Human. No-holds-barred. Urgent.
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Life and Death Decisions

Lachlan McIver

The impossible job of a doctor in some of the world's wildest places.

I found Dad dead on the side of a dirt road. I was sixteen; he was forty-nine.
After Lachlan McIver’s father suffers a sudden, fatal heart attack it sends him into a spiral of grief and outrage. This tragedy inspires him to become a doctor and he eventually finds his calling – providing care for communities in some of the most remote and neglected parts of the world.
In this no-holds-barred memoir, Lachlan recounts his experiences treating patients and tackling health problems across dozens of countries, from rural communities around Australia and the islands of the South Pacific, through natural disasters and civil war zones, to the headquarters of the World Health Organization and Médecins Sans Frontières (Doctors Without Borders) in Switzerland.
Lachlan is forced to confront not only the frustrations of trying to provide medical care in extremely under-resourced environments, but broader crises such as health inequities, climate change and drug-resistant infections. He also faces his own personal battles, including with depression, alcohol abuse and bankruptcy.
This is a deeply human look at the personal cost of our broken global health system, and how we must work together to change it for the better. It’s what we need right now.

About the Author

Dr Lachlan McIver specialises in rural and remote medicine, tropical medicine and public health, and did his PhD on the health impacts of climate change. Originally from Millaa Millaa in Far North Queensland, his travels to date have spanned almost one hundred countries. He has co-authored close to fifty scientific publications in medical journals and textbooks on topics ranging from environmental health and infectious diseases to anaesthetics and emergency medicine. He is an adjunct Associate Professor at James Cook University in Australia and the co-founder of the international non-profit organisation Rocketship Pacific Ltd, which focuses on improving health in Pacific island countries. He currently lives in Switzerland, where he works as the Tropical Diseases & Planetary Health Advisor at the Geneva headquarters of Doctors Without Borders (Médecins Sans Frontières).


’Just brilliant... The book of the Decade.' – Tim Flannery


‘a hugely important and enjoyable book that will restore your faith in humanity and what is possible… Deeply moving and at times tragic but never losing a sense of optimism or hope.’  – Sir Jeremy Farrar

Life and Death Decisions tells us the very human stories that shine a light on some of the biggest challenges of our time, including climate change and inequality. Lachlan's work in some of the most difficult places on earth brings a better understanding of how much we all have in common and why it is so urgent to work together to solve these urgent problems.’ – Dr Kate Gregorevic, author of Staying Alive
‘An honest, powerful and riveting book that demonstrates Lachlan's courage in the face of the hardest of circumstances.’ – Levison Wood, author of Walking The Nile
‘Life and Death Decisions cuts close to the bone. McIver deftly dissects the malaise of modernity in a memoir that pulls no punches, that's set against the backdrop of the climate crisis, and drug resistant bacteria in the arse end of times. Life and Death Decisions is all at once brave, funny, shocking, and down to earth in one human's outrageously honest account of humanity.’ – Aaron Smith, author of THE ROCK: Looking at Australia’s heart of darkness from the edge of its wild frontier
‘To call Life and Death Decisions a memoir is to undersell the vast importance and reach of this outstanding, brilliant work ... A book as important as this comes along only once in a generation or so, and it not only deserves a wide readership, but commands it. These are the words, and deeds, of hope.’ - Dr Michelle Johnston, author of the novels Dustfall and Tiny Uncertain Miracles

a detailed look at his work’s many complexities and the daily push/pull he must negotiate. Compelling stuff.’ - The AU Review




Pub Date
September 2022




Memoir. Health inequality. Global health. Rural medicine.