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Being Mortal: Medicine and What Matters in the End

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 endingMedicine 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 extends 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....

Title : Being Mortal: Medicine and What Matters in the End
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ISBN : 9780805095159
Format Type : Hardcover
Number of Pages : 282 pages
Url Type : Home » Being » Being Mortal: Medicine and What Matters in the End

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Being Mortal: Medicine and What Matters in the End Reviews

  • Trish

    10/27/17 The most remarkable discussion of this book takes place between Atul Gawande and Kristin Tippett in the 10/26/17 podcast posted on the OnBeing website. In the discussion we learn that Gawande went to medicine through politics which may not surprise some of you. I had a radical insight as I listened: that doctors, by oath, are meant to provide life-giving care to rich and poor alike, without discrimination. Does that lead almost directly to the discussion about whether healthcare is a ri

    "The only way death is not meaningless is to see yourself as part of something greater: a family, a community, a society. If you don’t, mortality is only a horror."


    My great aunt lived to be 102 years old. She would often say, looking at the younger generations, "It’s wonderful to get old." Gawande touches on this in his memoir chronicling the death of his father and in his discussion of dying well. Older folks have more moments they classify as happy than do younger folks. Oldsters generally experience less anxiety, too, perhaps from having “seen it all before,” but perhaps also because they know bad times do pass. Usually.

    I still think my great aunt was being just a little facetious, since the rest of Gawande’s book tells us pretty explicitly that old age is not for wimps. In fact, as Elizabeth Gilbert suggested in her novel The Signature of All Things, we do better when we turn towards “the great changes that life brings” rather than turn our wills away. Gawande tells us how it is possible in some cases to choose less treatment rather than more when faced with life-threatening illness and experience a better quality of life in our final days.

    This is pretty grim stuff but Gawande is graceful, as graceful as he can be when the choices are so limited and so frankly horrible. When a loved one (or we ourselves) must make choices, it is wise, he counsels, to ask ourselves a few questions: What do we fear most? What do we want most to be able to do? What can/can’t we live without? What will we sacrifice so that we can accomplish what it is we want? Our choices may change as circumstances change, so one has to revisit occasionally, to make sure we (and our family and our doctors) are proceeding along the path we have chosen for ourselves.

    It is almost, but perhaps not quite, enough to make one wish for a sudden, early death. We all must go through it, so we’re not alone. It’s just that medical knowledge, technology, and skill can do only so much, and after that we still have to face the inevitable. Gawande gives lots of examples of patients and of people he has known who have these choices thrust upon them. On balance, he concludes, those who accept, rather than thoughtlessly fight, a terminal prognosis have a better death.

    This book is worth reading, maybe more so before you need it. Filling out the hospital’s required “health care directive” is actually difficult unless you have someone like this to explain what it actually means. No intervention may mean weeks instead of months; it may also mean calm instead of recovering from radical surgery. It may just be unbearably depressing. I get that.

    One interesting study Gawande talks about is one in which people who know their time horizons are short, or who experience life-threatening conditions (e.g., living in a war zone, 9/11, surviving a tsunami) change their view of what they want out of life, their "hierarchy of needs" as defined by Maslow. People with unlimited horizons put a high premium on growth and meeting people who are interesting and influential. Those with foreshortened horizons look to their closest friends and family for sustenance and comfort. War zones may not grant you friends or family, but certainly intense, highly-charged, and memorable relationships result from them. Little is expected, much is granted. And I guess that is key. There is more generosity to go around when one is in the final days and it may be best not to occlude that blessing with a confusion of treatments that do not mean a better life.

    Gawande addresses some of the most difficult questions we have to decide in a lifetime. It is not easy to read. But it helps, I think, to know what choices we can make when the time comes for someone we love or for ourselves.

    ---------------------------------------------

    Months later.

    I have been thinking about the first quote I put at the beginning of my review since I read it. I wonder if that is not quite right. It is not mortality that is a horror if one is not part of a larger group. It is life itself. ...more

  • Rebecca Foster

    An essential guide to decision-making about end-of-life care, but also a more philosophical treatment of the question of what makes life worth living. When should we extend life, and when should we concentrate more on the quality of our remaining days than their quantity? Most of the book weighs the plight of the elderly (it’s not just grim nursing homes out there), but there are also plenty of illustrative cases about the terminally ill. The “Letting Go” chapter is among the best; it grew out o ...more

  • Jen

    Simply put: This is a book about dying. But, on one's own terms. Gawande boldy argues that the medical world has got it wrong when it comes to the treatment of the dying. The objective of medicine should not be to ensure health and survival; rather it should be about the quality of life and what it means to die with dignity, a sense of purpose, and most importantly, control over one's life. It's about being able to write the final chapter the way you want to and to enable well-being in the sense ...more

  • Will Byrnes

    (Added a link - 4/18/15 - at bottom)

    In the past few decades, medical science has rendered obsolete centuries of experience, tradition, and language about our mortality and created a new difficulty for mankind: how to die.
    Being Mortal is completely irrelevant for any readers who do not have elderly relations, do not know anyone who is old or in failing health, and do not themselves expect to become old. Otherwise, this is must-read stuff. Life may be a journey, but all our roads, however long ...more

  • Erika

    This is a brilliant, fascinating, and extremely important book. I wish I had read it before my mother died because I would have asked her more probing questions about her priorities in the last couple of months of her life.

    Yet while Being Mortal made me regret the conversations I didn't have with my mom, I also came away feeling optimistic about the possibility for much-needed change in the way we think about age and dying in our culture.

    Gawande is an influential author, journalist, researcher
    ...more

  • Josh

    As I sit here at work, basically doing nothing but typing this review and speaking to my fiancé on Microsoft Lync, I am drinking a cup of coffee and wondering about my mortality.  Yes, I admit, I usually think of it more than once a day, sometimes twice a day, but never 4.5 times a day because that’s actually impossible.

    When reading Gawande’s ‘Being Mortal’, I found myself not questioning my own life, but many others; he exposed a sense of compassion in this misanthropic heart and how the geriat
    ...more

  • Ken

    Anyone who is planning on dying some day should read this book.

    It can be jumpy at times, but overall, Gawande's a straight shooting, no-nonsense writer who gives the straight dope on nursing homes, assisted living, hospice, and the heart-rending decisions we are all forced into at our end-of-days.

    As many of his accounts deal with cancer cases, it's a bit of a downer, but it's medicine to be taken and there's no better way to illustrate his point than through real-life examples, including his o
    ...more

  • Lisa Vegan

    This book is excellent. It’s accessible and always interesting. It’s one of those books that probably everybody should read. I’m thinking every physician should read it upon graduating from medical school or during their residency. I think that it’s an important book.

    I do disagree with him at times, though overall think what he says is spot on.

    The parts where I disagree are in two major areas: The main one is his reluctance about supporting widespread assisted suicide because he says in those pl
    ...more