Love and Mercy in the ICU (with Dr. Wes Ely)

The ICU can be a traumatizing place for patients, who are frequently heavily sedated, rendered unable to speak by breathing tubes, isolated by family visit limitations, and sometimes even physically restrained. In fact, a significant proportion of patients discharged from the ICU later develop persistent cognitive impairments and physical disabilities. Over the past two decades, Dr. Wes Ely has worked to improve the care of patients in the ICU, leading landmark studies resulting in the development of delirium prevention protocols that are now adopted in ICUs everywhere. Today, Dr. Ely co-directs the Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center at Vanderbilt University Medical Center. In this episode, Dr. Ely joins us to share his career-long fight to reform ICU medicine and to recount poignant stories that illuminate and elevate the humanity of patients amid the chaos of the ICU — and in the process discusses themes that seldom appear in contemporary medical discourse, such as love, beauty, and mercy.

In this episode, you will hear about:

• How Dr. Ely discovered medicine as a calling while growing up in rural Louisiana - 2:33
• How a fascination with cardiopulmonary physiology, combined with an interest in patient relationships, led Dr. Ely to critical care medicine - 4:27
• A discussion of how patients in ICUs can often be “de-humanized” - 6:31
• A story from early in Dr. Ely’s career that illustrates “malignant normality” — when treatment norms led to patient harm - 10:40
• A discussion of physician burnout and how the dehumanization of patients contributes to it - 13:27
• What Dr. Ely and his colleagues have learned through years of research about the harmful standard practices of ICU care - 18:53
• An explanation of the ABCDEF treatment bundle designed by Dr. Ely and his collaborators to improve outcomes of patients in the ICU patients - 24:04
• How Dr. Ely processes the guilt and shame he feels from the harm he inadvertently caused to patients early in his career - 29:37
• Reflections on how eye contact, physical touch, and openness of the heart are essential to good medicine - 36:03
• A discussion on how Dr. Ely’s spirituality has influenced his approach to patient care - 44:51
• What it means to provide healing when patients are facing serious illness, even at the end of life - 50:45

Dr. Wes Ely is the author of Every Deep-Drawn Breath, a chronicle of his experiences caring for ICU patients.

You can find out more about his work at ICUDelirium.org

Follow Dr. Ely on Twitter @WesElyMD

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

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