Thursday, September 19, 2019

Being Mortal: Medicine and What Matters in the End by Atul Gawande

The simple view is that medicine exists to fight death and disease, and that is, of course, its most basic task. Death is the enemy. But the enemy has superior forces. Eventually, it wins. And in a war you cannot win, you dn't want a general who fights to the point of total annihilation. You don't want a Custer. You want Robert E. Lee, someone who knows how to fight for territory that can be won and how to surrender it when it can't, someone who understands that the damage is greatest if all you do is battle to the bitter end.
This is about the conversation no one wants to have — as we grow older and frailer or face incurable disease (no matter our age) — how do we cope? What should we ask our doctors and our loved ones in order to try to ensure the best outcome, under circumstances in which "complete cure" may not be possible? This book looks at all sorts of situations, from the person in a senior care home who needs a sense of purpose to a young mother with terminal cancer.

I read this at the urging of my daughter whose book club had discussed it. As other reviewers have noted it can be depressing. However, so are some of the circumstances in which we may find ourselves by the end of our lives. It is worth pushing through to the end because author Atul Gawande works through the physical difficulties of aging and disease to look at what makes us have our best days. I especially appreciated the questions he asks to help people identify what's most important to them when their world has narrowed because they are on their way out of it. How do we finish our story in the way that is most meaningful to us?

At the end I was in tears, but they were good tears. This is a thoughtful and honest book which I wholeheartedly recommend.

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