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How We Die: Reflections of Life's Final Chapter, New Edition Paperback – January 15, 1995
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From Publishers Weekly
The 1994 NBA nonfiction winner, Yale physician Nuland's study of the clinical, biological and emotional details of dying was a 14-week PW bestseller.
Copyright 1994 Reed Business Information, Inc.
Drawing upon his own broad experience and the characteristics of the six most common death-causing diseases, Nuland examines what death means to the doctor, patient, nurse, administrator, and family. Thought provoking and humane, his is not the usual syrup-and-generality approach to this well-worn topic. Fundamental to it are Nuland's experiences with the deaths of his aunt, his older brother, and a longtime patient. With each of these deaths, he made what he now sees as mistakes of denial, false hope, and refusal to abide by a patient's wishes. Disease, not death, is the real enemy, he reminds us, despite the facts that most deaths are unpleasant, painful, or agonized, and to argue otherwise is to plaster over the truth. The doctor, Nuland stresses, should instill in dying patients the hope not for a miraculous cure but for the dignity and high quality of the remainder of their lives as well as of what they have meant--and will continue to mean--to family, friends, and colleagues. Nuland also has strong feelings about suicide and "assisted death": the doctor should be prepared psychologically and practically to help the longtime patient slip off the scene in relative comfort. William Beatty --This text refers to an out of print or unavailable edition of this title.
Top customer reviews
Read this book for your sake, but also for the sake of everyone you love. It will change the way you think about disease and dying, no doubt about it.
He makes an amazing point "Nowadays, the style is to hide death from view".... "death is therefore to be secluded and to occur in sequestered places.... began discreetly in the 1930's and 1940's and became widespread after 1950.... Our senses can no longer tolerate the sights and smells in the early nineteenth century that were part of daily life, along with suffering and illness. The psychological effects have passed from daily life to the aseptic world of hygiene, medicine and morality. The perfect manifestation of this world is the hospital, with it's cellular discipline. Although it is not always admitted, the hospital has offered families a place where they can hide the unseemly invalid whom neither the world nor they can endure.... 80% of American deaths now occur in the hospital (written in 1994) the figure has gradually risen since 1949 when it was 50%, in 1958 it reached 61% and in 1977 it was 70%."... Update from 2010 section "at the present time, 40% of Americans die in acute care hospitals" ..."dropped to as low as 20% in relatively rural areas and 50% to more desely populated areas, which no doubt reflects the growing influence of outpatient palliative care and the autonomy, driven insistence on dying at home".... "we have YET FAILED to DE-medicalize death" (all caps mine)
"Nowadays, the style is to hide death from view"
How We Die is not only about death but it is also very much about life.
Dr. Nuland describes the natural cycle of our lives with compassion. It is not pretty, but I finished the book with a reminder that each moment counts. As they say, no one gets out of here alive.
i was saddened to hear of Dr. Nuland's recent passing. I sincerely hope that he met his demise with the grace and fortitude that he met the many other tragedies in his successful life.