Every Deep-Drawn Breath: A Critical Care Doctor on Healing, Recovery, and Transforming Medicine in the ICU

“Within ICUs, patients on the brink of death are cared for in well over one hundred thousand intensive care beds each day, in around three thousand hospitals around the country.” This is one of the many harrowing statistics that Dr. Wes Ely provides his readers with in his abundantly intriguing book, Every Deep Drawn Breath. From real patient cases to the history of present-day medical practices, and more, Dr. Ely covers an wide variety of topics regarding critical care and what it means to be an excellent caregiver to patients in the hospital.A very large portion of this book revolves around the PICS phenomenon. PICS is an acronym for Post Intensive Care Syndrome, something that I, as a clinician, along with many of my colleagues, hadn’t heard about before reading this book. Ely describes PICS as “a debilitating condition composed of ‘neck-up’ brain problems and ‘neck down’ body problems that survivors of critical illness often experience after a stay in the ICU.” Dr. Ely believes that PICS is the result of heavy sedation given to patients in the ICU. Throughout his research, Ely proved that sedation causes what he refers to as “ICU delirium.” He and his colleagues pioneered several commonly used practices in the ICU used by clinicians regularly. One of these assessments was the Confusion Assessment Method for the ICU, also known as CAM-ICU. He used this assessment to monitor the risk of brain injury and delirium for his patients. He describes his mission to decrease the number of PICS cases and the trials and tribulations he has experienced throughout the book. His headstrong beliefs were frowned upon by many, but his arguments and thought processes won me over instantly.Dr. Ely also expresses how to be a better caregiver to patients throughout this text. He believes that many clinicians have lost their sense of humanity in the chaos of critical care. He expresses how many healthcare workers refer to patients as “bed numbers” or by their diagnosis, rather than actual human beings with names and lives. His way of arguing his point that this is a common practice of complacency that needs to end, really hit home for me. I realized that I was guilty of this very thing. Since reading this book, I have regularly used Dr. Ely’s words and examples as a basis for my care for my patients. His way of persuasion through facts, statistics, and research is incredibly hard to argue against. He is an example of a remarkable physician who cares deeply for his patients. His words will make anyone want to be a better clinician after reading this book.Ely writes in a way that anyone can understand, while keeping his text relevant and interesting. He describes many clinical terminologies so that all readers can understand by not only providing the medical terms for practices but breaks them down into simpler terms such as referring to mechanical ventilation as what is commonly known as life-support. He gives a concise history on the early stages of mechanical ventilation during the Polio epidemic, along with the how ICU units came to be common practice in hospitals, globally. He describes how older practices don’t always equate to best practices, and how medical personnel must be open to change in order to provide the best care to their patients. His breakdown of facts, statistics, and personal stories of his career and personal life, help put into perspective the intensity of the medical field on clinicians and patients alike.I would highly recommend this book to anyone working in medicine, though it is written in a manner that would interest anyone who has been, or has visited someone, in a hospital. Dr. Ely represents what medicine should be and is an excellent role model, for physicians, nurses, respiratory therapists, and caregivers of all kinds. His expertise and bedside manner shine through the pages of this book. I felt as though I knew him personally after reading it. His mission is what healthcare is about: humanity and caring for each other. I plan to use this book as a basis for my entire career and to take his wisdom with me to provide outstanding care to my patients. I hope to be able to change medicine in a positive way throughout my career, as Dr. Ely has. I hope that anyone who reads this book would be as inspired as I am.

I considered it my mission to introduce this fantastic and thought-provoking book. Every researcher, physician, nurse, and anyone involved in patient care must learn this holistic approach, as medicine is not only about addressing physical aspects. I was inspired by the stories and moved by how Dr. Ely transformed heartbreaking experiences in the ICU into meaningful actions for patients. The combination of technology and human touch has the power to improve the patient's outcomes and lives. Learn, enjoy and bring humanities into the practice 💫

This is a profoundly meaningful book, especially in our day and age when technology and science seem to be eclipsing the humanistic dimension of medicine. Through a series of gripping, real-life patient stories and his personal path of discovery, Dr Ely takes the reader on a journey that challenges the medical establishment to recognize what is largely an overlooked epidemic among survivors of ICU stays (Post Intensive Care Unit Syndrome), while simultaneously illustrating the importance of restoring a lost ideal in modern medicine: compassion (to suffer with). This window into the heart of Dr Ely transmits a deep wisdom and authenticity that modern medicine is literally starving for. I laughed, cried, and reflected long after completing this book. As a physician, this book has challenged me to truly live the ideals that drew me to medicine in the first place. To see the person in the patient, to meet them where they are, to treat the whole person (not just labs and imaging), to recognize the profound meaning of suffering, and to lean into my relationships with my patients rather than build interior walls. There is something for everyone in this book, you will not be disappointed! Thank you, Dr Ely!

With "Every Deep-Drawn Breath" critical care innovator and physician Dr. Wes Ely delivers an important and timely work that provides hope for patients and their families affected by a stay in the intensive care unit. Post-intensive Care Syndrome or (PICS) is a debilitating condition that affects ICU patients, often brought on by the treatment they receive. Thanks in large part to Dr. Ely's groundbreaking research, in recent years the wider medical community has begun to formally recognize and treat symptoms of PICS, which can include PTSD, depression, memory loss and nerve damage. It is Dr. Ely's fascinating, often crusading, investigation into the causes of PICS that propels the narrative.We follow Dr. Ely's professional journey, his early days as an idealistic medical student, through residency and up to the present-day as a Chair in Medicine at Vanderbilt University. He brings the reader close to the lives of his patients affected by PICS, and how their different symptoms and outcomes informed Dr. Ely's quest to make changes, often against a resistant medical community, to the way ICU patients are treated. For decades, the old model of keeping ICU patients on ventilators, maximally sedated and immobile, was leading to, among other problems, long-term brain damage and muscle loss that we now understand as PICS.What ultimately makes Every Deep-Drawn Breath so compelling is Dr. Ely's belief in finding the human in the patient. This goes hand in hand with his ICU innovations, such as reducing sedation to allow more interaction with the patients. Little things like touching the patient, looking them in the eye, understanding their back story all contribute to the overall care. As we come to know Dr. Ely's actual patients in these pages, we understand his urgent need to change the way ICU patients are treated while in hospital, and as important, what happens to them after discharge.Along the way, Dr. Ely weaves the tale of the technological innovations that led to the development of the modern ICU, and the surprising ways in which those changes came about. Ans we learn about Dr. Ely's own contributions to the treatment of ICU patients, such as the A2F bundle, and the creation of the Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center at Vanderbilt.Whether a doctor, nurse, or general reader, I highly recommend this work of hope and humanity

Absolutely a must read for anyone lucky enough to be working in critical care. 10/10

Doctor Wes writes a unique book, withstories that affected me deeply. I highly recommend this outstanding book.

'Every Deep Drawn Breath' is a raw yet heartening read. I believe anyone who comes in contact with an ICU patient would benefit from reading this book. Dr Ely implores the medical profession to draw from their humanity along as their medical skills, to see the patient as a person, and to consider that critical illness rehabilitation needs to begin in the ICU. He shows us by considering best practice the critically ill have a fighting chance to regain autonomy. I am forever grateful for those ICU professionals who saved my life many years ago. However we cannot step back into our lives without acknowledgement of the struggle and the offer of support. Barbara Egan

In this world where virtually every corner of the globe has been explored, the journey now being shared with us by disciplines including neuroscience, medicine, psychology and spirituality into the human brain is every bit as important as the first explorers to new shores. Authors like Dr.Ely are our 'wilderness wayfinders,' using his knowledge, experience and compassion to take us ito this important -- maybe MOST important - destination. So grateful to have found this book for my own work.

A pleasure to read and be privy to the blossoming of a Doctor’s awakening to his patients lives and the changes he recognized were needed to be a true partner I their recovery. Excellent!!!