ICU events are not uncommon but knowing what to do when a loved one is placed there is. This work explores the ICU with an eye toward guiding families to getting the best care for their beloved patient
Intensive care will touch almost all of us at some point – whether directly, or through our families and or friends. This book is for every family of patients in the ICU, who have suddenly entered an intimidating and alien world, in which they feel powerless and out of control. In simple, direct language, Lara Goitein, MD, gives clear explanations of all aspects of intensive care – what all those lines and tubes are; common conditions such as sepsis and acute respiratory distress syndrome (ARDS); physical changes in patients and what they mean; common procedures and their risks and benefits; and the people and the culture of the ICU. One full section of the book is devoted to Covid-19-specific issues.
In addition, the book provides concrete advice for how family members can be effective advocates on behalf of their loved ones –what to know before giving consent for procedures, how to interact with ICU staff, how to help the ICU team guard against common complications of ICU care, and how to approach important decisions about end-of-life care. Along the way, the author gently reminds of us of what, in the end, matters most in the ICU.
For readers who may be distracted and exhausted, this is a clear, accessible guide with concrete recommendations for getting the best care and asking the right questions along the way. A compassionate resource in a time of extreme stress, this book offers support to anyone touched by an ICU stay.
Lara Goitein, MD, is a physician specializing in pulmonary and critical care medicine, and has practiced in ICUs for twelve years, including at the Massachusetts General Hospital (Boston, MA), Intermountain Healthcare (St. George, Utah), University of Washington Medical Center and Harborview Medical Center (Seattle, WA), Group Health Cooperative of Puget Sound (Redmond, WA), Presbyterian Hospital (Albuquerque, NM), and most recently at Christus St. Vincent Regional Health System (Santa Fe, New Mexico). In this capacity she has cared for thousands of patients and supported their families through their ICU stays. During the last five years, Dr. Goitein designed and implemented a novel hospital quality program. She is one of sixteen members of JAMA Internal Medicine’s editorial board and serves as a frequent reviewer and guest editor for that journal. She has been published frequently in leading medical journals as well as mainstream media outlets.
1. The first 24 hours
2. The first 3 days
3. The first 2 weeks
4. Common procedures for ICU patients
5: COVID-19-specific issues in the ICU
6: After the first 2 weeks: Prolonged ICU care and big picture decisions
7: Dying in the ICU
8: Surviving the ICU
Conclusion: How will you be?
Appendix: Supporting prevention of complications: Daily questions for ICU team
About the Author
The intensive care unit can be an intimidating and frightening place. Dr. Goitein, who has
practiced medicine in intensive care settings, has created a very practical guide to help family and friends advocate and care for their loved ones there. She begins by noting that they will spend a great deal of time waiting. She then discusses the various medical staff members and their roles, including, most importantly, who is actually in charge of the patient’s care. She covers visiting times and protocols, common medical procedures, and all the monitors, alarms, and machines that sustain life, including diagrams. The author then deals with the difficult situation of long-term ICU stays, death, and dying. She also explains post-ICU care and rehabilitation. Being an advocate for the patient is vital, and Dr. Goitein tells readers how to do this: have a copy of current medical records and advance directives, and know when to ask questions. She also notes the importance of self-care for the family and discusses the financial aspects of intensive care. This is an excellent resource for public and consumer health libraries.
Even before COVID-19, millions of Americans needed ICU care each year, and the majority of them survived. But we’ve never had, until Dr. Lara Goitein wrote this book, a clear and compassionate handbook for how to understand, much less negotiate, the ICU. From COVID to catheters, the business of saving imperiled lives is rendered here in straightforward (and often, poetic) terms, which reminds us that all those drawing breath should be familiar with what occurs in an ICU. This is the book that makes that possible.
Lara Goitein has produced an essential guide to one of the most difficult journeys through the one of most difficult wards in any hospital—the Intensive Care Unit. As an intensive care doctor herself, she is the perfect guide to provide the perspective, compassion, and acceptance that families and patients need as they navigate this intense journey.
With our aging population and now with Covid, more and more people are experiencing a stay in a hospital’s intensive care unit. While all of us have seen the inside of an ICU on TV shows and movies, actually having a family member in “the unit” is one of life’s most disorienting experiences. Who are all of these people? What are they doing? What is that machine? And, most importantly, what will happen to my loved one? In The ICU Guide for Families, intensive care physician Lara Goitein manages to demystify the ICU in a way that balances technical accuracy with true compassion. It is a must-have resource for families who find themselves anxiously trying to navigate this unfamiliar world.
There is no more overwhelming and isolating experience than having someone you love surrounded by machines in an ICU. In The ICU Guide for Families, Dr. Goitein combines an insider’s experience, a teacher’s patience, a writer’s clarity, and a physician’s compassion to provide readers with all of the information I wish I, as a doctor at the bedside, had the time or the skills to give myself. But you need to read this book before you need to read this book. Read it if you are having a serious operation. Read it if you are talking to a parent about their wishes for intensive care. Read it if someone you love has someone they love who is sick in an ICU.
It’s not necessarily an easy read. But suffice to say, you will have the most ideal guide in Dr. Goitein, and the writing choices and descriptors she employs.
Merely the mention of the Covid-19 pandemic adds a chilly note to any proceeding, literary or otherwise. But with the tonalities measured and balanced in Dr. Goitein’s The ICU Guide for Families, such a mentioning seems just worldly. It folds seamlessly into the fabric of the read, ironically a comfort in the sense it feels Goitein analyzes everything relevant to the modern-day, hypothetical ICU scenario. She isn’t afraid of describing, or ever shies away from the ramifications of, the potential pitfalls and bumps along the way. Yet every example is often countered by the presence of genuine silver linings. It reinforces that dealing with the sickness of a loved one is never a clear-cut deal.
11/14/21, Santa Fe New Mexican: Dr. Lara Goitein wrote an op-ed about what it means to ration care and the book is mentioned.
11/20/21, Healthystic: Dr. Lara Goitein wrote an article offering advice on making difficult decisions for a loved one in the ICU.
12/1/21, Authority Magazine: Dr. Goitein was interviewed about the five things we need to do to improve the US healthcare system.