Being Mortal looks at end of life medicine and the medical professionals who handle it

The reviews of Atul Gawande’s best-selling book, Being Mortal: Medicine and What Matters in the End, praise the author’s look at how the medical profession handles aging and death.

“Powerful.” ―New York Magazine

“Being Mortal, Atul Gawande’s masterful exploration of aging, death, and the medical profession’s mishandling of both, is his best and most personal book yet.” ―Boston Globe

“Beautifully crafted . . . Being Mortal is a clear-eyed, informative exploration of what growing old means in the 21st century . . . a book I cannot recommend highly enough. This should be mandatory reading for every American. . . . it provides a useful roadmap of what we can and should be doing to make the last years of life meaningful.” ―

“Beautiful.” ―New Republic

“A needed call to action, a cautionary tale of what can go wrong, and often does, when a society fails to engage in a sustained discussion about aging and dying.” ―San Francisco Chronicle

A best-selling author and surgeon, Gawande’s book was reviewed by New York Times critic Sheri Fink at the end of last year. Here’s what she had to say of Gawande’s personal meditation of how we can better live with age-related frailty, serious illness and approaching death:

“It began with a tingle in the surgeon’s fingers and a pain in his neck. A couple of years later, he learned he had a tumor inside his spinal cord. That was when the difficult choices began. Should he have it removed right away in a risky operation, as his doctor recommended? Or should he take time to consider this question: At what point would the expanding tumor cause debility bad enough to justify the risk of greater debility or even death in trying to fight it?
“The surgeon in the story is the father of Atul Gawande, who is also a surgeon as well as a writer for The New Yorker. His new book, Being Mortal, is a personal meditation on how we can better live with age-related frailty, serious illness and approaching death.

It is also a call for a change in the philosophy of health care.
“Gawande writes that members of the medical profession, himself included, have been wrong about what their job is. Rather than ensuring health and survival, it is ‘to enable well-being.’

“If that sounds vague, Gawande has plenty of engaging and nuanced stories to leave the reader with a good sense of what he means. In a society that values independence, what happens when that is no longer possible? We need to reckon with the reality of the body’s eventual decline, he argues, think about what matters most to us, and adapt our society and medical profession to help people achieve that.

“Gawande writes: ‘For many, such talk, however carefully framed, raises the specter of a society readying itself to sacrifice its sick and aged. But what if the sick and aged are already being sacrificed — victims of our refusal to accept the inexorability of our life cycle?’

“Medical professionals are the ones who are largely in control of how we spend our ‘waning days,’ he writes, yet they are focused on disease, not on living. “ ‘Medicine has been slow to confront the very ¬changes that it has been responsible for — or to apply the knowledge we have about how to make old age better.’” The experts quoted here argue that doctors should not only treat disease but also concern themselves with people’s functional abilities, and that most medical trainees should learn about geriatrics.

“In the first part of the book, Gawande explores different models of senior living — from multigenerational households to newfangled nursing homes. In the latter part, which is shorter, he shifts somewhat abruptly to end-of-life medicine, promoting hospice as a model of care.
“The two sections are anchored by two of Gawan¬de’s most memorable New Yorker essays, which make up two of the book’s eight chapters —Things Fall Apart and Letting Go. Around them are rich stories from his own family.
Being Mortal is a valuable contribution to the growing literature on aging, death and dying. It contains unsparing descriptions of bodily aging and the way it often takes us by surprise. Gawande is a gifted storyteller, and there are some stirring, even tear-inducing passages here.

“The stories give a dignified voice to older people in the process of losing their independence. We see the world from their perspective, not just those of their physicians and worried family members.”