J. L. Old and D. L. Swagerty. Philadelphia: Lippincott Williams & Wilkins; 2007. $59.95. ISBN 0-7817-6343-6. 348 pp.

Palliative care is a rapidly developing specialty, and accordingly, there are dozens of books available for the clinician, from novice to expert. Topics for these books range from narrow and specialized, such as Surgical Palliative Care, to broad and comprehensive, such as Ferrell and Coyle's expansive Textbook of Palliative Nursing. In contrast, A Practical Guide to Palliative Care is intended to provide the reader with a user-friendly introduction to the specialty, stating: "Designed for easy use at the bedside, this manual contains the practical information health care professionals need to provide optimal end-of-life care." With the vast array of resources to choose from, however, I would not be drawn to this particular book. Beyond being far too basic for an experienced practitioner in palliative care, I would not recommend it even to a novice clinician.

First, I could not help but bristle at the introduction: "This book is intended to be simple, succinct, and practical for everyone who may take care of a patient near the end of life. Much of palliative care is just common sense." Common sense? The authors have unwittingly, in the first page, undone what those of us who practice in this field have spent years trying to demonstrate: that providing exemplary care to patients with complicated and advanced illnesses demands more than "just common sense." Rather, the specialty of palliative care is research driven and clinical practice is evidence based.

Second, the manual never quite makes it out of the outline stage. It is organized largely with headings followed by brief explanatory paragraphs and long lists of bullet points. There are 100 chapters, but rarely does a chapter exceed 3 or 4 pages. Complicated topics are glossed over. Chapter 48, "Spiritual and Existential Suffering," consists of 2 headings with a total of 7 bullet points. Chapter 90, "Children and Death," is presented in a succinct 3 pages, again most of it in bullet points or tables.

To move beyond my initial bias, I asked a fourth year medical student who was beginning a clinical rotation with our palliative care service to browse through the book and share her impressions. Her summary was that it was simplistic to the point of not being helpful. Clinicians new to the field of palliative care will be better served by exploring the many other texts, manuals, and journals available on the market.