Monday, November 9, 2015

Book review: Being Mortal: Medicine and What Matters in the End by Atul Gawande

Dr. Gawande is a brilliant writer. What is so brilliant about him is how he presents difficult, sometimes complicated material so well. You often don't even notice the writing at all, which is the sign of a brilliant writer.

Dr. Gawande also seems like an excellent doctor. He's certainly one I'd like on my side. He's always trying to learn and grow, and in that effort, he has noticed that he has difficulty discussing the very rough conversations with patients, particularly about mortality and the end of life. He often knows when he's reached the point where trying more techniques or experimental treatments is just throwing good money after bad, but he hesitates to tell his patients that they should give up. He wants to improve his communication and improve the quality of life for his patients who are at the end of their lives. Along the way he learns more about pain control and a great deal about palliative care and hospice. For example, much to his surprise, people who enter hospice often turn out to live quite a bit longer than predicted, and live longer than patients still actively treating and fighting who are at the same stage. And the key seems to be that they are happier, able to do things they enjoy and spend time with loved ones, and aren't in pain and having bad side effects.

Meanwhile, his own father, a doctor as well (urologist), starts to have some odd symptoms. His hand has a numbness and he starts dropping his tennis racket. Proving the stereotype, he doesn't get this checked out for a long time, and when he does, it's terrible news. Through the course of the book, Dr. Gawande's father goes through risky treatments and ups and downs. But Dr. Gawande remembers what he has learned about quality of life and about asking the right questions: What will make you happy? How do you want to live? What is your goal at the end of this? His family has the hard conversations about the end.

This is an important book. And it's important to have read this and thought about it before you really need to.I expect it's a book that I'll have to go back to, when the time comes to have those conversations with my own loved ones, but I'm so glad to have gotten a primer on the subject well before that time. And a well-written one at that.

I borrowed this book from my mother.

No comments: