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Every Deep-Drawn Breath: A Critical Care Doctor on Healing, Recovery, and Transforming Medicine in the ICU Paperback – September 20, 2022

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Winner of a Christopher Award—now with a discussion guide

“Perhaps one lesson to draw from the pandemic, with help from books like this one, is that the ICU experience can be changed for the better” (The Washington Post) for both patients and their families. You will learn how in this timely, urgent, and compassionate work by a world-renowned critical care doctor.

In this rich blend of science, medical history, profoundly humane patient stories, and personal reflection, Dr. Wes Ely describes his mission to prevent ICU patients from being harmed by the technology that is keeping them alive. Readers will experience the world of critical care through the eyes of a physician who drastically changed his clinical practice to offer person-centered health care and through cutting-edge research convinced others to do the same.

Dr. Ely’s groundbreaking investigations advanced the understanding of post– intensive care struggles and introduced crucial changes that reshaped treatment: minimizing sedation, maximizing mobility, and providing supportive aftercare. Dr. Ely shows that there are ways to bring humanity into the ICU and that “technology plus touch” is a proven path toward returning ICU patients to the lives they had before their hospital stays. An essential resource for anyone who will be affected by illness—which is all of us.
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From the Publisher

Every Deep Drawn Breathe

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Editorial Reviews

Review

"A timely book, its message an urgent one. . . . Perhaps one lesson to draw from the pandemic, with help from books like this one, is that the ICU experience can be changed for the better." —Washington Post

"With its vivid observations and heartfelt tone,
Every Deep-Drawn Breath is a joy to read. Ely’s passion for his patients leaps from the pages, inspiring readers to channel Ely’s humility and love for life to brighten the future of medicine, and mankind." —The Federalist

"An intensely emotive journey through the science and history of the intensive care unit. . . .
Every Deep-Drawn Breath is a paragon of humanity that will have lasting positive effects."The Lancet

"[A] powerful new book. . . . provides true insight into what can be accomplished with humility, perseverance, dedication and above all else, love.” —
Intima: A Journal of Narrative Medicine

"A remarkable look at transformations in ICU care. . . . This humble—and humbling—look at the limits and potential of medicine will stick with readers.”
Publishers Weekly, starred review

“In this dynamic, often touching debut, the author chronicles a personal, passionate return to the ethical heart of the Hippocratic oath. . . . Meaningful, thought-provoking insight into the world of critical care.”
Kirkus Reviews

"Timely."
—St. Louis Post-Dispatch

"A stunning, heartbreaking, and hopeful book, expressing Dr. Ely's profound union of compassion and medical skill. Given that most of us will stay in an ICU, attend a loved one there, or even die in one, I hope that many readers demand treatment according to the humane practices Dr. Ely has pioneered. I equally hope that every critical care doctor and hospital administrator reads this beautiful book, puts its protocols into practice, and makes their ICUs more humane and medically effective."
—Katy Butler, author of Knocking on Heaven's Door

Every Deep-Drawn Breath is an enthralling journey through the ongoing evolution of critical care. In this richly illustrated book, with stories of people who teetered on the edge of death and survived to find their lives forever changed, Dr. Ely, a thought leader in his field, reveals hard lessons he’s learned, innovations he’s led, and his compelling, bright vision for the future of medicine.” Ira Byock, MD, active emeritus professor, Dartmouth Geisel School of Medicine, author of Dying Well and The Best Care Possible, founder and chief medical officer of the Institute for Human Caring

“Through rich and remarkable accounts of caring for patients in the ICU, Dr. Wes Ely places the humanistic mission of medicine front and center, where it belongs, in this outstanding book.”
—Eric Topol, MD, Professor, Scripps Research, author of Deep Medicine

“A remarkable book from a legendary physician. Dr. Ely revolutionized critical care and now, through stories that are intimate, honest, and brave, he reveals the failings and the great promise of the field. This could not be more timely—in the wake of a pandemic that challenged the humanity of our profession, Ely shows us the road forward. A must read.”
—Daniela Lamas, MD, author of You Can Stop Humming Now: A Doctor's Stories of Life, Death, and in Between

"
Every Deep-Drawn Breath is a beautiful, honest gem. If you’re interested in the wild world of the ICU, in the interface between nature and human nature, in how medicine (at its best) learns from good intentions gone awry, in the difference between in vitro and in vivo, or in how a good doctor becomes great, here is the book for you. I'm grateful to Dr. Ely for his candor and his storytelling." —BJ Miller, MD, author of A Beginner's Guide to the End

"Thanks to Dr. Wes Ely and his colleagues, help is on the way for ICU patients, as well as the healthcare professionals who care for them.
Every Deep-Drawn Breath is a must read for anyone who may someday be impacted by an ICU, which means all of us." Jessica Zitter, MD, MPH, author of Extreme Measures: Finding a Better Path to the End of Life

“The ICU is an important, mysterious character in the story of modern medicine, and
Every Deep-Drawn Breath is its deeply felt, thoroughly researched biography. With compassion, grit and grace, Dr. Ely takes us into this liminal space and shows us, through the stories of his patients and his life, what it means to mobilize technology to save lives while also confronting the unintended pain and suffering that ICU care can inflict. This book illuminates the humanism, heroism, and humility required to stand with people at life’s edge, and reminds us to seek meaning and purpose in the life we have, a life sustained by each breath we take.” Sunita Puri, MD, author of That Good Night: Life and Medicine in the Eleventh Hour

“In this fascinating and eye-opening book, Wes Ely makes the radical argument that we should be helping critically ill patients stay awake and engaged, not routinely sedating them into unconsciousness. Combining dogged research, intense reflection, and page-turning stories, Dr. Ely reminds us that we have to treat the patient, not just the disease.”
—Danielle Ofri, MD, PhD, Clinical Professor of Medicine, NYU School of Medicine, and author of When We Do Harm: A Doctor Confronts Medical Error

“With the storytelling sensibilities of Oliver Sacks and the surgical precision of Atul Gawande, Dr. Wes Ely has given us an unforgettable journey of patients and doctors traveling in the disorienting world of intensive care, ultimately leading toward redemption for Dr. Ely himself. Required reading for all mortals. If you liked
When Breath Becomes Air, you will love this book.” —Angelo Volandes, MD, author of The Conversation: A Revolutionary Plan for End-Of-Life Care

Every Deep Drawn Breath deserves a wide and deep readership. . . . it summons physicians to seek relief for their patients' endemic suffering, but not by standard yet short-sighted procedures that ignore post-ICU torment. On the contrary, doctors must humbly recognize their own limits, indeed their inevitable mistakes. Precisely and ever so admirably, this is what Wes Ely has done. —Ralph C. Wood, Emeritus Professor of Theology and Literature, Baylor University

“A treasure trove of hard-won wisdom. Reading
Every Deep-Drawn Breath is like getting a backstage pass to the cloistered world of medical science. A gifted storyteller, Wes Ely brings his humanity to every moment, inspiring us to reexamine our own beliefs and reimagine what is possible. He has seamlessly woven together the private stories behind the very public successes and failures of our well-intentioned ICU care. Illuminating and generous, he revisits with humility the pivotal moments of his career in this wise gift of a book.” —Rana Awdish, MD, author of In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope

About the Author

E. Wesley Ely, MD, MPH, is an internist, pulmonologist, and critical care physician. Dr. Ely earned his MD at Tulane University School of Medicine, in conjunction with a Masters in Public Health. He serves as the Grant W. Liddle endowed chair in medicine and is a physician-scientist and tenured professor at Vanderbilt University Medical Center. He is also the associate director of aging research for the Tennessee Valley Veteran’s Affairs Geriatric Research Education Clinical Center (GRECC). He is the founder and codirector of the Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, an organization devoted to research and ongoing care for people affected by critical illness. Dr. Ely has had numerous studies published in The New England Journal, JAMA, and The Lancet, and his writing has appeared in The Wall Street Journal, The Washington Post, USA TODAY, StatNews, The Daily Beast, and numerous other publications. He lives in Nashville.

Product details

  • Publisher ‏ : ‎ Scribner (September 20, 2022)
  • Language ‏ : ‎ English
  • Paperback ‏ : ‎ 368 pages
  • ISBN-10 ‏ : ‎ 1982171162
  • ISBN-13 ‏ : ‎ 978-1982171162
  • Item Weight ‏ : ‎ 10.4 ounces
  • Dimensions ‏ : ‎ 5.5 x 1.1 x 8.38 inches
  • Customer Reviews:
    4.8 4.8 out of 5 stars 528 ratings

About the author

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Dr Wes Ely
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Dr. Ely is an ICU doctor, research scientist, author, professor of medicine and critical care. His focus is on amplifying human dignity, which took on a heightened role during the COVID pandemic through his NIH-funded research protocols, advocacy for patients and families, and the writing of Every Deep-Drawn Breath. He hopes these efforts allow people a way through health crises toward healing and recovery.

Customer reviews

4.8 out of 5 stars
4.8 out of 5
528 global ratings
This book will change your mind and future life
5 Stars
This book will change your mind and future life
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 💫
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Top reviews from the United States

Reviewed in the United States on March 17, 2023
“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.
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Reviewed in the United States on October 1, 2023
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 💫
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5.0 out of 5 stars This book will change your mind and future life
Reviewed in the United States on October 1, 2023
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 💫
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3 people found this helpful
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Reviewed in the United States on November 27, 2021
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!
2 people found this helpful
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Reviewed in the United States on March 16, 2022
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
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Top reviews from other countries

Tanner
5.0 out of 5 stars Inspiring Read
Reviewed in Canada on April 16, 2024
Absolutely a must read for anyone lucky enough to be working in critical care. 10/10
Jose Mario
5.0 out of 5 stars An exciting and inspiring book!!!
Reviewed in Brazil on October 8, 2021
Doctor Wes writes a unique book, with
stories that affected me deeply. I highly recommend this outstanding book.
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Jose Mario
5.0 out of 5 stars An exciting and inspiring book!!!
Reviewed in Brazil on October 8, 2021
Doctor Wes writes a unique book, with
stories that affected me deeply. I highly recommend this outstanding book.
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Barbara Egan
5.0 out of 5 stars A raw yet heartening read. Anyone who is in contact with an ICU patient would benefit from this book
Reviewed in the United Kingdom on December 21, 2022
'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
Iggy
5.0 out of 5 stars Importance of wayfinding
Reviewed in Canada on July 3, 2022
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.
Kate Costelloe.
5.0 out of 5 stars Thought provoking.
Reviewed in Canada on November 17, 2021
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!!!