Being Mortal: Medicine and What Matters in the End
by Atul Gawande
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.
An Amazon Best Book of the Month, October 2014: True or false: Modern medicine is a miracle that has transformed all of our lives.
If you said true, youd be right, of course, but thats a statement that demands an asterisk, a but. Weve been wrong about what our job is in medicine, writes Atul Gawande, a surgeon (at Brigham and Womens Hospital in Boston) and a writer (at the New Yorker). We think. . .[it] is to ensure health and survival. But really. . .it is to enable well-being. And well-being is about the reasons one wishes to be alive. Through interviews with doctors, stories from and about health care providers (such as the woman who pioneered the notion of assisted living for the elderly)and eventually, by way of the story of his own fathers dying, Gawande examines the cracks in the system of health care to the aged (i.e. 97 percent of medical students take no course in geriatrics) and to the seriously ill who might have different needs and expectations than the ones family members predict. (One striking example: the terminally ill former professor who told his daughter that quality of life for him meant the ongoing ability to enjoy chocolate ice cream and watch football on TV. If medical treatments might remove those pleasures, well, then, he wasnt sure he would submit to such treatments.) Doctors dont listen, Gawande suggestsor, more accurately, they dont know what to listen for. (Gawande includes examples of his own failings in this area.) Besides, theyve been trained to want to find cures, attack problemsto win. But victory doesnt look the same to everyone, he asserts. Yes, death is the enemy, he writes. But the enemy has superior forces. Eventually, it wins. And in a war that you cannot win, you dont want a general who fights to the point of total annihilation. You dont want Custer. You want Robert E. Lee… someone who knows how to fight for territory that can be won and how to surrender it when it cant. In his compassionate, learned way, Gawande shows all of usdoctors includedhow mortality must be faced, with both heart and mind. Sara Nelson
Wise and deeply moving. ?Oliver Sacks
Illuminating. ?Janet Maslin, The New York Times
Beautifully written . . . In his newest and best book, Gawande has provided us with a moving and clear-eyed look at aging and death in our society, and at the harms we do in turning it into a medical problem, rather than a human one. ?The New York Review of Books
Gawande’s book is so impressive that one can believe that it may well [change the medical profession] . . . May it be widely read and inwardly digested. ?Diana Athill, Financial Times (UK)
Being Mortal, Atul Gawande’s masterful exploration of aging, death, and the medical profession’s mishandling of both, is his best and most personal book yet. ?Boston Globe
American medicine, Being Mortal reminds us, has prepared itself for life but not for death. This is Atul Gawande’s most powerful–and moving–book. ?Malcolm Gladwell
Beautifully crafted . . . Being Mortal is a clear-eyed, informative exploration of what growing old means in the 21st century . . . a book I cannot recommend highly enough. This should be mandatory reading for every American. . . . it provides a useful roadmap of what we can and should be doing to make the last years of life meaningful. ?Time.com
Masterful . . . Essential . . . For more than a decade, Atul Gawande has explored the fault lines of medicine . . . combining his years of experience as a surgeon with his gift for fluid, seemingly effortless storytelling . . . In Being Mortal, he turns his attention to his most important subject yet. ?Chicago Tribune
Powerful. ?New York Magazine
Atul Gawande’s wise and courageous book raises the questions that none of us wants to think about . . . Remarkable. ?Peter Carey, The Sunday Times (UK)
A deeply affecting, urgently important book–one not just about dying and the limits of medicine but about living to the last with autonomy, dignity, and joy. ?Katherine Boo
Dr. Gawande’s book is not of the kind that some doctors write, reminding us how grim the fact of death can be. Rather, he shows how patients in the terminal phase of their illness can maintain important qualities of life. ?Wall Street Journal
Being Mortal left me tearful, angry, and unable to stop talking about it for a week. . . . A surgeon himself, Gawande is eloquent about the inadequacy of medical school in preparing doctors to confront the subject of death with their patients. . . . it is rare to read a book that sparks with so much hard thinking. ?Nature
Eloquent, moving. ?The Economist
Beautiful. ?New Republic
Gawande displays the precision of his surgical craft and the compassion of a humanist . . . in a narrative that often attains the force and beauty of a novel . . . Only a precious few books have the power to open our eyes while they move us to tears. Atul Gawande has produced such a work. One hopes it is the spark that ignites some revolutionary changes in a field of medicine that ultimately touches each of us. ?Shelf Awareness
A needed call to action, a cautionary tale of what can go wrong, and often does, when a society fails to engage in a sustained discussion about aging and dying. ?San Francisco Chronicle
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