I tell DeFilippo's story, for instance, as if I were the one tending to him hour by hour. But that was actually Max Weinmann, an intensivist (as intensive-care specialists like to be called). I want to think that, as a general surgeon, I can handle most clinical situations. But, as the intricacies involved in intensive care have mounted, responsibility has increasingly shifted to super-specialists like him.

Research shows patients in intensive care units get well faster if they're cared for by intensivists, or doctors who specialize in those patients. But there are too few of those physicians. That shortage, combined with technology costs, makes running a state-of-the-art intensive care unit impossible for many community hospitals.

Orloff then started the transplant program at Sharp Memorial Hospital. The surgeon, who held a press conference after his team accomplished the first liver transplant on Oct. 31 in a 21-hour operation, has since been unavailable for comment. … She died Nov. 21 of complications. …

Commenting on the blood use in the 21-hour first transplant, Moossa, UCSD's surgical chief, said: "The numbers are astronomical. I think the anesthesiologists and the intensivists should be congratulated for keeping the patient alive so long. The volume of blood is near the point of incompatibility with life."