Lara Goitein, M.D. is all about covering bases with the release of her new book. It’s titled The ICU Guide for Families: Understanding Intensive Care and How You Can Support Your Loved One, and as the words suggest concerns navigating the ICU world. Dr. Goitein fancies herself something of a guide for such a world, courtesy of her experience and work as a clinician for twelve years. “The intensive care unit (ICU) is an intimidating place, overwhelming to most people on the outside.

This book is for anyone who is suddenly immersed in this frightening world because a family member or close friend needs care there. Its purpose is to tell you in direct and simple language what you need to know to navigate this new world, and to be an effective advocate for the person you love. My hope is that a friend, doctor, or the hospital will give you the book at the beginning of your journey, and that it will come with you each day and keep you company in the ICU waiting room,” she writes in the book’s introduction. “…Even before the COVID-19 pandemic, many of us directly or indirectly had some experience with ICUs. About four million people in the United States are cared for in an ICU each year, and more than a fifth of everyone who dies in the country will do so after an ICU admission.

Tragically, the pandemic has increased the chances that many more of us will experience ICU care. COVID-19 raises some special issues, such as visitation and infection control policies, which are discussed in chapter 5 of this book – but for the most part, the ICU experience is similar for patients with or without COVID-19.”

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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.

Sometimes it even requires the abandoning of typical familial relations, and overall expectation. “I have seen the ICU be the catalyst for reunions of profoundly disrupted families,” Goitein writes. “On one occasion, my patient, an elderly woman, was dying from sepsis. Her son had been in jail for many years after murdering his own abusive father in order to protect his mother from domestic violence. I arranged to have him escorted from jail to be at his mother’s bedside during her death. I do not know the details of what transpired between this man, his mother, and his several siblings and other relatives who were present over the course of that long night – but I do know from the tears and embraces that it was a time of closeness and forgiveness.”

Garth Thomas