Lara Goitein - The ICU Guide for Families: Understanding Intensive Care and How You Can Support Your Loved One

Dr. Lara Goitein is a Harvard-trained physician specializing in pulmonary and critical care medicine who has worked as a doctor in intensive care units for 12 years. Currently she is President-Elect of Medical Staff at Christus St. Vincent Regional Medical Center in Santa Fe, New Mexico, and founding medical director of a hospital quality program called Clinician-Directed Performance Improvement. She is on the editorial board and is a frequent writer for the medical journal JAMA Internal Medicine, and is a reviewer for its series Physician Work Environment and Well-Being. Dr. Goitein also writes for the lay press, including an article in the New York Review of Books called, Training Young Doctors: The Current Crisis. Her professional interests include measuring and improving healthcare quality, physicians professional well-being, graduate medical education, the effects of the financial environment on the teaching and practice of medicine, and care at the end of life. She is a graduate of the Intermountain Advanced Training Program in Healthcare Delivery Improvement. Dr. Goiteins work in quality improvement at Chris-tus St. Vincent Regional Medical Center has received national attention: she was a speaker at the IHI/NPSF Patient Safety Congress in Boston in May of 2018, and recently wrote an article about the quality improvement program she directed in Health Affairs. Right now, Dr. Goitein is taking a break from clinical practice, and is home with her two sons while they do online school, in Santa Fe, New Mexico.

I would like to thank my three readers for their generous gifts of time and insight. Im profoundly grateful to my brother-in-law, Jerry Hauser. His thoughtfulness and ability to empathize with imagined family members in the ICU, no doubt sharpened by his own recent experiences, were invaluable. My colleague Dr. Susan Pasnick once again proved herself one of the smartest and most knowledgeable ICU doctors I know it is immeasurably reassuring to have had her expert eyes on this project. And last but not least, my mother, Dr. Marcia Angell, brought the same elegance, heart, intelligence, and perfect grammar with which she has edited my writing since I was five years old. Not everyone is lucky enough to have an editor-in-chief of the New England Journal of Medicine as a mother, and Marcia Angell, at that. I would like to thank my many mentors and teachers of ICU medicine, including Dr. Taylor Thompson, Dr. Mark Tonelli, Dr. Gordon Rubenfeld, Dr. J. Randall Curtis, and Dr. Leonard Hudson. It is amazing to see that the most interesting things being written about ICU medicine are now being written by the kids with whom I trained, including Dr. Jeremy Kahn and Dr. Catherine Lee (Terri) Hough now they are my teachers, too. I greatly appreciate the tutelage of Ms. Wanda Jiron in issues pertaining to hospital billing. I would like to thank my wise agent, Ms. Alice Martell, and my publishing editor Ms. Suzanne Staszak-Silva. Finally, thanks to my husband, Tom Burdick. He is also a doctor, and contributed his intelligence and experience to these pages during many conversations at the dinner table. He helped me to carve out the time for this project with his typical warm generosity, good humor, and enthusiasm.

Use the table on the next page as a guide to questions for nurses and doctors that may help to prevent typical complications of ICU care.

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