by Atul Gawande.
Publication date: October 2014
Category: nonfiction; medicine, end of life, long-term care
Summary (from the publisher):
In Being Mortal, bestselling author Atul Gawande tackles the hardest challenge of his profession: how medicine can not only improve life but also the process of its ending.
Medicine has triumphed in modern times, transforming birth, injury, and infectious disease from harrowing to manageable. But in the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit. Nursing homes, preoccupied with safety, pin patients into railed beds and wheelchairs. Hospitals isolate the dying, checking for vital signs long after the goals of cure have become moot. Doctors, committed to extending life, continue to carry out devastating procedures that in the end extend suffering.
Gawande, a practicing surgeon, addresses his profession’s ultimate limitation, arguing that quality of life is the desired goal for patients and families. Gawande offers examples of freer, more socially fulfilling models for assisting the infirm and dependent elderly, and he explores the varieties of hospice care to demonstrate that a person’s last weeks or months may be rich and dignified.
Full of eye-opening research and riveting storytelling, Being Mortal asserts that medicine can comfort and enhance our experience even to the end, providing not only a good life but also a good end.
Being Mortal: Medicine and What Matters in the End is a beautifully written, thoughtful, moving, and important book that will profoundly influence the way that you think about how America (and the rest of the rich world) manage the debility that comes with aging, and the separate (but related) issue of how the health care system fails people who are dying. It’s a must-read for anyone with aging parents, or anyone who hopes to grow old, and also for physicians.
While many books have been written about these issues, Gawande’s book stands out for his brilliant writing and the book’s superior editing. Many different strands of thought and story are woven together into a compelling, coherent whole that I read in a single sitting.
First, Gawande covers the origin of “nursing homes” and the more recent “assisted living” movement. With excellent stories and insight, he explains the fundamental tension between what the system thinks the elderly want–safety, security, food, medicine–and what actually makes people happy–the power to make their own choices and live their own lives.
In the second part of the book, he delves into the way modern medicine drives ever-more interventions and treatments and procedures at the end of life, even when this medicalization of dying diminishes the quality of what life remains. He makes a compelling argument for how doctors (and patients) should be talking to each other to help the dying achieve the kind of end they really want.
Along the way, the author’s anecdotes from his own practice as a surgeon are illuminating, but none approach the power of his own story. Gawande walked this path himself, at his parents’ side, when his father was diagnosed with a spinal tumor. His portrayal of this very personal journey has something to teach us all–and will elicit more genuine emotion than any novel.
A page-turning, beautiful, important book that won’t take you long to read but will empower you and give you much to think about. Highly recommended.