This is not an easy book to read. But it's an essential book to read. Atul Gawande is a surgeon and writer who brings deep resources of professional and personal experience to bear on the very core of what we all face: physical decline and death. Chapter 2 is essentially a litany of what happens to our bodies and minds as we age.
It's sobering for someone like myself who feels pretty good for a fellow in his sixties. But what's even more sobering is how we deal with this decline as individuals, as health care providers and as a society. This is the focus of most of the rest of the book.
Warehousing the frail in nursing homes is not an acceptable option. Using powerful drugs in a vain attempt to cure the incurable while inflicting more pain and suffering than the original disease is not an acceptable option. But these options seem to be what happens with most of us. Dr. Gawandi's thesis is that we need to find a better way to deal with aging and end of life care.
Fortunately, though change is slow and spotty, change is happening. Being Mortal offers bright spots in a rather bleak landscape as examples of how things can be better. But even these efforts to provide a better life situation face personal, social, legal and economic hurdles that hinder widespread adoption.
Dr. Gawande describes new approaches to senior living taking place around the country that allow people to live at home or in home-like situations even up to the doorstep of death. He also knows that doctors and medical students need to learn how to look at people they are treating as whole persons and not just a jumble of diseases and symptoms to be treated. Both are long-term goals, but the changes are accelerating and his book is a comprehensive framework for helping to make those changes.
Many of the personal stories of people struggling with their mortality are touching, some are inspiring - none more so than Dr. Gawande's own struggle as he deals with his father's decline and death. This experience became a major impetus for the book as he realized how difficult the passage was even for a family of doctors such as theirs.
Dr. Gawande's insights and elegant writing make this book ultimately a pleasure to read, despite its difficult subject. But if you prefer to approach this subject in another medium, PBS's Frontline will be airing an episode on the book on February 10. Watch locally on KEET or later, online at PBS.org.
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An uplifting lecture about death
Interview with Charlie Rose: