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5.0 out of 5 starsThis book could be a game changer
ByN. B. Kennedyon September 23, 2014
This book could be a game changer, if enough people read it and take it to heart. Atul Gawande addresses end-of-life care, and how we're getting it wrong, both within the medical establishment and in our families.
Dr. Gawande's book focuses both on medical procedures and living conditions in later life. He addresses the reality that as people near the end of life, decisions about their living situation are primarily aimed at ensuring safety at the expense of retaining autonomy, especially when adult children are making the decisions. "We want autonomy for ourselves and safety for those we love," a friend tells the author. We mistakenly treat elders as children, Dr. Gawande says, when we deny them the right to make choices, even bad choices. People of any age want the right to lock their doors, set the temperature they want, dress how they like, eat what they want, admit visitors only when they're in the mood. Yet, nursing homes (and even assisted living communities) are geared toward making these decisions for people in order to keep them safe, gain government funds, and ensure a routine for the facility.
In addition, Dr. Gawande shows how end-of-life physical conditions are most often treated as medical crises needing to be "fixed," instead of managed for quality of life when treatment has become futile. Life is more than just a stretch of years; it must have meaning and purpose to be worth living, he says. This is a familiar concept (in fact, I read parts of this book in The New Yorker), but he builds a strong case for reform through case studies, stories from his own life, and examples of how individuals are either becoming victims of, or bucking, the system. He addresses assisted suicide only briefly, but he mentions it in relation to end-of-life care. "Assisted living is far harder than assisted death, but its possibilities are far greater as well," he writes.
The good news is that some people are doing what they can to improve the well-being of elders nearing the end of their lives. He demonstrates the beauty of hospice care in the home. He tells a great story of a doctor who convinced a nursing home to bring in two dogs, four cats and one hundred birds! It was a risky proposal, but the rewards were phenomenal. It made the place, and the people, come alive. I am aware, though, that these movements rely on individuals, and only if enough people have a vision for change will it come about. For that reason, I hope this book makes a big splash!
Dr. Gawande's book focuses both on medical procedures and living conditions in later life. He addresses the reality that as people near the end of life, decisions about their living situation are primarily aimed at ensuring safety at the expense of retaining autonomy, especially when adult children are making the decisions. "We want autonomy for ourselves and safety for those we love," a friend tells the author. We mistakenly treat elders as children, Dr. Gawande says, when we deny them the right to make choices, even bad choices. People of any age want the right to lock their doors, set the temperature they want, dress how they like, eat what they want, admit visitors only when they're in the mood. Yet, nursing homes (and even assisted living communities) are geared toward making these decisions for people in order to keep them safe, gain government funds, and ensure a routine for the facility.
In addition, Dr. Gawande shows how end-of-life physical conditions are most often treated as medical crises needing to be "fixed," instead of managed for quality of life when treatment has become futile. Life is more than just a stretch of years; it must have meaning and purpose to be worth living, he says. This is a familiar concept (in fact, I read parts of this book in The New Yorker), but he builds a strong case for reform through case studies, stories from his own life, and examples of how individuals are either becoming victims of, or bucking, the system. He addresses assisted suicide only briefly, but he mentions it in relation to end-of-life care. "Assisted living is far harder than assisted death, but its possibilities are far greater as well," he writes.
The good news is that some people are doing what they can to improve the well-being of elders nearing the end of their lives. He demonstrates the beauty of hospice care in the home. He tells a great story of a doctor who convinced a nursing home to bring in two dogs, four cats and one hundred birds! It was a risky proposal, but the rewards were phenomenal. It made the place, and the people, come alive. I am aware, though, that these movements rely on individuals, and only if enough people have a vision for change will it come about. For that reason, I hope this book makes a big splash!
Top critical review
33 people found this helpful
3.0 out of 5 starsSomethings to Consider toward the End
ByMargaret N. Flanneryon November 6, 2015
Book is mostly well written. It is about death and dying, so be prepared to read it when one is in a good frame of mind. It profiles patients who are terminal and how they and their families coped with the specter of death. Doctor Gawande relates the stories of courageous patients nearing the end of their lives. Bear in mind, they are upper middle class, obviously have means at their disposal and even though their prospects are bleak. I wondered what people who do not have the luxury of good insurance and top-notch medical care experience at the end of their lives. Perhaps it is better, not going through the excruciating treatments, frequent hospital stays and non-stop tests, many of which are painful. Maybe poorer patients die sooner but more comfortably? Are they just given 'comfort care' and left alone? Are they well cared for or neglected? The book doesn't address this at all.
However, after reading the book, I made some changes in my medical directions concerning my end care, put my property in my and my heirs names, changed my bank account to POD (Pay on Death) to my only child and made plans to supervise my living arrangements as long as I am conscious and competent to do so. Also, spoke to my Complementary Care doctor about my wishes. However, I understand that what we wish and plan for today my be far different from what actually occurs.
Oh yes, when being treated as a terminal patient, put on make-up. Doctors seem to like that.
However, after reading the book, I made some changes in my medical directions concerning my end care, put my property in my and my heirs names, changed my bank account to POD (Pay on Death) to my only child and made plans to supervise my living arrangements as long as I am conscious and competent to do so. Also, spoke to my Complementary Care doctor about my wishes. However, I understand that what we wish and plan for today my be far different from what actually occurs.
Oh yes, when being treated as a terminal patient, put on make-up. Doctors seem to like that.
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This book could be a game changer, if enough people read it and take it to heart. Atul Gawande addresses end-of-life care, and how we're getting it wrong, both within the medical establishment and in our families.
Dr. Gawande's book focuses both on medical procedures and living conditions in later life. He addresses the reality that as people near the end of life, decisions about their living situation are primarily aimed at ensuring safety at the expense of retaining autonomy, especially when adult children are making the decisions. "We want autonomy for ourselves and safety for those we love," a friend tells the author. We mistakenly treat elders as children, Dr. Gawande says, when we deny them the right to make choices, even bad choices. People of any age want the right to lock their doors, set the temperature they want, dress how they like, eat what they want, admit visitors only when they're in the mood. Yet, nursing homes (and even assisted living communities) are geared toward making these decisions for people in order to keep them safe, gain government funds, and ensure a routine for the facility.
In addition, Dr. Gawande shows how end-of-life physical conditions are most often treated as medical crises needing to be "fixed," instead of managed for quality of life when treatment has become futile. Life is more than just a stretch of years; it must have meaning and purpose to be worth living, he says. This is a familiar concept (in fact, I read parts of this book in The New Yorker), but he builds a strong case for reform through case studies, stories from his own life, and examples of how individuals are either becoming victims of, or bucking, the system. He addresses assisted suicide only briefly, but he mentions it in relation to end-of-life care. "Assisted living is far harder than assisted death, but its possibilities are far greater as well," he writes.
The good news is that some people are doing what they can to improve the well-being of elders nearing the end of their lives. He demonstrates the beauty of hospice care in the home. He tells a great story of a doctor who convinced a nursing home to bring in two dogs, four cats and one hundred birds! It was a risky proposal, but the rewards were phenomenal. It made the place, and the people, come alive. I am aware, though, that these movements rely on individuals, and only if enough people have a vision for change will it come about. For that reason, I hope this book makes a big splash!
Dr. Gawande's book focuses both on medical procedures and living conditions in later life. He addresses the reality that as people near the end of life, decisions about their living situation are primarily aimed at ensuring safety at the expense of retaining autonomy, especially when adult children are making the decisions. "We want autonomy for ourselves and safety for those we love," a friend tells the author. We mistakenly treat elders as children, Dr. Gawande says, when we deny them the right to make choices, even bad choices. People of any age want the right to lock their doors, set the temperature they want, dress how they like, eat what they want, admit visitors only when they're in the mood. Yet, nursing homes (and even assisted living communities) are geared toward making these decisions for people in order to keep them safe, gain government funds, and ensure a routine for the facility.
In addition, Dr. Gawande shows how end-of-life physical conditions are most often treated as medical crises needing to be "fixed," instead of managed for quality of life when treatment has become futile. Life is more than just a stretch of years; it must have meaning and purpose to be worth living, he says. This is a familiar concept (in fact, I read parts of this book in The New Yorker), but he builds a strong case for reform through case studies, stories from his own life, and examples of how individuals are either becoming victims of, or bucking, the system. He addresses assisted suicide only briefly, but he mentions it in relation to end-of-life care. "Assisted living is far harder than assisted death, but its possibilities are far greater as well," he writes.
The good news is that some people are doing what they can to improve the well-being of elders nearing the end of their lives. He demonstrates the beauty of hospice care in the home. He tells a great story of a doctor who convinced a nursing home to bring in two dogs, four cats and one hundred birds! It was a risky proposal, but the rewards were phenomenal. It made the place, and the people, come alive. I am aware, though, that these movements rely on individuals, and only if enough people have a vision for change will it come about. For that reason, I hope this book makes a big splash!
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This is a timely book for me because my parents are very elderly (94 and 88) and determined to stay in their home until the last possible second. After reading this thought provoking book that teaches so much I am thinking that it may be possible for them to stay until the end which could be next week or a few years from now. It's going to take some organizing, but it looks like it is worth some research and time. It makes me sad to see how much of their independence they have lost, but they still enjoy their lives as limited as they are.
There is a tendency to treat old people like children which I realize now is usually very wrong. My dad is a diabetic and we (my siblings and I) have told him over and over that his diet of sugary cereal or cinnamon rolls and orange juice for breakfast and light store brand fruit yogurt with grapes and three cookies for lunch is not what he should be eating. He acts surprised every time we mention this, but doesn't change a thing because I now understand that he wants the independence of eating as he pleases. He has lost so much--can barely hear or see or walk, that he needs these very small pleasures to continue. I imagine he doesn't see the point in giving up anything else because he has so little left. My mother's memory is going and she has COPD, but somehow has lots of get up and go. She does a lot for my dad even though I suspect she is the sicker one. Being Mortal is making me think about the best way to help my parents which will probably start with asking them what they want.
One thing that surprised me completely was Dr. Gawande's statement that genetics is only a small part of reaching old age. Here I've been thinking that because my parents have lived so long that reaching old age is probably a no brainer for me. I have to think about that possiblity some more--a lot more.
This book has some touching stories about very sick people and how their lives ended. Unfortunately for many sick people the medical community is driven to act, but not necessarily to do what is best for the individual. It seems to me that they've forgotten "the do no harm" part of being a doctor. It seems to me it does harm people to ruin the time sick people have left.
A very through provoking book that will ultimately make me think about what I want when the end is near. I wish everyone would read it; especially medical people.
There is a tendency to treat old people like children which I realize now is usually very wrong. My dad is a diabetic and we (my siblings and I) have told him over and over that his diet of sugary cereal or cinnamon rolls and orange juice for breakfast and light store brand fruit yogurt with grapes and three cookies for lunch is not what he should be eating. He acts surprised every time we mention this, but doesn't change a thing because I now understand that he wants the independence of eating as he pleases. He has lost so much--can barely hear or see or walk, that he needs these very small pleasures to continue. I imagine he doesn't see the point in giving up anything else because he has so little left. My mother's memory is going and she has COPD, but somehow has lots of get up and go. She does a lot for my dad even though I suspect she is the sicker one. Being Mortal is making me think about the best way to help my parents which will probably start with asking them what they want.
One thing that surprised me completely was Dr. Gawande's statement that genetics is only a small part of reaching old age. Here I've been thinking that because my parents have lived so long that reaching old age is probably a no brainer for me. I have to think about that possiblity some more--a lot more.
This book has some touching stories about very sick people and how their lives ended. Unfortunately for many sick people the medical community is driven to act, but not necessarily to do what is best for the individual. It seems to me that they've forgotten "the do no harm" part of being a doctor. It seems to me it does harm people to ruin the time sick people have left.
A very through provoking book that will ultimately make me think about what I want when the end is near. I wish everyone would read it; especially medical people.
I became a fan of Atul Gawande upon reading his first book in 2002: Complications: A Surgeon's Notes on an Imperfect Science. In reading many of his previous books I found he always asked questions: Why do we do things; for what purpose; is this working to achieve the best results for the patient in his physical and cultural circumstance? Gawande tackles the dilemmas of medical ethics by approaching them with sagacious common-sense. I think most of his books should be required reading in medical schools.
In this new book Being Mortal: Medicine and What Matters in the End, Gawande looks at the problems of the aging population and inevitability of death. He points out that you don't have to spend much time with the elderly or those with terminal conditions to see how common it is for modern medicine to fail the people it is supposed to be helping. In speaking of elder care he sadly points out that "Our reluctance to honestly examine the experience of aging and dying has increased the harm and suffering we inflict on people and has denied them the basic comforts they need most". Many physicians are so hell bent on preserving life that they cause horrible and unnecessary suffering.
Gawande points out that sometimes in striving to give a patient health and survival their well-being is neglected. He describes well-being as the reason one wishes to be alive. He looks at the "Dying Role" as the end approaches describing it as the patient's ability to "share memories, pass on wisdom and keepsakes, settle relationships, establish legacies and make peace with their God. They want to end their stories on their own terms." He feels that if people are denied their role, out of obtuseness and neglect, it is cause for everlasting shame.
Gawande shares his deep seated feelings in this book by revealing personal vignettes of how friends and family coped with these powerful and challenging issues. He follows a hospice nurse on her rounds. He discloses how is mother-in-law Alice's life is changed by taking up residence in a senior facility as the only reasonable option. Senior facilities and nursing homes, even the best run, are often sterile institutions that can cause psychological anguish. He includes how he dealt with the final wishes of his father. It is a melancholy yet empowering picture of a man and physician honoring his father.
Atul Gawande provides the reader with an understanding that though end of life care is inevitable there are ways to humanize the process. The patients, their families, the medical professionals are coming to terms with how to better face the decision making processes that will be, in many cases, the last decision. The subject matter is complex and sensitive but the moral of the book is that "The End Matters".
In this new book Being Mortal: Medicine and What Matters in the End, Gawande looks at the problems of the aging population and inevitability of death. He points out that you don't have to spend much time with the elderly or those with terminal conditions to see how common it is for modern medicine to fail the people it is supposed to be helping. In speaking of elder care he sadly points out that "Our reluctance to honestly examine the experience of aging and dying has increased the harm and suffering we inflict on people and has denied them the basic comforts they need most". Many physicians are so hell bent on preserving life that they cause horrible and unnecessary suffering.
Gawande points out that sometimes in striving to give a patient health and survival their well-being is neglected. He describes well-being as the reason one wishes to be alive. He looks at the "Dying Role" as the end approaches describing it as the patient's ability to "share memories, pass on wisdom and keepsakes, settle relationships, establish legacies and make peace with their God. They want to end their stories on their own terms." He feels that if people are denied their role, out of obtuseness and neglect, it is cause for everlasting shame.
Gawande shares his deep seated feelings in this book by revealing personal vignettes of how friends and family coped with these powerful and challenging issues. He follows a hospice nurse on her rounds. He discloses how is mother-in-law Alice's life is changed by taking up residence in a senior facility as the only reasonable option. Senior facilities and nursing homes, even the best run, are often sterile institutions that can cause psychological anguish. He includes how he dealt with the final wishes of his father. It is a melancholy yet empowering picture of a man and physician honoring his father.
Atul Gawande provides the reader with an understanding that though end of life care is inevitable there are ways to humanize the process. The patients, their families, the medical professionals are coming to terms with how to better face the decision making processes that will be, in many cases, the last decision. The subject matter is complex and sensitive but the moral of the book is that "The End Matters".
Byamachiniston February 20, 2018
Dr. Gawande writes that modern medicine can extend the limit of our mortality, but there is a finite boundary to that limit. This book is emotionally difficult because the reader and Dr. Gawande confront painful topics that one is loath to consider: aging, frailty and death. Yet, these are essential stages of life and there are essential decisions that one must make at each stage.
One can see the signs of aging as they appear on the outside: gray hair, age spots, and wrinkles. Dr. Gawande, a surgeon, also shares what he sees when he peers inside the body of an older patient. Each day some parts of the body die and are remade while others wear and change with constant use. What happens when the limitations of one's aging body require a change in one's lifestyle? There are now many choices and Dr. Gwande rails against settling for just safety and longevity, institutionalization and restriction. He relates the history of nursing homes and visits first-hand the many options for living a life of privacy and community, of vibrancy and purpose. He applauds those in the field of gerentology who have thought "outside the box" for the development of active communities for those who are aged and frail.
The reader experiences the morphing of Dr. Gawande from a mere practitioner to the son of a dying parent. How does a doctor broach the difficult end-of-life options with terminally ill patients and loved ones? The menu of medical options for treatment can be insufficient and it is essential that the practitioner also ask the patient what she or he wants most in the finite time remaining. Is it a mistake to prolong suffering or is it better to provide value in a shortened life? The author suggests that courage is required for both aging and sickness: the courage to confront the reality of mortality and the courage to act on the truth of that reality. Have the courage and the wisdom, dear reader, to explore these difficult topics presented in the pages of this transformative book.
One can see the signs of aging as they appear on the outside: gray hair, age spots, and wrinkles. Dr. Gawande, a surgeon, also shares what he sees when he peers inside the body of an older patient. Each day some parts of the body die and are remade while others wear and change with constant use. What happens when the limitations of one's aging body require a change in one's lifestyle? There are now many choices and Dr. Gwande rails against settling for just safety and longevity, institutionalization and restriction. He relates the history of nursing homes and visits first-hand the many options for living a life of privacy and community, of vibrancy and purpose. He applauds those in the field of gerentology who have thought "outside the box" for the development of active communities for those who are aged and frail.
The reader experiences the morphing of Dr. Gawande from a mere practitioner to the son of a dying parent. How does a doctor broach the difficult end-of-life options with terminally ill patients and loved ones? The menu of medical options for treatment can be insufficient and it is essential that the practitioner also ask the patient what she or he wants most in the finite time remaining. Is it a mistake to prolong suffering or is it better to provide value in a shortened life? The author suggests that courage is required for both aging and sickness: the courage to confront the reality of mortality and the courage to act on the truth of that reality. Have the courage and the wisdom, dear reader, to explore these difficult topics presented in the pages of this transformative book.
ByHande Zon December 24, 2014
Unfortunately, we consider people at the terminal stage of life only when we have close friends or relatives who are in that situation or when we find ourselves at death's door. Thus, until then, we rarely think about our mortality seriously enough to feel capable of handling it when we or our loved ones are nearing the end of life.
In this lucid book, Atul Gawande takes us to a close and personal view of several people close to him, including his wife's grandmother, Alice Hobson, and his own father, who is also a surgeon like Atul himself. We are introduced to them when they were already at an age many of us consider 'old', but they were still young in spirit and in flesh - vibrant and independent. Gradually, Atul describes the effect of advancing years on them, how for example, Alice began to fall frequently, how his father began to feel numbness in his fingers, and then we see them no longer physically strong, but frail and weak, and realise how age and illness are such devastating twin catastrophe we will face in a matter of time.
Atul shows us why it is that old people resist going to nursing homes. He shows us the dilemma that family members experience when they try to let the obviously old and weak family members live the independent lives they want, and yet have the safety and attention they obviously need. Decisions as to where to house them are difficult enough, but as the author shows, there are even more difficult decisions to be made when a terminal illness is diagnosed. Do they go for treatment, and if so, which type of treatment- and bear with their debilitating after-effects - or do they forgo treatment altogether?
In the course of taking us through the end of life of these people, Atul also takes us through a grand tour of the hospital, the nursing home, the hospice, and other alternative facilities for the terminally ill. More importantly, he makes us examine what it is that we understand to be the meaning of life because when we are nearing the end of it, we all have our personal reasons to fight for the extra year or two, or to gracefully accept the end.
In this lucid book, Atul Gawande takes us to a close and personal view of several people close to him, including his wife's grandmother, Alice Hobson, and his own father, who is also a surgeon like Atul himself. We are introduced to them when they were already at an age many of us consider 'old', but they were still young in spirit and in flesh - vibrant and independent. Gradually, Atul describes the effect of advancing years on them, how for example, Alice began to fall frequently, how his father began to feel numbness in his fingers, and then we see them no longer physically strong, but frail and weak, and realise how age and illness are such devastating twin catastrophe we will face in a matter of time.
Atul shows us why it is that old people resist going to nursing homes. He shows us the dilemma that family members experience when they try to let the obviously old and weak family members live the independent lives they want, and yet have the safety and attention they obviously need. Decisions as to where to house them are difficult enough, but as the author shows, there are even more difficult decisions to be made when a terminal illness is diagnosed. Do they go for treatment, and if so, which type of treatment- and bear with their debilitating after-effects - or do they forgo treatment altogether?
In the course of taking us through the end of life of these people, Atul also takes us through a grand tour of the hospital, the nursing home, the hospice, and other alternative facilities for the terminally ill. More importantly, he makes us examine what it is that we understand to be the meaning of life because when we are nearing the end of it, we all have our personal reasons to fight for the extra year or two, or to gracefully accept the end.
ByEvaon March 16, 2018
I love this book so much i bought a copy for my mother's primary care physician, neurologist, memory care manager and preacher. When someone you love is dying, how do you even begin to know how to think about it? This book has been a rock under my feet. However, it's biggest weakness is in it's lack of coverage of dementia patients. What do you do when the answers to "what is a good day in your current state?" changes in ways no one can predict and they cant articulate? What do you do when you ask them if they understand their condition and limitations and they have no clue they have dementia? These are my struggles with my parents (both have dementia). At the same time, there was still a lot of useful advise about dying. I highly recommend it.
ByFranklin the Mouseon December 29, 2017
The late Dr. Sherwin Nuland wrote a highly informative book entitled 'How We Die'. Dr. Gawande's book title could have been 'How We Are Allowed to Die'. It goes the next step and analyzes the medical establishment and how humans deal with their coming death. Well into the early twentieth century the Grim Reaper was a daily companion and a near fatalistic attitude was held in our culture about it. From babies to healthy adults were susceptible to a myriad of ways of quickly kicking the bucket. The latter part of the twentieth century, however, introduced medical and technological discoveries which helped prolong the inevitable. Ironically it also altered our culture's mindset about dying itself and we have become less willing go gently into the night. As the author so aptly states, “… (we are) a society that faces the final phases of life by trying not to think about it.” 'Being Mortal' does an outstanding job of guiding the reader through the complexities involved in our deteriorating bodies and end-of-life care.
Dr. Gawande has a clear and compassionate writing style. He is a humble physician who openly relays his ignorance in many aspects of medicine outside his field of expertise. The reader is taken along on the author's journey of discoveries. The book's core helps you understand the emotional challenges for the patient, their loved ones, and the ham-handed approach taken by hospitals who focus on prolonging death even if it overlooks the patient's wishes. These are not cut-and-dried issues. The author retells compelling episodes of people struggling with either their mortality or the loss of their autonomy. He even includes a story of the very personal loss of his dad. They are all excellent examples. Dr. Gawande covers such things as demographic shifts in aging, the history of dying in America prior to the late twentieth century, the creation of nursing homes, assisted-living facilities, how our motivations shift as we age, how we respond to pain, and assisted suicide.
'Being Mortal' is a superb book. It does not bog itself down in technical medical jargon but is written for the average person. It is not a self-help book but I imagine it will be therapeutic and helpful to most readers. The book also is not simply about the last days of a person's life but also facing and adapting to our body's inevitable decline. I can think of no book I've ever read that does a better job of presenting the issue. Read it for yourself and your loved ones. Even if you have already gone through the death of someone important in your life, the book may be some solace. We're all members of the dying club. No one is allowed to quit the merry death band and become immortal.
Dr. Gawande has a clear and compassionate writing style. He is a humble physician who openly relays his ignorance in many aspects of medicine outside his field of expertise. The reader is taken along on the author's journey of discoveries. The book's core helps you understand the emotional challenges for the patient, their loved ones, and the ham-handed approach taken by hospitals who focus on prolonging death even if it overlooks the patient's wishes. These are not cut-and-dried issues. The author retells compelling episodes of people struggling with either their mortality or the loss of their autonomy. He even includes a story of the very personal loss of his dad. They are all excellent examples. Dr. Gawande covers such things as demographic shifts in aging, the history of dying in America prior to the late twentieth century, the creation of nursing homes, assisted-living facilities, how our motivations shift as we age, how we respond to pain, and assisted suicide.
'Being Mortal' is a superb book. It does not bog itself down in technical medical jargon but is written for the average person. It is not a self-help book but I imagine it will be therapeutic and helpful to most readers. The book also is not simply about the last days of a person's life but also facing and adapting to our body's inevitable decline. I can think of no book I've ever read that does a better job of presenting the issue. Read it for yourself and your loved ones. Even if you have already gone through the death of someone important in your life, the book may be some solace. We're all members of the dying club. No one is allowed to quit the merry death band and become immortal.
ByBarbara B.on July 3, 2015
"Being Mortal" is written from the perspective of a physician, who understands the nature of illness and the difficulties in communicating with those most affected by terminal diseases (both the individual him- or herself and the family). What makes this book so special is that the author personalizes the situations, by his descriptions of debilitations and eventual deaths of people he has known well, including his father. I could definitely relate to the comment that his father's most important consideration was that he wanted to continue to be able to play tennis as he aged and dealt with decisions about whether and when to have surgery. Gawande's observations force the reader to think about the question of quality versus length of life. Modern medicine seems to focus on extending life, regardless of the extent of debilitation or suffering of the patient. I came to believe that prior frank conversations with the affected person and his or her caregivers about what is most important to them (e.g., avoidance of pain, ability to be active, avoidance of cognitive deterioration, etc.) would immensely help in subsequent decisions about treatment. I liked the book so much that I ordered two copies, one to give to a younger acquaintance, who is dealing with an aging father.
BySithmaithon October 26, 2017
I can't say enough about how much I love this book. It literally changed my life and I recommend it to everyone.
This is the second time that I've read it. The first was during a particularly anxious time in my life. Someone very close to me was diagnosed with cancer, just a few days after Robin Williams committed suicide and just a few days before the anniversary of my sister Ginger's suicide. Not long after this, a long time colleague died of lung cancer. And all of this was while my beloved job was ending because our plant was shutting down permanently and my friends and colleagues were scattering to the four winds where I would likely never see them again. Needless to say, it was a rough time, and I began suffering from anxiety in a way I'd never experienced. I would lie awake at night, unable to sleep, worrying about death - mine, people close to me, my dogs. My doctor prescribed Prozac, but that really didn't help.
This book is what made all the difference. So much of anxiety is really about uncertainty and a loss of control, and death is something that most of us are unfamiliar with. Where once you lived with elderly relatives who aged, became infirm, and died, now the act of dying has been turned over to the medical establishment. Most people don't die at home, and elderly relatives don't live with us. They're independent as long as they can be, then they enter nursing homes or assisted living facilities. We don't want to talk about death, often because we superstitiously believe that will bring it to us.
So we grow old and die without being prepared for it. While most of us would say that we want to die peacefully at home, surrounded by family and friends, we don't know how to make that happen, and because we don't, that isn't usually how we go.
This book helps us work through the things that are important to us - what makes life worth living and how we can maintain that worthwhile life as long as possible. It demystifies aging and death, and helps us understand the choices that we will have to make, for ourselves and for others.
Dr. Gawande helps us understand how the medical establishment looks at death, and why they're not really prepared to help us to age and die in the way we would like. He admits his own mistakes and shows how what he's learned helped make his own father's transition what his father wanted it to be.
Even if you don't want to think of your own mortality, most of us are going to be involved in helping loved ones age and die. Read this book, and it will remove much of the uncertainty. It shows how we can have the end of our life be under our control as much as possible, and how to accept when that control is no longer possible.
This is the second time that I've read it. The first was during a particularly anxious time in my life. Someone very close to me was diagnosed with cancer, just a few days after Robin Williams committed suicide and just a few days before the anniversary of my sister Ginger's suicide. Not long after this, a long time colleague died of lung cancer. And all of this was while my beloved job was ending because our plant was shutting down permanently and my friends and colleagues were scattering to the four winds where I would likely never see them again. Needless to say, it was a rough time, and I began suffering from anxiety in a way I'd never experienced. I would lie awake at night, unable to sleep, worrying about death - mine, people close to me, my dogs. My doctor prescribed Prozac, but that really didn't help.
This book is what made all the difference. So much of anxiety is really about uncertainty and a loss of control, and death is something that most of us are unfamiliar with. Where once you lived with elderly relatives who aged, became infirm, and died, now the act of dying has been turned over to the medical establishment. Most people don't die at home, and elderly relatives don't live with us. They're independent as long as they can be, then they enter nursing homes or assisted living facilities. We don't want to talk about death, often because we superstitiously believe that will bring it to us.
So we grow old and die without being prepared for it. While most of us would say that we want to die peacefully at home, surrounded by family and friends, we don't know how to make that happen, and because we don't, that isn't usually how we go.
This book helps us work through the things that are important to us - what makes life worth living and how we can maintain that worthwhile life as long as possible. It demystifies aging and death, and helps us understand the choices that we will have to make, for ourselves and for others.
Dr. Gawande helps us understand how the medical establishment looks at death, and why they're not really prepared to help us to age and die in the way we would like. He admits his own mistakes and shows how what he's learned helped make his own father's transition what his father wanted it to be.
Even if you don't want to think of your own mortality, most of us are going to be involved in helping loved ones age and die. Read this book, and it will remove much of the uncertainty. It shows how we can have the end of our life be under our control as much as possible, and how to accept when that control is no longer possible.
ByMaryon January 2, 2017
Just as many other reviewers have advised, this book is a must read for physicians and patients alike. This book would be particularly useful for young physicians or those interested in medicine. The book will give you a better perspective of the other side of medicine. The side of medicine is where patients don’t get better; where you may no longer be able to help despite the knowledge, skills and experience. I think that young physicians and premeds often think about the greatness of medicine, like saving lives and improving health, but not often about the loss of life they will witness so often, or the inability to help patients despite all the medical advances. This book will also be very useful for non-medical folks, young or old, or those who may have family or friend facing health issues, aging, or terminal illnesses. While there is nothing that will prepare one fully for the difficult times, this book will be a great asset in adding to the knowledge about how to go through those times. This book will probably make you cry, but I guarantee that you will not want to stop reading it until you get thought the very last page.
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