Medicine and What Matters in the End
By: Atul Gawande
Published: October 7, 2014
Publisher: Metropolitan Books
Non-Fiction
I learned a lot about dying during my time working in Hospice. I saw families so overcome with grief that I wasn't sure how they could go on. But, I also saw relief in some families, realizing the pain, suffering, and constant caregiving was behind them. Death is a personal experience that every person handles differently and that experience for both the patient and caregiver can depend on their faith, their life experiences, their family or lack of family support, and also how the medical profession has communicated with them about the reality of death and the process ahead of them. Atul Gawande, a well-known surgeon, and son of a well-known surgeon chronicles the many aging patients he has examined, as well as his father's declining health. He also examines the many ways our lives are extended to due medicines not available even ten years ago.
After seeing multiple reviews raving about this book and calling it a must-read for anyone with aging parents, I decided to pick it up. Reading BEING MORTAL was an eye-opening and convicting look into medicine and what lies ahead for each of us in our life-extending world of medical care. Whether you are reading this as a member of the aging population or as a child of aging parents, this book will make you stop and question how you want to direct medical care for your future and those of your family.
Some of the fascinating information in the book was related to the history of nursing homes. The level of care has changed astronomically since the very first facilities opened. In 1983, it took an aging mother and a daughter studying gerontology to come up with the idea that many of us see today, a "living center with assistance" for the elderly. This concept of assisted living began the idea of no one ever feeling like they were institutionalized. Thousands of people have been able to live independently for years because of the creation of this nursing home concept.
Most of us don't want to think about the years ahead of us where we will no longer be able to live independently. We ignore our parent's shaking hands or unsteady gait because having the conversation is too overwhelming. It's easy to take a few tasks off their hands to allow them to keep getting by. But, frankly, most of the time, many are unprepared for the idea of needing help and our parents refuse most offers of assistance until it's usually too late to do anything about it.
In many cases, those in the medical field are looking so closely at the ailments and how to fix them rather than focus on how we can maintain a quality of life. Usually trying to fix the multiple ailments makes matters worse for the patient. Ultimately, medical professionals must decide "which mistake they fear most - the mistake of prolonging suffering or the mistake of shortening valued life." page 244.
I know too well how the word “dying” or “death” is avoided by doctors and families alike. Gawande believes if we were allowed to live while dying, and being honest about how we want those days to look, the medical care should reflect those desires, even if it goes against our internal need to “save them”.
Most of us don't want to think about the years ahead of us where we will no longer be able to live independently. We ignore our parent's shaking hands or unsteady gait because having the conversation is too overwhelming. It's easy to take a few tasks off their hands to allow them to keep getting by. But, frankly, most of the time, many are unprepared for the idea of needing help and our parents refuse most offers of assistance until it's usually too late to do anything about it.
In many cases, those in the medical field are looking so closely at the ailments and how to fix them rather than focus on how we can maintain a quality of life. Usually trying to fix the multiple ailments makes matters worse for the patient. Ultimately, medical professionals must decide "which mistake they fear most - the mistake of prolonging suffering or the mistake of shortening valued life." page 244.
I know too well how the word “dying” or “death” is avoided by doctors and families alike. Gawande believes if we were allowed to live while dying, and being honest about how we want those days to look, the medical care should reflect those desires, even if it goes against our internal need to “save them”.
Ultimately, Gawande hopes that sharing his knowledge with others and creating a conversation about "death" and "dying", will allow the medical professionals to be more comfortable in having those conversations. The patient is then allowed to write their own life story. As the aging patient, we can have the freedom to shape our final years based on what is important to us and if our body betrays us, then we have laid out the course of treatment that fits best with our needs and desires.
This isn’t a happy read, as death marks many of his patient’s stories. But, it will offer you a chance to reflect on what is truly important to you in the rest of your life. Whether you leave this Earth without any notice or after struggling through an illness, Gawande wants to be sure you have made choices, shared them with those you love, and lived each day to its fullest potential.
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| Atul Gawande - source |
Atul Gawande is an author of three bestselling books: Complications, a finalist for the National Book Award; Better, selected by Amazon.com as one of the ten best books of 2007; and The Checklist Manifesto. His latest book is Being Mortal: Medicine and What Matters in the End.
He is also a surgeon at Brigham and Women’s Hospital in Boston, a staff writer for The New Yorker, and a professor at Harvard Medical School and the Harvard School of Public Health. He has won the Lewis Thomas Prize for Writing about Science, a MacArthur Fellowship, and two National Magazine Awards. In his work in public health, he is Executive Director of Ariadne Labs, a joint center for health systems innovation, and chairman of Lifebox, a nonprofit organization making surgery safer globally. He and his wife have three children and live in Newton, Massachusetts. For more information, check out his website, HERE.
He is also a surgeon at Brigham and Women’s Hospital in Boston, a staff writer for The New Yorker, and a professor at Harvard Medical School and the Harvard School of Public Health. He has won the Lewis Thomas Prize for Writing about Science, a MacArthur Fellowship, and two National Magazine Awards. In his work in public health, he is Executive Director of Ariadne Labs, a joint center for health systems innovation, and chairman of Lifebox, a nonprofit organization making surgery safer globally. He and his wife have three children and live in Newton, Massachusetts. For more information, check out his website, HERE.
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