Abstract
Ironically, “A Second Act” is Doctor Morgan’s third book. Regardless, it is every bit as good as his first two best-sellers: 2019’s “Critical,” and 2023’s “One Medicine.” Matt is an Intensive Doctor by day (and night and weekend, presumably), and a creative non-fiction author in whatever precious time remains. Remarkably, he keeps delivering humbling, engaging and widely applicable books. This 2025 offering was worth every second of my time, and its 258 pages and 11 chapters flew by. It was then eagerly passed around to medical and non-medical friends alike (sorry for the lost sales, Matt). In return, let me make a fulsome pitch to others, especially as the world appears to contain fewer book-worms and more screen-junkies.
Dr Morgan’s first book contained compelling stories from the front lines of Critical Care Medicine. His second provided examples of how animal physiology can propel human medicine. This one is similarly peripatetic, and no less relevant. It focuses on the estimated 6% who survive neurologically-intact after a cardiac arrest, and the title comes from how lives changed by getting a rare “second act.” You and I receive the wisdom and clarity that only comes from extreme events, but without the near-death lottery.
These stories start at the end. . .or what could so easily have been the end. Examples include, Ed who was struck by lightning at 17 (and suffered years of survivor guilt); Luca, 30, who was losing their COVID battle (until ECMO came to the rescue); Summer who attempted suicide at 25 (and regretted it as her breathing faded); Roberto, a physician, who was frozen solid and pulseless for almost 9 h; and Rhys, a rugby international, who suffered a catastrophic heart attack, but lived for 11 years while awaiting transplantation.
Morgan offers more than just “carpe diem” platitudes or “memento mori” warnings. In fact, his first example is his own Auntie Win, whose 97 years he celebrates at her funeral via a gloriously human eulogy. Matt gives voice and significance to her “5000 Saturdays and lazy Sundays, 1000 full moons, six solar eclipses, two proposals, and three billion heartbeats,” amongst other seemingly banal events. The point is, however, that we need to delight in these details as they give life rhythm and significance. For physicians, we should also remember there is more than the “hit the target miss the point” distractions that clog many of our medical charts.
Matt highlights the imperative to find meaning. He also celebrates the simple power of nature, the tragedy of squandering time, and the healing power of gratitude. He emphasizes the need to give space for those you love, and, also, for those who need our love. In other words, Matt’s message is not the hedonistic YOLO – you only live once – message so wide spread on social media. To the contrary, it is about seemingly little things that are not little, and being open to new experiences whether you’re long in the tooth or unstable in the ECG. Whether it’s a cold-water swim or learning the kazoo, Morgan encourages us to “go nuts.” I, for one, welcome his exuberance, especially for a profession that- let’s face it- sometimes wallows in pessimism.
Matt’s prose is also a delightful departure from what our profession usually delivers. With the risk of hyperbole, at times, it even resembles his countryman, Dylan Thomas. Examples include that the “The funeral was held under a pewter sky as if nature itself was a mourner.” He also wryly lists Auntie Win’s cause of death as “life,” and, despite owning his secular beliefs, he still encourages his Auntie to “write back if you can.”
In the final chapter, he brings his ideas together by staging a collective “living funeral.” Eight grown-men get to hear what people would say about them while contemplating their fragility and legacy. Then, like the survivors in this book, they – and we – get a second chance to get it right. This allows them – and us – to think about what it means to have led a good life. These ideas – also known as eudaimonia- are as old as Aristotle but are often forgotten. Medicine may have advanced but – not withstanding the 6% club – the inevitability of death has not. We should all do something about that before it is too late. As Morgan concludes: “even if we do have two lives, the second only begins when you realise you only have one.”
