Intensive Care

January 2026. During the recent holidays, families gathered to spend time together and enjoy the seasonal celebrations in their chosen traditions. For many of us, these are happy times, with work and woes set aside as much as possible. But illness, alas, does not honor the holiday calendar. Probably for most of us, the dinner table conversations included status reports on, let’s say, how Uncle Eddie’s cancer treatment is going, how well mom is recovering after her fall, how grandpa is faring in the retirement home given his worsening Alzheimer's, whether Aunt Tillie’s brittle diabetes has stabilized, and the list goes on. Everything gets turned upside down, no matter the season, when a family member suddenly develops a life-threatening condition. It could be a stroke, a heart attack, a head injury from a fall, or a terrible traffic accident. 911 sends the ambulance, someone hustles with the patient to the Emergency Department, and if luck holds and there’s a bed, the patient is admitted to the intensive care unit (ICU). Many of us in medicine have “done time” in the ICU, even if just a rotation while a student or in residency training. In my case, it was when I was a newly hatched psychiatrist on active duty in the Air Force, posted at the hospital at Andrews, where we were required to serve as general medical officers for rotations in the ER and ICU. But that was long ago, and it’s a mere drop in the bucket compared with the day-after-day work of the heroic medical team in today’s ICU. With the cacophony of alarms, beeping monitors, and intermittent CPR, moments of calm are rare. Here’s what can, paradoxically, get overlooked: What is it like to be a patient in one of those ICU beds, perhaps for weeks? Or to be a close relative of someone on the ventilator whose life-or-death status is touch-and-go? And in particular, for the fortunate ones who recover, are there lingering medical concerns from the ICU experience itself? In this issue of the Journal, Torncello and colleagues present a “primer” for the practicing psychiatrist focusing on a crucial aspect of the world of intensive care: the post-intensive care syndrome (PICS). They point out that “psychiatric morbidity following critical illness is associated with worsened physical functioning, increased mortality, and lower quality of life,” and that “psychiatrists occupy a key role in the multidisciplinary management of PICS.” Among ICU survivors, an estimated 54% experience PICS, involving ongoing medical issues, cognitive impairment, and psychiatric morbidity that can last for months and even years. The need for follow-up collaborative care involving a multidisciplinary team that includes outpatient psychiatrists is now well-established, although not always recognized.