To date, I’ve discussed Being Mortal: Medicine and What Matters in the End at least three separate times at at least three separate parties. Author and doctor Atul Gawande is everyone’s favorite author-doctor right now, and for good reason: he takes on a subject that no one likes to discuss but that everyone will one day face, offering valuable and practical advice. Two thumbs and two big toes up. (Questionably tasteful imagery intended.)
- Being Mortal’s main premise: We need to address end-of-life issues openly–preferably before the end of one’s life. Doctors shy away from notifying their patients about life expectancy, even (sadly) to the point of dishonesty at times. Families, similarly, don’t always want to face these realities honestly. And it doesn’t help that there’s always some new surgery, drug or other treatment to try.
- Hospice is underrated, undervalued and underutilized. It shouldn’t be. Palliative care leads to more peaceful deaths.
- Contrary to the opinions of some, old age can be a meaningful time of life. Older people seem to have better health outcomes when they have a greater sense of control over their environment and activities. The problem is, this takes creative problem-solving, and sometimes, safety is deprioritized in favor of independence.
- The author discussed the history of retirement and assisted living facilities and how these homes can improve.
- Another helpful section of the book goes into detail about the physical changes old age inevitably brings. It makes the point that the admirable character we all seem to believe in–the mentally and physically vibrant octagenarian who seems as healthy as a 40-year-old–is a cultural myth. The body breaks down in unpreventable ways, and when we deny this reality, our treatment of the elderly suffers, and our expectations of ourselves are often unrealistic. “Eventually, one too many joints are damaged, one too many arteries calcify. There are no more backups. We wear down until we can’t wear down anymore. It happens in a bewildering array of ways …” Gawande writes.
- Sometimes, less medical intervention is more. Some treatments do more harm than good, and it’s important to ask all the right questions and be fully informed.
- The author addresses doctors in the book as well, advising them on how to best approach end-of-life concerns. His description of the difficulty of treating senior citizens, with their multiplicity of small and large concerns, is admirably done.
- In conclusion, the author writes, “… People who had substantive discussions with their doctor about their end-of-life preferences were far more likely to die at peace and in control of their situation and to spare their family anguish.”
About the Author
Atul Gawande is an American surgeon, writer, and public health researcher. He earned his Bachelor’s degree in biology and political science from Stanford University, his medical degree from Harvard Medical School, and completed his surgical residency at Brigham and Women’s Hospital in Boston. He is a practicing general and endocrine surgeon and has held positions at prominent institutions such as Harvard Medical School and the Harvard T.H. Chan School of Public Health.
In addition to his medical career, Gawande is widely acclaimed for his compelling and thought-provoking writing. His articles and essays have appeared in publications such as The New Yorker, The New York Times, and The Lancet. He has also authored several influential books, including Complications: A Surgeon’s Notes on an Imperfect Science, Better: A Surgeon’s Notes on Performance, and Being Mortal: Medicine and What Matters in the End. In these works, he combines personal anecdotes, rigorous research, and insights from his medical career to shed light on the successes and failures of modern medicine and to advocate for improvements in patient care.
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