- Paperback: 296 pages
- Publisher: Penguin Books India; Latest Edition edition (16 December 2015)
- Language: English
- ISBN-10: 0143425579
- ISBN-13: 978-0143425571
- Package Dimensions: 19.8 x 12.9 x 2.3 cm
- Customer Reviews: 244 customer reviews
- Amazon Bestsellers Rank: #4,946 in Books (See Top 100 in Books)
Being Mortal: Medicine and What Matters in the End Paperback – 16 Dec 2015
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About the Author
Atul Gawande, MD, MPH, is a surgeon, writer, and public health researcher. He has written four New York Times bestsellers: Complications, Better, The Checklist Manifesto, and most recently, Being Mortal: Medicine and What Matters in the End. He is the winner of two National Magazine Awards, AcademyHealth’s Impact Award for highest research impact on healthcare, a MacArthur Fellowship, and the Lewis Thomas Award for writing about science.
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244 customer reviews
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As the author so succinctly puts it, specialist doctors now-a-days are trained to 'fix' a particular problem. Elderly patients suffering from multiple ailments are brought to a hospital by their anxious relatives. Once inside the hospital complex, the patient is taken over by a regimented system. He loses his autonomy. Human warmth is in short supply and there is a certain chill in the atmosphere. Doctors do not have the time or inclination to have detailed discussion with the patient or his relatives. The system is heavily weighed in favour of the service provider, i.e., the hospital administration, doctors, pharmaceutical companies, insurance companies etc. The service seeker is left at the mercy of the heartless system.
The title of the book reminds us that man is after all mortal. In many cases, hospitals prolong life unnecessarily, painfully and at an exorbitant cost. An old and infirm person prefers to spend his last days at a place that provides homely comfort and medical care at an affordable price. The author cites several innovative models being tried by people dedicated to the cause of alleviating human suffering.
'Being Mortal' had a profound impact on me partly because I happened to read it when I had not yet recovered from the shock of my eighty five old mother's painful death. She was quite healthy in body and spirit until she was eighty. Then she had a sudden fall and broke her hip bone. An operation was done on her and a metal plate was implanted. A walking stick enabled her to walk on the level ground with difficulty. Her confidence was shaken as she lost her mobility. She considered herself a burden on the family. She became morose. Members of the family had little time to waste on her. She spent the day sitting alone on a chair in a dimly lit room and looking vacantly at a T.V. set. She had become incontinent. She was afraid she might wet the bed. Having lost her autonomy, she slowly sank into an abyss of dreadful agony which was reflected in her melancholy eyes. She often asked me piteously, " How long have I to live like this?" I had no answer. One day she stopped talking and eating altogether. She was admitted to a hospital. Doctors diagnosed it was a case of aspiration pneumonia. The pneumonia was controlled. But she never regained her ability to talk, drink or eat. She was brought back home. She spent her last days confined to her bed with all sorts of tubes sticking out of her frail body. Early one morning death came as a relief to her pain and shame.
A year has passed since my mother's death. Meanwhile I read 'Being Mortal'. The book's message rattled me. Nothing is more precious to a dying person than a smiling face or a loving gesture. Did my mother receive it in ample measure during the last phase of her life? Doubts linger.
The topic by itself is not new, having drawn numerous thinkers, philosophers and the likes into its folds. It is a tricky topic to deal with and this book gives us a fresh perspective as the author is a surgeon and has done significant work in the field of public health.
The book is divided into 8 chapters and the introduction tells us about Atul’s encounter with a gentleman suffering from metastatic prostate cancer and who lost his wife to lung cancer. He depicts the struggles of the treatment choices and the patient’s choices who refused to give up when presented with the odds.
Through extensive research and interviews, Atul takes us on a journey to understand our mortality. The inevitable decline of our bodies, the origins of assisted living, hospices and the like are all discussed in an easy to understand fashion. He also deals with the most grey and difficult area of medicine – decision making. How does one deal with bad news? How does one convey it effectively to the patient? How does one present difficult choices to a patient? Is modern-day medicine providing useful life to end-stage patients or only prolonging their suffering? Atul tries to answer these and many other questions with real-life examples. The story of his own father’s struggle with a spinal cord tumour is very moving and beautifully written.
He talks about the importance of the ‘dying role’ and how it’s been forgotten in this technological world. If we deny this role to our patients then are we really doing it right, he wonders.
A must read book for every doctor, paramedic and anyone who wonders about mortality and the choices at life’s very end...