Being Mortal: Medicine and What Matters in the End was such a much-needed look at how the medical system treats death. I had wondered whether it would be depressing to read, and there were certainly sad moments and stories, but it was also hopeful and uplifting, and I found myself losing track of time while reading it sometimes. Even when statistics and information are provided, the narrative moves smoothly enough into stories and commentary to not get bogged down.

Gawande traces some of the history of the way humans have treated end-of-life care, emphasizing the advent of the nursing home, as well as "assisted living" and other attempts to bridge the gap between the hospital and the home. He also includes the stories of the (non-elderly) terminally ill as he explores the questions of what people who are dying really need -- and how we even get to the point where we are able to recognize "dying" for what it is, when we try to stave off death at any cost. He says:

“The problem with medicine and the institutions it has spawned for the care of the sick and the old is not that they have had an incorrect view of what makes life significant. The problem is that they have had almost no view at all. Medicine’s focus is narrow. 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.” 

He contrasts the traditional attitude of medicine, which is to solve problems and offer as much information and possibilities as it can, with the type of care (hospice) that looks to instead focus on the here and now rather than sacrificing the "now" for slim and unlikely future gains for the elderly and terminally ill -- but as he illustrates, it can be very difficult to draw that line. 

There were so many eye-opening things to think about here. This is a book that will probably resonate with many people -- even those of us who are not elderly or terminally ill have loved ones who are or will be, and it's worth thinking about what is most important during that journey, and developing a little bit of preparation for difficult conversations that will inevitably happen.

Scrounged From: A local used book sale.

Format: Hardcover
Author: Atul Gawande
Pages: 282
Content Advisory: Naturally, in a book that discusses death, there are many descriptions of people who are aging and dying, as well as some descriptions of their ailments and medical procedures. As I said, some of these are very sad, but the tone of the book overall is uplifting. Other than that, I remember a few minor swear words, but nothing else that I'd consider objectionable. Gawande does briefly mention "assisted death" toward the end, but that's not what the book is about. While he doesn't appear to be opposed to the idea, he also critiques it, and emphasizes that this attitude leaves us in danger of not valuing "assisted living" enough.

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