How We Die Pb [Paperback]

Sherwin Nuland (Author)

Book Description

Publication Date: May 5, 1994

An account of what happens to us when we die, whether through heart failure, cancer, AIDS, Alzheimer's disease, murder, accident or suicide. Sherwin Nuland is a surgeon in the US and the author of "The Doctors", which explored the ethics of the medical world.

Product Details

• Paperback: 352 pages
• Publisher: The Hogarth Press Random Hous (May 5, 1994)
• Language: English
• ISBN-10: 0701162775
• ISBN-13: 978-0701162771
• Product Dimensions: 8.4 x 5.4 x 1.1 inches
• Shipping Weight: 12 ounces
• Average Customer Review: 5.0 out of 5 stars  See all reviews (1 customer review)
• Amazon Best Sellers Rank: #555,551 in Books (See Top 100 in Books)

Customer Reviews

Most Helpful Customer Reviews

6 of 6 people found the following review helpful:

5.0 out of 5 stars When bad things happen to all people, January 13, 2005

By 

E. A. Lovitt "starmoth" (Gladwin, MI USA) - See all my reviews
(HALL OF FAME REVIEWER)    (TOP 100 REVIEWER)    (REAL NAME)   

This review is from: How We Die Pb (Paperback)

A motto on the walls of hundreds of autopsy rooms all over the world can be translated as: "This is the place where death rejoices to come to the aid of life."

"How We Die" is a book where death rejoices to come to the aid of life. Distinguished surgeon Sherwin B. Nuland estimates that only one in five deaths is peaceful, or at least quick. The rest of us are doomed to prolonged suffering before we shuffle off of this mortal coil. However, if we know what our end is going to be like, if the mystery of say, death by cancer is explained to us, we might at least lose our fear of the unknown.

The first time I read this book, I didn't derive any comfort at all from knowing exactly how I might die. But now that I've been through the shadow of cancer, I reread "How We Die" and it didn't frighten me any longer. Dr. Nuland is right. It is better to know, especially since you may need to decide whether you want to be kept alive for as long as possible, no matter what the price in pain, indignity, and loss of function. The author serves as our Virgil, leading us down through the dread circles of terminal disease and accidental death in a graphic, unsentimental fashion. The only time he loses his cool is during his description of young men and women dying of AIDS. "What dignity or meaning can be snatched from such a death will never be known, except by those whose lives have embraced the life just lost."

The worst manner of death, no matter what the cause, seems to be at the hands of physicians who are willing to inflict the most drastic surgeries, chemotherapies, dialysis, and all manner of 21st century medical procedures on patients who have only a short time left to live, or who do not understand the risks and pain of the procedures that are being pressed upon them. Dr. Nuland was guilty of this type of major medical intervention on two patients who were dying, one of them his own brother. "I might have understood that my way of giving Harvey [his brother] the hope he asked for was not only a deception but, given what we knew about the toxicity of the experimental drugs, an almost certain source of added anguish for all of us."

The lessons that Dr. Nuland would like us to learn from "How We Die:"
* Your doctors are likely to want to prolong your life, no matter what the cost. It is up to you to decide whether the cost is worth the few weeks or months of prolonged life. What will your quality of that life be? For example, are you willing to accept a feeding tube, but not a ventilator?
* Fill out that advanced directive to either prohibit or encourage major resuscitative efforts, in case you reach a point where you are no longer able to speak for yourself. I had to answer this question for my mother on her last trip to the emergency room, because she had refused to think about what her end might be like.
* "The greatest dignity to be found in death is the dignity of the life that preceded it." The end itself is likely to be undignified, painful, and a source of anguish to our loved ones.

Dr. Nuland effectively dispels the myth of the dignified death, but he gives us realistic, compassionate advice on how to prepare for those final hours.