Being Mortal- a book review

Some treatments, rather than extending life can prolong the suffering. Still it is heart wrenching for patients and families, along with their doctors, to decide that it is time to forgo treatment and instead opt for palliative care, with or without hospice.

Being Mortal 

Medicine and What Matters in the End

by Atul Gawande, M.D. 
This post was updated July 10, 2021

Atul Gawande, MD, MPH, is a surgeon, writer, and public health leader. He is a practicing endocrine surgeon at Brigham and Women’s Hospital and a professor at Harvard Medical School and the Harvard T.H. Chan School of Public Health.

He founded Ariadne Labs, a joint center for health systems innovation, and Lifebox, a nonprofit organization making surgery safer globally. He also co-founded CIC Health, which operates COVID-19 testing and vaccination nationally, and served as a member of the Biden transition COVID-19 Advisory Board.

Dr. Gawande writes for The New Yorker magazine and has written four New York Times best-selling books. He won two National Magazine Awards, AcademyHealth’s Impact Award for highest research impact on healthcare, a MacArthur Fellowship, and the Lewis Thomas Award for writing about science.

In 2021 he delivered the commencement address at Stanford University , from which he had graduated. In his speech he referenced the COVID-19 pandemic, calling it the third highest cause of death in 2020. He also told the graduates,

We are often most energized when we help others express their worth.

Atul Gawande

(This blog post features affiliate links which pays a small commission to this blog from purchases, without additional cost to you)

In Being Mortal, he explores the way most people now live, age and die and for the most part it’s not a pleasant prospect.

How we care for elderly people

As people age and lose independence due to frailness, illness, mental decline and poverty, they often also lose whatever is most important to them- their home, pets, hobbies, possessions. And these losses often occur to protect them from harm as they progress into assisted living centers, nursing homes and hospice.

Dr. Gawande describes how his  family in India expected  to care for their elderly relatives, which differed from what he saw happen when they immigrated to the United States. After becoming a physician, he recognized that our care of the elderly often robs them of the well-being that he sought to promote in his practice.

He wondered how it can be done differently. To find out, he interviewed people who are developing novel ways to provide care to older people, care that preserves their independence, dignity and choices while still keeping them safe and protected.

Most of us either have relatives or friends facing these decisions, or are facing them ourselves. If not now, we all will eventually. Whichever the case, this book shows

“how the ultimate goal is not a good death but a good life-all the way to the very end.”

Atul Gawande
woman sitting in a cemetery
photo from the Lightstock.com collection, an affiliate link

How we care for dying people

Finally, Dr. Gawande discusses end -of -life care- that is, care when a disease has become terminal and a cure is no longer likely. Sometimes it is difficult to determine when that occurs. As he says, it is rare in medicine when there truly is “nothing more we can do”.

However, just because we can do something, doesn’t mean we should. Some treatments, rather  than extending life just prolong the suffering. Still it is heart wrenching for patients and families, along with their doctors, to decide that it is time to forgo treatment and instead opt for palliative care, with or without hospice.

(Palliative care focuses on symptom management and social and emotional support for patients and families.)

Dr. Gawande poignantly describes this process by sharing in detail his  father’s cancer diagnosis, treatment, progression, hospice care and death. He shows how difficult a process this can be, given that even he and his parents, all of whom are physicians, struggled to come to terms with the reality of terminal illness and the dying process. Though they were all familiar with and experienced in dealing with the medical system, they still felt unprepared to face the decisions required at the end of life. But in the end, both he and his father felt at peace with the outcome and Dr. Gawande senior did experience “a good life-all the way to the very end.”

I  enjoyed listening to this interview with Dr. Gawande-

 Atul Gawande on Priorities, Big and Small

a podcast interview with Tyler Cowen

Other books by Dr. Gawande

Complications : A Surgeon’s Notes on an Imperfect Science

In gripping accounts of true cases, surgeon Atul Gawande explores the power and the limits of medicine, offering an unflinching view from the scalpel’s edge. Complications lays bare a science not in its idealized form but as it actually is―uncertain, perplexing, and profoundly human.

Better: A Surgeon’s Notes on Performance 

The struggle to perform well is universal: each of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives may be on the line with any decision.

Atul Gawande, the New York Times bestselling author of Complications, examines, in riveting accounts of medical failure and triumph, how success is achieved in this complex and risk-filled profession

The Checklist Manifesto:How to Get Things Right

Atul Gawande shows what the simple idea of the checklist reveals about the complexity of our lives and how we can deal with it.

Here is Dr. Gawande’s speech at the Stanford Commencement

sharing the HEART of health from birth to death

I appreciate all of you who are following Watercress Words, and if you aren’t I invite you to join the wonderful people who are. You can meet some of them in the sidebar, where you can click on their image and visit their blogs. Use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me.

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Dr Aletha

COURAGE for the UNKNOWN SEASON- a review

Written especially for Baby Boomers-those of us born between 1946 and 1964- Courage for the Unknown Season offers sound advice and encouragement to anyone who wants to be prepared for aging. For those younger, it will help you understand and deal with the challenges your parents and grandparents are encountering now;

COURAGE for the UNKNOWN SEASON

Navigating What’s Next with Confidence and Hope

By Jan Silvious

Even though Jan Silvious titled her book, Courage for the Unknown Season, we know what that season is-the season of aging and its inevitable, relentless progression toward death.

We’ve seen it, some of us are already in it, and it can be a scary place, with many unknowns other than the end. Jan refuses to let aging intimidate her, and wrote this book to help others take on our fear of aging, loss, illness, disability, and death with confidence and hope.

She starts the book with a chapter titled “Resilience”, followed soon by “Fight Fear”. She advises us “Don’t Forget to Laugh”, and to “Clean Up after Yourself”- that is, deal with our personal possessions so our family doesn’t have to when we are gone.

I ‘m glad she offers practical tips on staying healthy that she learned from a physician friend. In the chapter “Head Toward Ninety” she lists several steps to maintain wellness-

  • exercise
  • adequate sleep
  • health promoting food
  • pursue a healthy mind and spirit

“READ, STAY CURIOUS, FORGIVE, DROP THE BITTERNESS, AND PURSUE PEACE.”

Jan Silvious
person holding the Holy Bible
image from the LIGHTSTOCK.COM collection, an affiliate link

She points us to Psalm 92 from the Bible, and suggests meditating on it to gain a “wealth of spiritual health.”

“It is good to give thanks to the Lord
And to sing praises to Your name, O Most High;
 To declare Your lovingkindness in the morning
And Your faithfulness by night,

For You, O Lord, have made me glad by what You have done,
I will sing for joy at the works of Your hands.”

Psalm 92: 1-4 (NASB)

New American Standard Bible (NASB)

Copyright © 1960, 1962, 1963, 1968, 1971, 1972, 1973, 1975, 1977, 1995 by The Lockman Foundation

Later, she takes us by the hand, without mincing words about the pain we will experience with loss, and walks us through steps to navigate “Grief and Hope”.

Jan uses examples from her life, her family, friends, and colleagues of using our later years to cherish old memories while continuing to make new ones. She doesn’t try to convince us that aging isn’t painful, but encourages us to find new ways to find joy and fulfillment when the old ways are no longer possible.

Why you should read this book

Written especially for Baby Boomers-those of us born between 1946 and 1964- Courage for the Unknown Season offers sound advice and encouragement to anyone who wants to be prepared for aging. For those younger, it will help you understand and deal with the challenges your parents and grandparents are encountering now; but stow away a copy for 10, 20, 30 or more years when you will appreciate its wisdom for your own life.

I enjoyed reading it since I have or am experiencing much of what she discusses, and her perspective validates my own. For those things I have yet to encounter, I appreciate her suggestions and warnings.

“NO MATTER WHAT SEASON YOU ARE IN, THERE ARE TRUTHS THAT CAN HELP YOU APPROACH THE UNKNOWN WITH CONFIDENCE AND HOPE.

TRUST THAT GOD IS THE GOD OF OUR SEASON, NO MATTER WHAT IT LOOKS LIKE, NO MATTER HOW UNKNOWN.”

Jan Silvious

the author

Jan Silvious

Jan Silvious is a long-time speaker, professional life coach, wife, mother, and grandmother. She is author of eleven books, including Big Girls Don’t Whine and Fool-Proofing Your Life. Jan and her husband, Charlie, live in Tennessee, and have three grown sons, two daughters-in-love, five charming grandchildren and a very bright rescued pit-bull, Rocky-Buddy.

Jan Silvious, author
Jan Silvious, author

Disclosure: I read an advance review copy of this book which I received complimentary from  Tyndale via NetGalley in return for writing a review.

This post contains affiliate links, which if used by readers, pay a small commission to support this blog.

sharing the HEART of health with faith, hope, and love

I appreciate all of you who are following Watercress Words, and if you aren’t I invite you to join the wonderful people who are. You can meet some of them in the sidebar, where you can click on their image and visit their blogs. Use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me.

FAITH HOPE LOVE in block letters
Faith ,Hope ,and Love

(1 Corinthians 13:13)

Dr Aletha

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