I would never have chosen to
read Being Mortal: Medicine and What
Matters in the End (Kushiel's Legacy), by Atul Gawande (2014). Books about death don’t interest me. Let me qualify: fictional books about death
do not bother me. Non-fictional books,
about the inevitability of death, the processes of death, don’t interest
me. It’s not just disinterest. It’s that I do not wish to confront or
consider the subject. Right now, my plan
is to continue living and not to think about the end result. Such a delusion
that may be.
Being Mortal is beautifully written. It moves back and forth from discussions of
attitudes towards death at various times in history, to the development of
approaches to “handling the elderly” through nursing homes, assisted living,
independent living, hospice care, and so on. One of Gawande’s main concerns is
the fact the developing technology has greatly extended the lifespan of human
beings and enables doctors and others to cure or treat diseases that in the
past would have led to early death. The
unwanted effect of such life-extending technology is that the body continues to
break down. Dementia, Alzheimer’s,
various ailments and products of the aging process can leave the elderly in an
unhappy state—blind, unable to care for themselves, unaware, in pain, separated
from loved ones and familiar environments.
He makes note of the considerable costs of life-extending technology
that allows the dying to survive into such a miserable state.
Gawande uses various examples
from his practice as a doctor to illustrate the development of his attitudes
over his career to death. His main
example is his father, also a medical doctor. The account of his father’s
decline and ultimate death is moving.
Gawande believes that as much as
possible the elderly and the dying should be empowered to take control of their
own mortality. If they want life
extended as much as possible, even though that may end in a coma, unable to
communicate with loved ones and others, he supports that wish. But if they want to maintain a quality of
life up to the point of death, relatively free of pain, able to continue living
and enjoying family and friends, he supports that too.
The book is informative and compassionate
and though I still hate the subject I am glad I read it.
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