Being Mortal: Medicine and What Matters in the End Kindle Edition

This book is stunning. Clear, thoughtful, and at times hard to read, the book gives a first hand account of the author's experiences with end of life situations. His perspective is an unusual one; he's a clinician engaging with patients who are making end-of-life decisions or who were having others (such as well-meaning family members) make decisions for them. The situations are fascinating. His analyses, though they begin as medically-based, evolve into the thoughtful and humane. The book offers unique insights, and it's really well written.

This is an important read on what human well-being means and encourages us to confront the inevitable: death.The author writes on the subject fluently and beautifully and in a very compelling and empathetic way.Here are some key takeaways I took from it:1. Death and dying are becoming more prolonged and complex. Modern medicine is keeping many of us alive for longer.2. However, we still haven’t figured out how to deal with this new(ish) reality and how to have helpful conversations about dying. Indeed, our failure to do so may be accelerating death.3. Among what scared people about death is not death itself but dependence on others and loss of autonomy and independence.4. There are many different types of care for the dying, including nursing homes, assisted living communities, hospices etc.5. A medicalised and clinical approach to conversations around dying does not honour well-being of the individual.6. We need to have more “interpretive” ways of talking about dying. That includes asking people what they would like to prioritise if time is running short; what trade offs they are willing to make, and what level of being alive they are willing to tolerate.7. There are different organisations doing different things when it comes to caring for older adults. Sometimes these organisations do not prioritise the older adults’ well-being. A relentless focus on safety might render a cloistered life unbearable.8. It is essential to consider what the older adult wants. These are difficult conversations to have but they are important to help ensure that as many of us as possible can reach the end of our lives in dignity and well-being.Highly recommended.

Talking about ones mortality is a definite conversation stopper at many gathering. In our society with the rapid growth of medicines which can cure most diseases or at least elongate the process the reality of dying is pushed well into the future. Death is not an "up" subject, we'll find a way to get around its reality.BEING MORTAL is written with great compassion and wisdom. Dr. Atul Gawande considers both sides of the issue very throughly from the perspective of first the doctor who is the "fixer" of all things medical. All to often our Doctor is locked into the cure, a full on no holds chemical battle with the illness and is not able or will ing to address with the patients the fact that this illness will cause the patients death. It is not going to go away. Many doctors are unable to early on tell the patient that this illness is fatal, you will die once these interventions are exhausted. That conversation is not in their "black bag." The book addresses dying with very personal stories, the experience of patients living with chronic or measurable fatal illnesses. It goes beyond the common, "medical intervention" to look at accepting that this illness is fatal and prolonged suffering with it is optional. When do we, the patient, draw the line in the sand and say, "I'm not going to continue to fight a losing battle, I believe there is another path to follow."The journey I shared with my wife Helen is passionately told throughout the book. There came a time when she had had enough suffering from the standard interventions, "chemo, to surgical procedures." Finally she said that had to stop. Many lines in the book quoted verbatim what we had heard from our doctor, "well there is another new more aggressive chemo we can try now", wait, hold on we've been through three already. BEING MORTAL speaks to the issue of dying from two approaches diverse approaches, facing the reality and living with a chronic illness with a new focus placed on quality of life. Yes, you can die of a chronic illness and still have comfort, control and dignity. At one point in the book Dr. Gaqande puts both sides of the argument in sharp focus when he writes from his honest and realistic viewpoint; "The medical approach applies its own pressure always remaining an all or nothing, in one direction, toward dong more, because the only mistake clinicians seem to fear is doing too little. Most have appreciation that equally terrible mistakes are possible in the other direction - that doing too much could be no less devastating to a person's life." Many readers of this book will understand this point at a very personal level."In the book Dr. Gawande uses statistics in such a way that they become personal and allow you to ponder where we are in 2015 in regard to facing death as a society. From the book one gets the feeling that there is strength in getting involved early with a Hospice program. He states, " those who...entered Hospice far earlier, experienced less suffering and at the end of their lives - and at they lived 25% longer. For some making the decision to die under Hospice care in not an option they will exercise. However, the experiences of many people have had over the past twenty years are beginning to make the case. They speak to the merits of pain management, end of life quality of life.Dr. Gawawda has made it possible for my family to discuss the dying process in real time. We are spending time while we are all healthy pondering the issues together knowing that they surely one day will be as we say, "up close and personal." The book is a road map of sorts into those in their precious last months, weeks or days in the life. For a family about to see a loved one pass on and become an ancestor. BEING MORTAL allows the patient, family and fiends the opportunity to have a final bonding. I know my family and Helen's friends celebrated her life the entire seven months she was dying of cancer. Through it all we had many happy moments. BEING MORTAL mirrored out experience. An excellent book and one I would recommend be read by all medical students, nurses and us the family members who will share the journey with them.Tom Wicks