Living life, facing death-a review of A Beginner’s Guide to the End

Even as a physician, I was surprised at the claim that only 10% to 20% of us will die without warning. The rest of us will know we have something that will likely take our life. And even if we don’t, we all know we will die eventually, although we tend to think and act as if it’s a well kept secret, and maybe it is.

A Beginner’s Guide to the End

Practical Advice for Living Life and Facing Death

by B.J. Miller, M.D. and Shoshana Berger

This book’s tag line sums up the content of this book perfectly. I have reviewed other books about death on this blog; they were more biographical, philosophical, and spiritual and touched less on the practical. This book is on the other end of the spectrum; more practical, but also philosophical ,and spiritual. ( And I mean spiritual in a broad sense, not necessarily religious.)

The book begins with a brief biographical section where each author shares their reason for writing a book about death. Dr. Miller, a palliative care physician, had a life-threatening injury. He writes,

I got close enough to see something of death and come back from the ledge, only to realize that it’s in and around us all the time.

Ms. Berger, an editorial director, took care of her dying father. She wrote,

I remember those years as being full of anxiety and grief but also as a time of drawing closer.

an illustration from the book

How the book unfolds

The book consists of 5 sections that mimic the progression from life to illness to death. Even as a physician, I was surprised at the claim that only 10% to 20% of us will die without warning. The rest of us will know we have something that will likely take our life. And even if we don’t, we all know we will die eventually, although we tend to think and act as if it’s a well kept secret, and maybe it is.

The sections are as follows

  • PLANNING AHEAD
  • DEALING WITH ILLNESS
  • HELP ALONG THE WAY
  • WHEN DEATH IS CLOSE
  • AFTER

Although you could read the book straight through, you might want to skip to sections you need at whatever stage you are in. Chapter titles clearly tell you what to expect from their content. Here are some examples-

  • Yes, There’s Paperwork.
  • Can I Afford to Die?
  • I’m Sick
  • Love, Sex, and Relationships
  • Hospital Hacks
  • Care for the Caregiver
  • It’s Your Body and Your Funeral
  • Grief
  • How to write a Eulogy and an Obituary
  • Celebrating a Life

There are no photographs, charts, graphs, or info graphics, but scattered throughout are illustrative sketches that convey helpful information in a non threatening way. I have used some screenshots of a few of them to illustrate this post.

The authors conclude the book with Last Words, Acknowledgments, Resources (an extensive list), Notes, and Index.

Read this book

As much as I hope you don’t need it right now, unfortunately you do need it right now. So whatever stage of living, or dying, you or a loved one may be in, you will find something helpful here.

Find the book at your local library like I did, or get it from one of these book sellers; this would be a good book to keep on hand. (These affiliate links pay a commission to support this blog, while you pay nothing extra. )

Bestsellers at eBooks.com! Support Independent Bookstores - Visit IndieBound.org
Dr. Miller’s TED talk on WHAT REALLY MATTERS AT THE END OF LIFE

Here is another post from this blog about the dying experience

What books teach us about dying

an excerpt-

I reviewed these books  because understanding how other people and their families have faced death may relieve our dread, anxiety, or fear  about dying and death. Often it is not death itself that we fear but the dying process -the pain , disability, dependence, isolation, unfulfilled dreams.

In an essay  for JAMA, Dr. Zachary Sager, a geriatric and palliative care physician in Boston Massachusetts, described his response to  working with dying patients-

“I witnessed how people could be simultaneously resilient and fragile. I was moved by the connectedness between individuals.

I accept that death offers not only the expected reflection on life and mourning but an opportunity for a unique form of growth and healing. ”

The books I reviewed share  common themes, and events yet are each unique as are the people in them who demonstrate both resilience and fragility.

sharing the HEART of life and death

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

Being Mortal- a book review

a book review – Being Mortal -Medicine and What Matters in the End by Dr. Atul Gawande

Being Mortal 

Medicine and What Matters in the End

by Atul Gawande, M.D. 

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

 

 

Dr. Atul Gawande is a surgeon at Brigham and Women’s Hospital in Boston, Massachusetts and professor at Harvard Medical School. He writes for The New Yorker and has authored three other bestselling books.

He also (in June 2018) was named  CEO of the Amazon-Berkshire-JPMorgan Chase healthcare partnership, causing some to call him the “most feared CEO in healthcare.”

 

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.

Caring 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.”

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

Caring 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.”

Being Mortal is also available as a convenient low cost ebook from eBooks.com. (Using this affiliate link supports this blog.

drawing of various electronic devices-phone, PC, tablet,
graphic from Lightstock.com, an affiliate link

 

I  also 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.

 

I appreciate your sharing  this post on your social media pages.

And please follow Watercress Words for more information and inspiration to help you explore the HEART of HEALTH.

Thank you for  viewing  the advertisements and using the affiliate links  that fund this blog; with your  help, we can grow, reach more people, and support worthy causes that bring health and wholeness to people around the world.

Thanks for visiting.        26952564_10213093560871954_4239554644472378905_o

Dr. Aletha 

Being Mortal- a review

a book review – Being Mortal -Medicine and What Matters in the End by Dr. Atul Gawande

Being Mortal 

Medicine and What Matters in the End

Atul Gawande- Being Mortal-book cover

 

 

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

 

I read Being Mortal by Atul Gawande, M.D. (To be exact, I listened to the audio version)

Dr. Gawande is a surgeon at Brigham and Women’s Hospital in Boston, Massachusetts and professor at Harvard Medical School. He writes for The New Yorker and has authored three other bestselling books.

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.

Caring 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.”

 

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

Caring 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.”

 

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.

 

I appreciate your sharing  this post on your social media pages.

And please follow Watercress Words for more information and inspiration to help you explore the HEART of HEALTH.

Thank you for  viewing  the advertisements and using the affiliate links  that fund this blog; with your  help, we can grow, reach more people, and support worthy causes that bring health and wholeness to people around the world.

Thanks for visiting.        26952564_10213093560871954_4239554644472378905_o

Dr. Aletha