It’s a relief that someone like Atul Gawande, a physician, has published a book like Being Mortal. With lucid, non-technical writing—and a huge dose of compassion—Gawande lays out how his profession fails us in our final days. Not surprisingly, the book has garnered a good deal of attention nationwide.
Ironically, Gawande tells us what we really already know: that before taking our last breath, we want control over the time left to us—we want to live out those remaining days, months, or years with a degree of independence. Yet independence requires a quality of service that nursing homes and physicians rarely provide. We can do better, he insists. And he sets out to show us how.
First, the institutions: nursing homes and even assisted living feel like prisons, Gawande says. They’re regimented and deathly quiet—devoid of life and freedom. He then shows us three alternatives: incorporating animals and young children into a nursing home environment; designing “pods,” central living rooms encircled by private bedrooms; and creating “co-ops” in which neighbors band together to share the costs of home care.
Gawande makes a case for training doctors to follow an “interpretive” care method, teaching them how to find out what matters most to their patients. Currently, doctors present a bewildering array of treatment options with little discussion as to which treatment, if any, comes closest to meeting the patient’s emotional, not just medical, needs—two sets of needs sometimes in conflict.
Finally, Gawande examines—and extols—hospice. Hospice caregivers know how to ask the right questions, placing patients at the center in planning their own care. As a result, painful medical interventions are often avoided, medication regimes made more effective, and home life more manageable. The results have proven remarkable: extended lives, less pain, fewer falls, more peaceful endings—and lower end-of-life costs.
Being Mortal is richly told. Gawanda follows the lives and paths of a number of individuals, including his own father, as they come to grips with aging or fatal illnesses. It’s the kind of book that will have you nodding your head, and it should make a big difference in the national conversation about end times. Wth some rethinking and retooling, we can make those times not only tolerable but meaningful.
Book clubs, get ready to extend your meeting time: this book provides a lot to discuss in a 60- to 90-minute session.
A former college English instructor, Molly developed LitLovers after teaching an online literature course several years ago. It was so much fun—even the students loved it—that she decided to take it public. If Molly’s not working on LitLovers, she’s sleeping.