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Description - Being Mortal by Atul Gawande

For most of human history, death was a common, ever-present possibility. It didn't matter whether you were five or fifty - every day was a roll of the dice. But now, as medical advances push the boundaries of survival further each year, we have become increasingly detached from the reality of being mortal. So here is a book about the modern experience of mortality - about what it's like to get old and die, how medicine has changed this and how it hasn't, where our ideas about death have gone wrong. With his trademark mix of perceptiveness and sensitivity, Atul Gawande outlines a story that crosses the globe, as he examines his experiences as a surgeon and those of his patients and family, and learns to accept the limits of what he can do.

Never before has aging been such an important topic. The systems that we have put in place to manage our mortality are manifestly failing; but, as Gawande reveals, it doesn't have to be this way. The ultimate goal, after all, is not a good death, but a good life - all the way to the very end.

Published in partnership with the Wellcome Collection, a free visitor destination that explores the connections between medicine, life and art.

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Book Details

ISBN: 9781846685828
ISBN-10: 1846685826
Format: Paperback / softback
(200mm x 130mm x 20mm)
Pages: 304
Imprint: Profile Books Ltd
Publisher: Profile Books Ltd
Publish Date: 1-Jul-2015
Country of Publication: United Kingdom

Book Reviews - Being Mortal by Atul Gawande

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Book Review: Being Mortal by Atul Gawande - Reviewed by (21 Sep 2016)

Being Mortal is the fourth book by American surgeon and author, Atul Gawande. Early on in his book, he tells us :“…the purpose of medical schooling was to teach how to save lives, not how to tend to their demise” and that “I knew theoretically that my patients could die, of course, but every actual instance seemed like a violation, as if the rules I thought we were playing by were broken. I don’t know what game I thought this was, but in it we always won”.

But don’t get the wrong idea: this is not a book about dying, so much, as a book that looks at how the latter hours, days, weeks, months or even years of life can be improved. As we get older, and usually frailer (because there is no “…automatic defrailer…” [p44] available to us), we need to rethink where the emphasis should lie: “…our most cruel failure in how we treat the sick and the aged is the failure to recognise that they have priorities beyond merely being safe and living longer…” “We end up with institutions that address any number of societal goals – from freeing up hospital beds to taking burdens off families’ hands to coping with poverty among the elderly – but never the goal that matters to the people who reside in them: how to make life worth living when we’re weak and frail and can’t fend for ourselves”. Gawande’s wife’s grandmother, when institutionalised, remarked: “She felt incarcerated, like she was in prison for being old”

Gawande backs up his ideas with plenty of data that is both fascinating and revealing. And while an information dump could be boring, he illustrates all this with the results of studies and anecdotes about real people. It doesn’t get much more personal than the experience of his own father’s decline.

“Our responsibility, in medicine, is to deal with human beings as they are. People die only once. They have no experience to draw on. They need doctors and nurses who are willing to have the hard discussions and say what they have seen, who will help people prepare for what is to come…”

While many practitioners of palliative care will be familiar with what Gawande says, this book should be compulsory reading for most health care professionals. Oncologists, gerontologists, surgeons and intensivists (and their patients!) in particular would benefit from reading this book from cover to cover; those of us with ageing or debilitated family members, or those wanting to plan for their own eventual decline, would also find this book interesting and useful.

He concludes: “We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. Those reasons matter not just at the end of life, or when debility comes, but all along the way. Whenever serious sickness or injury strikes and your body or mind breaks down, the vital questions are the same: What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding?” Recommended. 5 stars


Author Biography - Atul Gawande

Atul Gawande is a surgeon, writer and public health researcher. He practices general and endocrine surgery at Brigham and Women's Hospital in Boston. He is also Professor of Surgery at Harvard Medical School and Professor in the Department of Health Policy and Management at the Harvard School of Public Health. He writes regularly for the New Yorker, and is the author of Better (9781861976574), Complications (9781846681325), The Checklist Manifesto (9781846683145) and Being Mortal (9781846685828).

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