Being mortal Medicine and what matters in the end

Atul Gawande

Book - 2014

Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families of the terminally ill.

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New York : Metropolitan Books/Henry Holt and Company 2014.
First edition
Physical Description
282 pages : illustrations ; 22 cm
Includes bibliographical references.
Main Author
Atul Gawande (author)
  • The independent self
  • Things fall apart
  • Dependence
  • Assistance
  • A better life
  • Letting go
  • Hard conversations
  • Courage.
Review by Booklist Reviews

*Starred Review* Distressed by how "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," surgeon Gawande (The Checklist Manifesto, 2010) confronts the contemporary experience of aging and dying. Culture and modern medicine encourage an end-of-life approach that focuses on safety and protection but is sadly shallow. He frets that residents of nursing homes are often lonely and bored. Physicians are keen on intervening whenever a body is diseased or broken. Yet this "medical imperative" applied to terminally ill individuals can be frustrating, expensive, and even disastrous. Gawande suggests that what most of us really want when we are elderly and incapable of taking care of ourselves are simple pleasures and the autonomy to script the final chapter of life. Making his case with stories about people who are extremely frail, very old, or dying, he explores some options available when decrepitude sets in or death approaches: palliative care, an assisted living facility, hospice, an elderly housing community, and family caregivers. One of these stories is the impassioned account of his father's deterioration and death from a tumor of the spinal cord. As a writer and a doctor, Gawande appreciates the value of a good ending. Copyright 2014 Booklist Reviews.

Review by Choice Reviews

Gawande's fourth popular book, Being Mortal, layers touching story after touching story into a devastating critique of how people approach the end of life.  At times, keeping all the narratives straight proves difficult, yet each piece of each narrative remains powerful.  These accounts are woven neatly together with personal and professional reflection as well as scholarship.  For example, in the midst of telling readers about his grandmother-in-law's approach to the end of life, surgeon/journalist Gawande (Brigham and Women's Hospital; Harvard Medical School; The New Yorker) quotes B. Vladeck, summing up the origins of one problematic approach: "describing the history of nursing homes from the perspective of the elderly ‘is like describing the opening of the American West from the perspective of the mules'" (Unloving Care: The Nursing Home Tragedy, 1980).  As Being Mortal draws to a close, Gawande offers some (albeit tentative) recommendations for improving how people face the end of life.  Though he does not break new ground here, he rightly points out and announces human shortcomings in a way that all can see and understand. Summing Up: Highly recommended. All levels/libraries. --A. P. Schwab, Indiana University--Purdue University Fort Wayne Abraham P. Schwab Indiana University--Purdue University Fort Wayne Copyright 2014 American Library Association.

Review by Library Journal Reviews

Leading surgeon, Harvard medical professor, and best-selling author, Gawande is also a staff writer at The New Yorker, which published the National Magazine Award-winning article that serves as the basis for this study of how contemporary medicine can do a better, more humane job of managing death and dying. [Page 50]. (c) Copyright 2014. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.

Review by Publisher Summary 1

A prominent surgeon argues against modern medical practices that extend life at the expense of quality of life while isolating the dying, outlining suggestions for freer, more fulfilling approaches to death that enable more dignified and comfortable choices.

Review by Publisher Summary 2

#1 New York Times BestsellerIn Being Mortal, bestselling author Atul Gawande tackles the hardest challenge of his profession: how medicine can not only improve life but also the process of its endingMedicine has triumphed in modern times, transforming birth, injury, and infectious disease from harrowing to manageable. But in the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit. Nursing homes, preoccupied with safety, pin patients into railed beds and wheelchairs. Hospitals isolate the dying, checking for vital signs long after the goals of cure have become moot. Doctors, committed to extending life, continue to carry out devastating procedures that in the end extend suffering.Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families. Gawande offers examples of freer, more socially fulfilling models for assisting the infirm and dependent elderly, and he explores the varieties of hospice care to demonstrate that a person's last weeks or months may be rich and dignified.Full of eye-opening research and riveting storytelling, Being Mortal asserts that medicine can comfort and enhance our experience even to the end, providing not only a good life but also a good end.