Being Mortal: Medicine and What Matters in the End by Atul Gawande
My rating: 5 of 5 stars
This is not just a book about aging, it's a book about dying, a topic few want to deal with. The treatise is an important one: how we hope to end our life is as crucial as how we hope to live it.
Gawande is such a great storyteller and offers so much hope, that you get absorbed in every anecdote he tells & every character he draws for you. He outlines in clear, patient language a better way for the medical community (and society at large) to approach & navigate the end-of-life decisions that all of us inevitably face. Doctors & caregivers, he argues, need to be better at having hard conversations, outlining realistic options for patients, & concentrating more on how to ensure quality of life when that life is nearing its end.
He does a very thorough review of the origin & slow transformation of nursing homes, assisted living facilities & the growing field of palliative medicine, and argues for the right of a patient to express his or her own autonomy as the end of life approaches.
One of the most fascinating statistics: patients in hospice care live 25% longer than those who don't elect hospice care (and thus get all the interventions from the medical community). That stat alone defines the book: the role of medicine to "save at all costs" really doesn't take into account the patient's wants & needs -- and those really matter, so much that when allowed, they prolong life.
I wish everyone would read this book because it lays out -- sanely, rationally -- the choices & options available to those hit with sudden bad news. Why not be prepared? And why not pick up a book by one of American's great new storytellers?
“You may not control life's circumstances, but getting to be the author of your life means getting to control what you do with them.”
“It is not death that the very old tell me they fear. It is what happens short of death—losing their hearing, their memory, their best friends, their way of life. As Felix put it to me, 'Old age is a continuous series of losses.' Philip Roth put it more bitterly in his novel Everyman: 'Old age is not a battle. Old age is a massacre.'”
“Culture has tremendous inertia,” he said. “That’s why it’s culture. It works because it lasts. Culture strangles innovation in the crib.”
“Your chances of avoiding the nursing home are directly related to the number of children you have.”
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