Friday, May 8, 2015

Being Mortal: Medicine and What Matters in the End


Being Mortal: Medicine and What Matters in the End
by Atul Gawande
Metropolitan Books, 2014
297 pages
source: library

"This is a book about the modern experience of mortality - about what it's like to be creatures who age and die, how medicine has changed the experience and how it hasn't, where our ideas about how to deal with our finitude have got the reality wrong." 

Summary (from goodreads):

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.

My thoughts:

Let me be very clear about this - Being Mortal  was not an easy book to read. It challenged me to think about things I'd rather not think about. But I'm certain it will be the most important book I read this year.

It raises important issues about aging, death, and the role of modern medicine. Consider this:
"Medical professionals concentrate on repair of health, not sustenance of the soul. Yet - and this is the painful paradox - we have decided that they should be the ones who largely define how we live in our waning days. For more than half a century now, we have treated the trials of sickness, aging, and mortality as medical concerns. It's been an experiment in social engineering, putting out fates in the hands of people valued more for their technical prowess than for their understanding of human needs." 
It is important, for both physicians and family members, to remember that:
"People with serious illness have priorities besides simply prolonging their lives. Surveys find that their top concerns include avoiding suffering, strengthening relationships with family and friends, being mentally aware, not being a burden on others, and achieving a sense that their life is complete. Our system of technological medical care has utterly failed to meet these needs..." 
That certain measures to prolong life may, in fact, be shortening or worsening whatever time remains often goes unnoticed.

Gawande suggests the posing the question, "If time is short, what is most important to you?"   This could be the perfect starting point for a hard conversation with loved ones or a discussion with health care providers. It's a worthy springboard for deep soul-searching as well.

According to Gawande, as a society
"We've begun rejecting the institutionalized version of aging and death, but we've not yet established our new norm. We're caught in a transitional phase." 
And finally,
"We've been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being."
Amen.

And I've only scratched the surface. There is so much worthy of discussion - with your spouse, your parents, your adult children, and even your book club.

Please... make time to read Being Mortal. You won't be sorry.

My rating:

22 comments:

  1. Thanks for your review JoAnn. This sounds like an important and helpful book to read. The death of a loved one is difficult time. I think reading this book will help put more into perspective.

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    1. Pat - It's definitely an important book! There is much more here than just end-of life issues. It also talks a great deal about maintaining the quality of life as a person ages.

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  2. This does sound like an important book. I've always felt the treatments they gave my mother in law at the end of her life severely decreased the quality of the time she had left.

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    1. Kathy - I think many people can say the same about the end of their loved one's lives. That's where the question of "If time is short, what is most important to you?" comes in.

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  3. Important issues to discuss; this book sounds like a good handling of it.

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    1. Care - Gawande's discussion makes so much sense... very well done!

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  4. I second your recommendation. This book has many, many important topics and lots of things to think over and discuss. No one likes to think about end of life issues, but we are all mortal. One day, the end will come. What indeed is most important to you and what do feel about quality of life vs. quantity? That's a place to start the thinking process.

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    1. Kay - There are SO many issues addressed in this book! And he handles them all so well. Thank you again for your wonderful review... not sure I would have gotten around to reading it so soon without the extra nudge from you and Les.

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    2. Should b!e required reading for everyone, don't you think? Not an easy topic, but so important

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    3. Les - Definitely! I'll be buying a couple more copies to give away.

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  5. This book is in my TBR pile. It is such a difficult subject that it's made it easy to put off reading. But your review makes me want to get started on the book.

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    1. Monica - Nobody really wants to read a book like this, but it is so important to think about these issues before we need to make a quick decision (of our own or for a loved one)

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  6. I've seen this book in bookshops. Thanks for your review, it's certainly an important book and thought-provoking. But as you've mentioned too, must be a difficult book to read.

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    1. Arti - It is no fun at all to read, but you'll still be glad you did :)

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  7. Everyone strongly recommends reading this one and it's on my list. I don't think I am ready to read it but then I doubt I will ever be ready to read it.

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    1. Athia - There really is no good time to read this, but perhaps now is not the best time for you ;-)

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  8. I've been a big fan of Gawande for 20 years - he should be given a free hand to reform the USA's health system. A wonderful, thoughtful person and a good writer.

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    1. GSGreatEscaper - I've been aware of Gawande for some time and read his columns occasionally, but this was my first exposure to his books. His earlier titles are now on my wish list!

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  9. Wow. Great review JoAnn! Modern medicine in this country is so backward on many levels, this one included. I think this would be a good one for me to read with my mother :)

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    1. Thanks, Stacy! This is such an amazing book. I've convinced my book club to read it this fall.

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  10. Tough subject matter. A somewhat related book is The End of Your Life Book Club, which is excellent.

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    1. Terra - Yes, very definitely tough subject matter, but I highly recommend it. I listened to The End of Your Life Book Club and though it was great, too!

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