Book Blog Habit - Being Mortal: Medicine and What Matters in the End by Atul Gawande

by Atul Gawande

This frank book is a plea to think seriously about what is important to us as we age, to understand our life-options, and to face our mortality.   No solution handbook for solving the intractable problems inherent in bodily decline, this is a book-long conversation with this brilliant physician/writer, who believes that life isn’t curable.

Organized into eight masterful chapters, Being Mortal melts our fantasies that our healthy life will persist until that far off day when we shall die suddenly and neatly. Says Gawande, “Today, swift, catastrophic illness is the exception.”  Instead, he

describes three real and distinct patterns of decline.  The first: we contract, treat and fight a fatal disease, enduring pain and staving off the terminal phase until the body can take no more.  The second pattern: we develop a chronic but treatable disease (such as emphysema), but we suffer repeated, often agonizing relapses until the body weakens and can no longer withstand even minor stresses.  And the third:  we gradually become frail with an “accumulated crumbling of one’s bodily systems.”  Gawande: “one too many joints are damaged, one too many arteries calcify.  There are no more backups.”

In the final three chapters, beginning with chapter 6, “Letting Go,” he deals with the dilemma of when to stop trying to prolong life, “When should we try to fix, and when should we not?”  Believing that “endings matter,” the doctor encourages us to focus less on prolonging life and more on making remaining life meaningful to us, personally.  

He closes by exploring the strategies of standard or aggressive medical care, palliative care, assisted suicide, and others, along with hard conversations with loved ones and our doctors, reminding us “hope is not a plan.”

This book should be read and passed along to everyone you love and who loves you.

-Jim Scott