Dec 29, 2022

Book Review: Being Mortal by Atul Gawande

 Wrapping up 2022 with this powerful, hard-hitting book that talks about modern medicine's approach toward mortality, sickness, aging and terminal illness.

Last year, when my dad's health was in a critical state, I was talking to a neighbor. He recommended that I should read this book. After almost 1.5 years, I picked it up on a casual visit to a bookstore.

This book is NOT for everyone.

However, it will resonate strongly

  • if you are a caregiver,
  • if you have parents or family members with multiple ailments,
  • if you have been running around for treatments and medical procedures for loved ones with critical stages of life-threatening diseases like cancer

I was pleasantly surprised to read such a different perspective coming from a doctor/surgeon. I could relate so much to the many conundrums that the author has brought up.

Each of us is forced to deal with the realities of decline and mortality of ourselves and our family members. It is painstakingly hard, takes a toll on our emotions and makes us doubt the choices and decisions that we end up making on behalf of others.

The author, in such beautiful and powerful words, brings up this point:

"The waning days of our lives are given over to treatments that addle our brains and sap our bodies for a sliver's chance of benefit."

He takes us on a journey, first by recognizing our need for the independent Self and how our systems start to fall apart and crumble. The medical cases and examples he shared throughout this book are so relatable, some make you teary-eyed and some give you hope amidst the crisis they end up going through. His own father's experience, the decisions and the tough conversations that followed - gave a whole new dimension to his perspectives on the importance of autonomy and control.

In the quest for safety and security, we end up losing our quality of life and our preferences on how our end lives ought to be. This loss is more profound when someone ends up in long treatment procedures in a hospital, the rigid schedules in a nursing home or even when there is huge uncertainty in the next steps of treatments that could lead to multiple complications.

The author gives examples of alternative solutions in the form of assisted living homes, independent homes suited for the elderly, and hospice support that lets terminally ill patients lead the last few days/weeks in ways that are fulfilling and peaceful.

The three types of the doctor-patient relationship - paternalistic, informative and interpretive - were super relevant.

His perspectives on the perils of the medical mindset to "do something, fix something" are something that every practitioner needs to ponder upon.

A few powerful quotes

"Once aging led to debility, it was impossible for anyone to be happy".

"How we seek to spend our time may depend on how much time we perceive ourselves to have."

"We want autonomy for ourselves and safety for those we love"

"Medical professionals concentrate on repair of health, not sustenance of the soul. Yet--and this is the painful paradox--we have decided that they should be the ones who largely define how we live in our waning days."

"The betrayals of body and mind that threaten to erase our character and memory remain among our most awful tortures."

"Over and over, we in medicine inflict deep gouges at the end of people's lives and then stand oblivious to the harm done."

"Endings matter, not just for the person but, perhaps even more, for the ones left behind."

Super impactful book and it answered many of my dilemmas. Must read if you fall into the category of people that I listed above, with whom this book would resonate.

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