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Q + A: E. Wesley Ely, MD, MPH

Posted by on Monday, October 18, 2021 in Fall 2021, Q+A .

Photo by Donn Jones

“Every Deep-Drawn Breath,” released Sept. 7 by Scribner, is the first book for a general readership from pulmonologist and critical care specialist E. Wesley Ely, MD, MPH, the Grant W. Liddle Professor of Medicine and founding co-director of the groundbreaking Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center.

Q: What is “Every Deep-Drawn Breath” about, and why did you write it?

It’s about humanization of the practice of medicine and the importance of seeing the entire person whom you’re treating. What drew me to write it was basically 30 years of being a doctor and getting gray-haired watching and learning from my patients. What really called me to the bedside was the intimate relationship with the people I was there to serve, yet I saw how critical care, as it became more technologically sophisticated, actually severed that relationship. All too often, the person I was there to see was sedated and restrained while on life support. Impaired from seeing the whole person, I felt myself becoming less of a physician. That drove me to do research over the past 20 years into ICU delirium, removing sedation and waking people up, getting them out of the bed and walking them even when on a ventilator. We developed an approach now used around the world as the cornerstone of critical care safety. The book shows how all that came to be, through the eyes of patients and their families.

Q: Does a particular patient story come to mind as an example?

As a young intern, the first person I ever cared for in the ICU was a woman named Teresa. It was only in the months and years after I took care of her that I saw how I had really contributed to destroying her life. The evidence-based care of that time told us to deeply sedate her into a coma, to paralyze her to tolerate the ventilator, which actually further destroyed her lungs — popped them and caused air leaks. It immobilized her for so long in a coma that she developed calcium deposits in her joints and ended up not being able to move her shoulders and elbows. And she acquired dementia while in the ICU that completely impaired her ability to go on with her life. In 2021, a lot of that care has been completely revamped by research that she helped stimulate, conducted by me and my CIBS Center colleagues and like-minded teams around the world.

Q: As a critical care physician, what has the COVID pandemic taught you?

COVID amplified the need for this book, because the technology that was available to us to care for human beings was separated from the humanistic component of care. The presence of family and loved ones at the bedside was often lost entirely, and the role of loved ones in the healing plan remains at least partially severed in many hospitals to date. It’s not OK to separate love and humanity and hope from technology — they must be integrated. Technology should never be allowed, as it was early in the pandemic, to remove the human touch.