Listen: An ICU physician on the moral dilemmas mechanical ventilators can raise

On the day in 1928 when the inventors of the iron lung wheeled their contraption into what is known today as Boston Children’s Hospital, they likely had one thing on their minds: saving the lives of children with polio. And that they did. For the first time in human history, the inability to breathe on one’s own stopped being an immediate death sentence.

But Philip Drinker and Louis Agassiz Shaw Jr., were also aware of a darker side of these machines and their successors: people with persistent critical illnesses — like those with Covid-19 today — tethered to ventilators for weeks, if not longer, living in a “twilight existence” of being kept alive by a machine.

This week on the “First Opinion Podcast,” intensive care physician Hannah Wunsch explores the history of mechanical breathing, the countless lives it has saved, and the moral dilemmas it created that have only grown with the technology.

“Once you’re in the ICU and having these problems, all kinds of other problems happen as well,” Wunsch said. “Fundamentally, it’s up to the body itself as to whether, ultimately, with all of that time and support, it’s going to strengthen or not. And unfortunately, often it doesn’t.”

The conversation stems from Wunsch’s First Opinion essay, “That ‘damn machine’: the dark side of mechanical ventilators in the ICU.”

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