In Every Deep-Drawn Breath: A Critical Care Doctor on Healing, Recovery, and Transforming Medicine in the ICU, pulmonary and critical care specialist Dr. Wes Ely chronicles his career-long “journey back to [his] original oath – first do no harm.”
During his first rotation in critical care, Ely adhered to accepted ICU protocols, using endless arrays of interventions to “push back against death” for his medically sedated patients. While these heroic efforts often cured a patient’s original illness, Ely soon witnessed how a number of patients “acquired completely different ailments” after their ICU care. For some, a combination of debilitating physical, cognitive, or mental health complications, now collectively known as post-intensive care syndrome (PICS), would encroach on, or even devastate, their ability to carry out the basic activities from their pre-ICU lives.
In the ensuing years, Ely would uncover new details about the life-changing effects wrought by the unfettered use of heavy medication, ventilation, and sedation on ICU patients. In response to this research, Ely helped create more cost effective, less intrusive, more patient-centric protocols for ICU care, which benefit patients and their families, and reinvigorate medical personnel, approximately 50 percent of whom are estimated to experience physician burnout.
Every Deep-Drawn Breath is punctuated with compelling stories about the humans involved in the history of medical innovation; of the nurses and doctors who were Ely’s contemporary pioneers in returning humanity to the ICU; and of Ely’s patients’ struggles with delirium and PICS. Ely also writes openly and honestly about his personal and professional moments of reckoning, lending an important undercurrent of commentary on the grace humans have to rectify their past flaws.
A2F and Seeing the Whole Patient
Often presenting as hallucinations, nightmares, delusions, or difficulty concentrating, delirium has long been considered an unfortunate and unavoidable side effect of intensive care. To challenge this notion, Ely conducted numerous delirium studies, the first of which quantified delirium’s prevalence. He found that 82 percent of his ICU patients developed delirium, and had triple the risk of dying within six months compared with patients who did not experience delirium.
Further studies homed in on the aspects
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