Review: Being Mortal by Atul Gawande
Being Mortal: Medicine and What Matters in the End
by Atul Gawande
Medicine has made astonishing advances in the past century, and it is capable of extending life far beyond expectations ten, twenty, or fifty years ago. But is extending life the best decision when it comes at the sacrifice of the quality of life? That is the question explored by Atul Gawande as he describes both the successes and the limits of medicine. He describes the slow decline of age, as the worlds of the ailing cave in. First they can no longer drive; than they can no longer care for themselves. In some cases, they can live with relatives or in an assisted living home for a time; for others, they go straight to a nursing home. Gawande also looks at the terminally ill, comparing palliative care with hospice. Ultimately, he encourages readers to ask the hard questions: to ask at what point the quality of life becomes so poor that it would not be not worth continuing to fight. He also reminds readers that doctors are human and don’t always know the answer. When they do know the diagnosis is not what patients will want to hear, they might soften the blow and give false hope. With many examples from his practice, including watching his own father’s heartbreaking decline, Gawande asks readers to contemplate their ends with compassion and awareness.
This isn’t the easiest book to read, but it’s necessary. My parents are getting older; they’re at the upper age range of the Baby Boomer generation, after all. I hope they have many years left, but it seems important that I know what could happen. Before they become too enfeebled to care for themselves, we need to have a conversation about what their expectations will be should they fall ill or otherwise incapacitated. Do they expect me to care for them? Will they willingly go into a nursing home? Do they want to live constantly plugged into a machine, or would that be intolerable? If they are unable to speak for themselves, at one point should I tell doctors, “No, it’s OK to stop treatment.”?
I learned a lot from this book about the different kinds of care out there for the ailing. I mean, I knew about nursing homes, of course, but there are so many kinds of assisted-living programs and pilot programs for new kinds of nursing homes. It made me hopeful that the nightmare scenario my parents dread (they’ve both said before that they absolutely don’t want to go to a nursing home) will not be so bad by the time they reach a point where we have to discuss it. The book also helped demystify many of the questions I’ve had about hospice care, and made it seem much less threatening and scary.
The personal stories illustrated Gawande’s points really well. You could really sense his conflict and pain as he dealt with his ailing father, trying to use the techniques that he was learning to use on patients, but struggling to do so because it’s his father, a man he’s admired all his life. It’s really sad to see his patients rage against their diagnosis, and heartbreaking to witness their decline. But I appreciate their examples, which honor the memories of those who have died by helping the living prepare for their own eventual end.
5 out of 5 stars
To read more about Being Mortal, buy it or add it to your wishlist click here.
Peeking into the archives...today in:
2014:
2013: The Resurrectionist by E. B. Hudspeth
2012: Fashionista Piranha on hiatus until May 24th...
2011: Bending the Boyne by J. S. Dunn
2010: New York City Library & Improv Everywhere Bust Some Ghosts
2009: Museum of Human Beings by Colin Sargeant
by Atul Gawande
Medicine has made astonishing advances in the past century, and it is capable of extending life far beyond expectations ten, twenty, or fifty years ago. But is extending life the best decision when it comes at the sacrifice of the quality of life? That is the question explored by Atul Gawande as he describes both the successes and the limits of medicine. He describes the slow decline of age, as the worlds of the ailing cave in. First they can no longer drive; than they can no longer care for themselves. In some cases, they can live with relatives or in an assisted living home for a time; for others, they go straight to a nursing home. Gawande also looks at the terminally ill, comparing palliative care with hospice. Ultimately, he encourages readers to ask the hard questions: to ask at what point the quality of life becomes so poor that it would not be not worth continuing to fight. He also reminds readers that doctors are human and don’t always know the answer. When they do know the diagnosis is not what patients will want to hear, they might soften the blow and give false hope. With many examples from his practice, including watching his own father’s heartbreaking decline, Gawande asks readers to contemplate their ends with compassion and awareness.
This isn’t the easiest book to read, but it’s necessary. My parents are getting older; they’re at the upper age range of the Baby Boomer generation, after all. I hope they have many years left, but it seems important that I know what could happen. Before they become too enfeebled to care for themselves, we need to have a conversation about what their expectations will be should they fall ill or otherwise incapacitated. Do they expect me to care for them? Will they willingly go into a nursing home? Do they want to live constantly plugged into a machine, or would that be intolerable? If they are unable to speak for themselves, at one point should I tell doctors, “No, it’s OK to stop treatment.”?
I learned a lot from this book about the different kinds of care out there for the ailing. I mean, I knew about nursing homes, of course, but there are so many kinds of assisted-living programs and pilot programs for new kinds of nursing homes. It made me hopeful that the nightmare scenario my parents dread (they’ve both said before that they absolutely don’t want to go to a nursing home) will not be so bad by the time they reach a point where we have to discuss it. The book also helped demystify many of the questions I’ve had about hospice care, and made it seem much less threatening and scary.
The personal stories illustrated Gawande’s points really well. You could really sense his conflict and pain as he dealt with his ailing father, trying to use the techniques that he was learning to use on patients, but struggling to do so because it’s his father, a man he’s admired all his life. It’s really sad to see his patients rage against their diagnosis, and heartbreaking to witness their decline. But I appreciate their examples, which honor the memories of those who have died by helping the living prepare for their own eventual end.
5 out of 5 stars
To read more about Being Mortal, buy it or add it to your wishlist click here.
Peeking into the archives...today in:
2014:
2013: The Resurrectionist by E. B. Hudspeth
2012: Fashionista Piranha on hiatus until May 24th...
2011: Bending the Boyne by J. S. Dunn
2010: New York City Library & Improv Everywhere Bust Some Ghosts
2009: Museum of Human Beings by Colin Sargeant