Being Mortal

Just finished the book by that title by Atul Gawande. Cousin Tina sent it to me a couple of weeks ago. It is a good read, but if you take my recommendation and read the book, please know that it gets better as it goes along. 

Gawande is a doctor who examines the end of life puzzle: When do we fix things and when do we accept the end and make people comfortable? In fact, the choice is rarely that stark, the reader learns through Gawande's personal experiences with patients, neighbors, friends--and his own family. Instead, the goal should be to ask the right questions and ask them early: What are you most afraid of? What are your goals? What would consititute a good day? Medical questions can be decided using those guidelines. The dizzying array of treatment options can be narrowed down. 

Central to the story is this surgeon's discomfort with dealing with death when it faces his patients. He admits to repeating mistakes even after learning his lesson, and he examines why. Doctors want to offer hope. That is why people come to them. They hope to get better. But what if they know there is no hope, at least hope for a prolonged life? 

Well, there is always the hope for a good few days and for eliminating treatments which promise only to make the next few days miserable. Here is where Gawande revealed a stunning fact: People who enter hospice live on average 25% longer than those who continue treatment in the hospital until death. 

Indeed, and Gawande does not mention this, there are people who survive hospice care. Harmon Killebrew was one. He entered hospice at least a decade before his eventual death. Turning away from treatment to acceptance and being comfortable improved his morale and saved his life. In his remaining years, Killebrew raised money for hospice and when he finally developed terminal cancer, he used his goodbye message to fans to advocate for the concept. 

Gawande does not purport to solve all the end-of-life conundrums. There is no right answer, and even people who give detailed instructions while healthy sometimes change their minds when they fall ill. However, Being Mortal can help anybody be more ready for the end whether for themselves, or for those they love.