Being Mortal

 

http://atulgawande.com/

 

Dr. Atul Gawande is as renowned for his writing as he is for his practice of medicine, but oh, how fortunate we would be if we had a doctor such as he when faced with serious illness and decisions. The subtitle of his newest book, "Being Mortal," is "Medicine and What Matters in the End."

Many of my readers are aware that my family is in the throes of a relentless illness and the seemingly impossible decisions that come with debilitating disease. Family discussions often bring unresolved issues to the surface and honesty can suffer at the hands of nuance. Watching a loved one come to terms with his own mortality causes one to become hyper-vigilant about his own beliefs and wishes. My living will is undergoing another iteration as I type.

But Dr. Gawande, with his Oxford and Harvard training, still finds himself hard-pressed to follow his own best advice when the patient is his father, a man of enormous vitality, a surgeon and humanitarian, struck down by an invasive tumor. Facing the prospect of quadriplegia, Dr. Gawande's dad and his mom, (also a doctor), begin investigating options. Reading about their quest for the best possible outcome is an eye-opening look at the medical profession and at the various "types" of doctors that Gawande identifies.

There are the information givers, you know, just the facts ma'am. There are the paternalistic who think they are doing you a favor by keeping you in the dark. But every now and then you might be fortunate enough to meet the partner. The one who sees you as a unique human being with goals, and a history, and an understanding and acceptance of the limitations of the medical profession.

Gawande's special gift is that he writes in a simple, uncomplicated way. We immediately feel relaxed and respected in his company. When he recalls families he's worked with over the years, he does so with compassion even when he explores decisions he may have questioned. He makes no judgments except when it comes to his own fellow physicians who fail the empathy test, doctors who operate no matter the risks, who ply the latest and greatest chemo even when the expected outcome may be a devastating extra few weeks of life.

He writes of palliative and hospice care and the phenomenal work these professional givers of life do. He wonders why their services aren't offered more  and shares vital studies from around the country proving that patients who have more of a say in how they want to be treated during their final months and years are happier, more peaceful, and have greater satisfaction than those hooked up to IV drips, ventilators, and feeding tubes.

This book should be required reading for the greatest generation and their children. Judging by its place on the New York Times bestseller list, perhaps it is making its way through my baby boomer generation.  We need to understand our options as we age, be better prepared to make our desires known to our families, and then, most difficult of all, have the moral courage to stand by what we believe when our time comes.