Cover for Where Night is Day

“James Kelly provides an exceptionally thoughtful narrative of the modern intensive care unit.  He characterizes the rhythms of the ICU and captures odd juxtapositions of the deeply emotional and highly technical, while he explores the complex history and unspoken social hierarchy of American hospitals. Through the experience of caring for critically ill patients and their families, he ultimately delivers a moving meditation on life and death.”

Peter Clardy, MD, Director, Medical Intensive Care, Beth Israel Deaconess Medical Center/Harvard Medical School

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Where Night Is Day will be of interest to doctors, nurses, medical and nursing students, patients, and those interested in the organization of health care delivery. This excellent and compelling book marries theory to observation. James Kelly has created an intriguing presentation of social science thought about the health professions and illness, the socialization process of medical and nursing students, a clinical ethnographic study of life in an ICU, and an auto-ethnography.”

Brian Hodges, MD, PhD, FRCPC, University of Toronto, coeditor of The Question of Competence: Reconsidering Medical Education in the Twenty-First Century

“James Kelly’s ICU is a relentless and claustrophobic space where all the stories begin in the middle and only some have endings. His book is an exhilarating and humbling depiction of nursing in the twenty-first century.”

Arthur W. Frank, author ofThe Wounded Storyteller: Body, Illness, and Ethics and Letting Stories Breathe: A Socio-Narratology


Where Night is Day

The World of the ICU

Where Night Is Day is a nonfiction narrative grounded in the day-by-day, hour-by-hour rhythms of an ICU in a teaching hospital in the heart of New Mexico. It takes place over a thirteen-week period, the time of the average rotation of residents through the ICU. It begins in September and ends at Christmas. It is the story of patients and families, suddenly faced with critical illness, who find themselves in the ICU. It describes how they navigate through it and find their way. James Kelly is a sensitive witness to the quiet courage and resourcefulness of ordinary people.

Kelly leads the reader into a parallel world: the world of illness. This world, invisible but not hidden, not articulated by but known by the ill, does not readily offer itself to our understanding. In this context, Kelly reflects on the nature of medicine and nursing, on how doctors and nurses see themselves and how they see each other. Drawing on the words of medical historians, doctor-writers, and nursing scholars, Kelly examines the relationship of professional and lay observers to the meaning of illness, empathy, caring, and the silence of suffering. Kelly offers up an intimate portrait of the ICU and its inhabitants.

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