long and intense battle against severe sepsis, as her body attacks itself. Tracey, who cared for the girl during her four weeks in intensive care, draws on her case to vividly illustrate why sepsis happens, in a sensitive, suspenseful story that renders cutting-edge science human, accessible, and unforgettable.
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Previous page
  1. Print length
    238 pages
  2. Language
    English
  3. Publisher
    Dana Press
  4. Publication date
    March 15, 2005
  5. Dimensions
    6 x 1 x 9 inches
  6. ISBN-10
    193259406X
  7. ISBN-13
    978-1932594065
  8. See all details
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Editorial Reviews

From the Inside Flap

The human body is capable of killing itself for little apparent reason, and it happens often enough to rank as the third most common cause of death in the United States today. Kevin Tracey, a neurosurgeon, immunologist, and highly regarded scientist, offers in Fatal Sequence an easily understandable account of the medical and scientific "perfect storm" that is severe sepsis, the medical crisis that can descend on patients fighting off even seemingly nonfatal illness or injury. Severe sepsis killed "Muppets" creator Jim Henson, who had been hospitalized for pneumonia, and took the life of Christopher Reeve, who was being treated for pressure sores of the skin.

Fatal Sequence tells the story of Janice, a one-year-old who arrives in the emergency room, burned by boiling water after she crawled behind her unsuspecting grandmother as she turned from the stove. She survives the night, but the following morning is only the beginning of her long and intense battle against severe sepsis, as her body attacks itself. Tracey, who cared for the girl during her four weeks in intensive care, draws on her case to vividly illustrate why sepsis happens, in a sensitive, suspenseful story that renders cutting-edge science human, accessible, and unforgettable.

From the Back Cover

The human body is capable of killing itself for little apparent reason, and it happens often enough to rank as the third most common cause of death in the United States today. Kevin Tracey, a neurosurgeon, immunologist, and highly regarded scientist, offers in Fatal Sequence an easily understandable account of the medical and scientific "perfect storm" that is severe sepsis, the medical crisis that can descend on patients fighting off even seemingly nonfatal illness or injury. Severe sepsis killed "Muppets" creator Jim Henson, who had been hospitalized for pneumonia, and took the life of Christopher Reeve, who was being treated for pressure sores of the skin.

Fatal Sequence tells the story of Janice, a one-year-old who arrives in the emergency room, burned by boiling water after she crawled behind her unsuspecting grandmother as she turned from the stove. She survives the night, but the following morning is only the beginning of her long and intense battle against severe sepsis, as her body attacks itself. Tracey, who cared for the girl during her four weeks in intensive care, draws on her case to vividly illustrate why sepsis happens, in a sensitive, suspenseful story that renders cutting-edge science human, accessible, and unforgettable.

Product details

  • Publisher ‏ : ‎ Dana Press (March 15, 2005)
  • Language ‏ : ‎ English
  • Hardcover ‏ : ‎ 238 pages
  • ISBN-10 ‏ : ‎ 193259406X
  • ISBN-13 ‏ : ‎ 978-1932594065
  • Item Weight ‏ : ‎ 15 ounces
  • Dimensions ‏ : ‎ 6 x 1 x 9 inches
  • Customer Reviews:
    4.3 4.3 out of 5 stars 15 ratings

About the author

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Kevin J. Tracey

Kevin J. Tracey

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Kevin J. Tracey, is President and CEO of The Feinstein Institute for Medical Research; Professor of Neurosurgery and Molecular Medicine at the Zucker School of Medicine at Hofstra-Northwell; and Executive Vice President, Research, at Northwell Health, in New York. A leader in the fields of inflammation research and bioelectronic medicine, his contributions to science include discovery and molecular mapping of neural circuits that control immune responses; identifying HMGB1 as a therapeutic target at the intersection of sterile and infective inflammation; and identifying the therapeutic anti-inflammatory activity of monoclonal anti-TNF antibodies. Professor Tracey received his B.S. (Chemistry, summa cum laude, Phi Beta Kappa) from Boston College in 1979, and his M.D. from Boston University in 1983. He trained in neurosurgery from 1983 to 1992 at the New York Hospital-Cornell University Medical, Center, and was a guest investigator at the Rockefeller University, before moving in 1992 to The Feinstein Institute in New York. An inventor with more than 60 United States patents, and author of more than 360 scientific publications, he is also cofounder of the Global Sepsis Alliance, a non-profit organization supporting the efforts of >1 million caregivers in more than 70 countries. His honors and awards include a Doctorate honoris causa from the Karolinska Institute, Stockholm, Sweden and lectureships from Harvard, Yale, Rockefeller University, the NIH, and elsewhere. He has been elected or inducted into the American Society of Clinical Investigation (2001), the American Association of Physicians (2009), the Long Island Technology Hall of Fame (2012), Alpha Omega Alpha (2014), and is a Fellow in the American Association for the Advancement of Science.

Customer reviews

4.3 out of 5 stars
4.3 out of 5
15 global ratings

Top reviews from the United States

Judy Otteson
5.0 out of 5 stars I've been there, and this book's GOOD.
Reviewed in the United States on May 8, 2008
Verified Purchase
I discovered this book three years ago, quite by accident, and it explained--in readable language and comfortable style--EXACTLY what had happened to my body when I came within moments of death in late '04 and early '05. Mine weren't burn wounds like Janice's, but treated the same--the result of a tiny (less than 1/2 inch), single dog bite that injected a bacteria into my bloodstream. My lungs "failed" (Acute Respiratory Distress Syndrome--ARDS)and began a process that led to a near-fatal clotting disorder, multi-organ failure, gangrene and amputation of four fingers and the front halves of both feet; skin and fat necrosis (blackening, rotting) from my waist down (eventually excised--carved off--almost to bone, from knees to ankles of both legs); extensive skin grafts (taken from my back), dramatic scarring, and limited ability to stand or walk. In a burn ward, like Janice in the book, there were brief moments of lucidity over a period of almost three months, during which I repeatedly asked, "What happened to me?" Thanks to Kevin Tracy's "Fatal Sequence," I now thoroughly understand the "domino effect" of severe sepsis and its all-too-common, tragic ending. Readers might accurately conclude, after reading this book, that in obituaries such terms as "pneumonia" or "brief illness" are euphamisms for SEPSIS that leads so quickly to demise. "Fatal Sequence" explores and reveals body functions and self-contained back-up systems of which few people are aware . . . until they fail. I cherish my two copies and highly recommend this book for folks still asking, "What happened?" and for any medical professional who has lost a patient to "infection," despite the best knowledge, resources, technology, treatment, and care. It is a simple, yet technically sound play-by-play account of the body's own dying process. Remarkable.
3 people found this helpful
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Much Happier Now
4.0 out of 5 stars The thing the author did best was to convey the story of the child victim ...
Reviewed in the United States on August 9, 2014
Verified Purchase
This is an engaging story, which is well told by a professional and expert in the field of sepsis and septic shock. The book began by telling a story of a young child brought in for care, who became affected by then then-poorly understood phenomenon of septic shock. I found the later descriptions of animal research to be disturbing - this fact isn't meant as a political commentary, just a 'you might want to be braced' comment regarding that portion of the book's contents.
The thing the author did best was to convey the story of the child victim with sensitivity. Even though all human victims were amalgams of patients seen over the years (so as to respect privacy), it was nice that the author still managed to convey the compassion healthcare workers feel for those they care for. Good book for a basic understanding of this complex field.
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MomX3
5.0 out of 5 stars CDC Sepsis Campaign References Dr. Tracey's Book.
Reviewed in the United States on October 5, 2015
Verified Purchase
Succinct! Dr. Tracey clearly has a gift expressing complex issues into meaningful text for laymen. The book was about a baby who suffered a whole body burn from a carless mistake her grandmother made while preparing dinner. This led to severe sepsis, septic shock and death. Dr. Tracey was consumed with his experience of caring for her, and therefore, it changed the course of his life.
I found I was able to learn about sepsis and shock in a way I could not from my pathophysiology book. Incredible learning tool.
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Ben K
5.0 out of 5 stars A formidable book, a must-read for any medical student
Reviewed in the United States on November 22, 2005
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This is wonderful book for the general public and requires little knowledge of medicine. It is written as a journal followed by a discussion and relates how a physician's compassion for a dying child leads to an important discovery in neuroimmunology. The book also describes in relatively simple terms the process of science and the steps involved in this discovery. At the end, Dr. Tracey introduces a medical theory called "the cytokine theory of disease," to explain many therapeutic effects observed in conventional and alternative medicine. Overall, this is a formidable book that anyone interested in a becoming a healthcare provider should read.
2 people found this helpful
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Smiley
4.0 out of 5 stars Shocking.
Reviewed in the United States on May 14, 2013
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Very well written. Anyone will be interested in the story. It helps to be a biology major or a physician for the last 20%. New insights into how the body works revealed at the end.
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John J. Pinelli
5.0 out of 5 stars Five Stars
Reviewed in the United States on June 17, 2018
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As a biologist, this was very interesting especially since i am a septic shock survivor.
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kapgross
5.0 out of 5 stars Five Stars
Reviewed in the United States on June 23, 2015
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Perfect...like brand new from the book store. Thanks!
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John Matlock
5.0 out of 5 stars A Tear for Janice's Struggles, A Prayer for the Future
Reviewed in the United States on June 5, 2005
About two thirds of this book is the story of Janice, an eleven months old girl who was admitted to the hospital with burns over 75% of her body. Her life expectancy with this much burn was about 25%, unlikely to survive the first night. But she did. She was recovering until her body began destroying itself. The name of her condition is severe sepsis.

Anyone with a child will shed tears as they read the struggles Janice's little body made against the infection and her own out of control immune system. But with Dr. Tracey this was a life changing experience as his experience with Janice's fight made him choose a life of scientific research into severe sepsis.

The remaining third of the book talks about the research Dr. Tracey and his associates have conducted in the subsequent years and serves as a preliminary finding as to what they have discovered, the status of the research, and the hope for the future.
3 people found this helpful
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Top reviews from other countries

ProtactInc
5.0 out of 5 stars Septic Shock and Severe Sepsis Are Very Different
Reviewed in Canada on May 7, 2020
Verified Purchase
Kevin J. Tracey's book Fatal Sequence is absolutely horrific. Thru its first 6 chapters it details a fatal pediatric burn case which is very difficult to read. For the remainder of the book Tracey details research that illuminated causes of Septic Shock and Sepsis.
In Chapter 7 Tracey describes the discovery of cachectin, now called tumor necrosis factor (TNF). He injected this cytokine into rats and produced Septic Shock, showing that it could produce the hallmark tissue death without infection. Next he goes on to show that Septic Shock could be eliminated by giving monoclonal anti-TNF antibodies before introducing lethal numbers of pathogenic bacteria to the test animals.
Fresh Barnard graduate Ona Bloom worked in Tracy's lab, looking for a cytokine released by macrophages in response bacteria exposure. Her candidate protein HMGB1 was a disappointment since it is part of the nucleus of most living cells. But it turned out, after many years of study, that HMGB1 could act as a cytokine and was important in mediating Severe Sepsis. Also, counteracting HMGB1 was effective in reducing lethality of the condition.
So, Septic Shock is brought on by TNF and causes a massive response of all white blood cells (WBCs). They end up clogging capillaries, damaging organs and will can cause hands and feet to turn grey or black.
Severe Sepsis is mediated by HMGB1 & causes epithelial layers (surface layers) to leak so function of organs, intestines, blood vessels is lost leading directly to demise. Autopsy will find few signs of the cause.
Tracey's lab went on to develop CNI-1493, a chemical that blocked TNF and other cytokine production by macrophages. They successfully used it in the brains of rats who had experimental strokes. It reduced TNF production and reduced stroke related brain damage. They accidentally injected CNI-1493 into brains of rats being used to study endotoxemia and found that the chemical was 300,000 times more effective if injected into the brain rather than the body. This created a mystery that lasted months until they guessed that the Vagus Nerve might have something to do with it. A literature search revealed that immunologists had mostly avoided the question whether or not the mind could influence health. Quoting Robert A. Good "Immunologists are often asked whether the state of mind can influence the body's defenses. Can a positive attitude, grief, depression, or anxiety alter ability to resist infections, allergies, autoimmunities, or even cancer? Such questions leave me with a feeling of inadequacy because I know...that such influences exist, but I am unable to tell how they work...In the face of this inadequacy, most immunologists are naturally uneasy and usually plead not to be bothered with such things." Despite this, in 1926 Metal'nikov and Chorine demonstrated Pavlovian-like immune responses in animals. Also J.Edwin Blalock showed that immune & nervous systems use the same molecules to communicate. Further work by Tracey's lab led to a publication demonstrating immune suppression using vagal nerve stimulation. Many more papers demonstrating that vagal nerve stimulation lowers excessive cytokine production have followed. But Tracey writes that "meditation, hypnosis and prayer can...increase vagus nerve output and inhibit...hypersensitivity responses in humans. Similarly, exercise, biofeedback...and acupuncture have each been used to modulate vagus nerve activity and reduce experimental inflammation." Tracey points out that trained athletes have extremely high vagus nerve activity with slow heart rates and high beat to beat variability. "Successful biathlon sharpshooters fire between heartbeats, and some professional baseball players and golfers actually strike the ball between heartbeats, when their hearts are still. This is accomplished by increasing vagus nerve output at the time of peak performance, which instantaneously slows the heart at the critical moment of function or impact. It's possible that being "in the zone" is a state of high vagus output."
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