Review: Being Mortal: Medicine and What Matters in the End

Being Mortal: Medicine and What Matters in the End
Being Mortal: Medicine and What Matters in the End by Atul Gawande
My rating: 4 of 5 stars

Being Mortal
Medicine and What Matters in the End
By Atul Gawande

Reviewed by Jay Gilbertson

This is one of those books that will change you. Wake you up. Throw you off balance and give you something to chew on. A whole lot. Everyone should read this and pass it around and book clubs should talk it over and kids should give it to parents. Schools should teach it. Are you getting my point here? Good. C’mon, let me tell you about it. Or better yet, let the doctor. Atul Gawande is a surgeon as well as a bestselling author.
“Maslow argued that safety and survival remain our primary and foundational goals in life, not least when our options and capacities become limited. If true, the fact that public policy and concern about old age homes focus on health and safety is just a recognition and manifestation of those goals. They are assumed to be everyone’s first priorities.”
Through interviews and actual patient cases Gawande experienced, he shares his insight into a new and surprising venue—end of life wishes. What are yours? Have you shared them? One of the many things author Gawande examines is how we as a society are set up to put our elders in nursing homes. To ensure their safety, to make sure their meds and dietary needs and all are met, followed and that’s that. Right?
What about the life part? Where’s the quality of life factor in all those nursing homes. Sure, there has been a huge push to re-name a great many of them. Senior Centers, Assisted Living, Retirement Retreat. And one of my favorites when referring to Florida—God’s Waiting Room. Good grief.
“We want autonomy for ourselves and safety for those we love. That remains the main problem and paradox for the frail. Many of the things that we want for those we care about are the things that we would adamantly oppose for ourselves because they would infringe upon our sense of self.”
Trying to make old age more meaningful seems to be a relatively new concept. Sure, we want to be safe, not fall and bust our hips, but have you been to a nursing home? Line up the beds, feed everyone at the same time and keep those meds coming! That isn’t living people, that’s storage until the expiration date hits.
No thank you.
Now that I have your attention, there are some basic things to keep in mind as you plan out your end of life scenario. There is getting old and staying in your own home, works for a time, but what is plan B? Where will you go and how will you pay for it? Get busy and find out! Then there is the possibility that you may hit a snag and be facing end of life issues. Guess what? We all die, so why not make some plans? If you are suddenly in need of palliative care, what do you want? If you don’t talk about this stuff, get it on paper and tell your friends and family, the medical community is designed to keep you alive no matter what.
No matter what.
“A few conclusions become clear when we understand this: that our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to shape one’s story is essential to sustaining meaning in life; that we have the opportunity to refashion our institutions, our culture, and our conversations in ways that transform the possibilities for the last chapters of everyone’s life.”

• Living Wills are just that
• Talk is cheap—write it down
• We’re in this together

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