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Few would dispute that the relatively young specialty of critical care medicine has come of age. In the bad old days, when all general surgeons and internists thought they knew how to "drive the ventilator" and prescribe fluids for a patient with septic shock and the adult respiratory distress syndrome, there was no alternative, because there was no specialty, no academic base, and no training in the practice of critical care medicine. The result was wetter lungs and lost souls. To give patients a better chance of surviving, this new specialty had to emerge quickly, and its highly trained practitioners
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