Tag Archives: aging

Being Mortal: Medicine and What Matters at the End by Atul Gawande

cover image of Being MortalBeing Mortal by Atul Gawande is a short book that everyone should read. The author writes not only with an expertise in medicine (surgery) — as a doctor who has talked with many patients over the years — but from personal experience with family and family friends.

The awful choices that people face when given a terminal diagnosis are much more tragic when the sick person is young. The author acknowledges this, but the main focus of the book is on people who, with advancing age, are faced with choices (both for themselves and for loved ones) between what all appear to be poor options (because returning to an earlier state of health and vigor — the only really good option — isn’t an option.) Dying is a sad time, even if the dying person is 100 years old, but medical professionals’ approaches to dying tend to be institutionalized or textbook (doctor/patient), rather than time-consumingly tailored to the needs and desires of an individual who is sick or whose body is wearing out.

An excerpt from the middle of Being Mortal:

“The simple view is that medicine exists to fight death and disease, and that is, of course, its most basic task. Death is the enemy. But the enemy has superior forces. Eventually, it wins. And in a war that you cannot win, you don’t want a general who fights to the point of total annihilation. You don’t want Custer. You want Robert E. Lee, someone who knows how to fight for territory that can be won and how to surrender it when it can’t, someone who understands that the damage is greatest if all you do is battle to the bitter end.

More often, these days, medicine seems to supply neither Custers nor Lees. We are increasingly the generals who march the soldiers onward, saying all the while, ‘You let me know when you want to stop.’ All-out treatment, we tell the incurably ill, is a train you can get off at any time — just say when. But for most patients and their families we are asking too much. They remain riven by doubt and fear and desperation; some are deluded by a fantasy of what medical science can achieve. 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 — and escape a warehoused oblivion that few really want.” — Being Mortal, by Atul Gawande

Being Mortal is about

how to figure out what is most important to an individual at the end; how perspectives change and continue to change  as the end of life approaches;

how medical professionals can help patients make decisions when available treatments don’t exist yet, are risky, or have already failed;

how to talk with each other about what we value most;

and, most of all,  how to listen to what patients and loved ones are trying to tell us.

If you like authors like Oliver Sacks, Mary Roach, and Jane Gross, who combine science with memoir in their writing, or if you like heart-piercing memoirs like When Breath Becomes Air by Paul Kalanithi or New Life, No Instructions by Gail Caldwell, then you will probably like Being Mortal, portions of which were previously published in The New Yorker.

Being Mortal
Gawande, Atul
Henry Holt, 2014
9780805095159
304pp.
$26.00

Disclosure: I borrowed this book through the public library. It had been read many times and was already water-damaged when I received it. (Honest!)

 

The Wising Off that Comes with Age: Let’s Explore Diabetes with Owls by David Sedaris (Audio) @HachetteAudio

cover image of audiobookLet’s Explore Diabetes with Owls, the latest collection of humorous essays by David Sedaris, should win back all of the author’s fans who didn’t like his foray into fables, Squirrel Seeks Chipmunk.

Read by the author, Let’s Explore Diabetes with Owls has 20 essays in all, some of which were previously recorded in front of an audience. Some of the essays appeared in print in The New Yorker magazine and maybe elsewhere, but they really do seem funnier when the author reads them in his dryly knowing, who-me? voice.

As a humorist, David Sedaris has a definite liberal bias, but politics is very rarely the subject of an essay, except as it relates to health care, President Barack Obama, and marriage laws. These are subjects in the titles of some of the essays, but the subjects of most of the essays are the author’s own experiences, or as they would be if they had all taken place on days when everything struck him as being highly significant or indicative of a universal truth, while being, at the same time, extremely annoying.

In Obama!!!!! the author, an American living in England with his partner Hugh, describes the experience of traveling in Europe after the 2008 election of President Obama and hearing “Obama!!!!” from everyone he meets, including shop clerks and waiters. At first, he doesn’t mind being constantly congratulated on his country’s behavior, and smiles along at the constant cry of “Obama!!!!!”, but after a while, he starts to tire of the implication that underlies the surprise and pride that Europeans keep expressing to him – that America, as a country, had been thought too immature, too ignorant, and too racist to elect a black president, but look! they did it!

At the end of the book, after the 20 essays, the author includes six monologues that are ostensibly there for teens to perform in their forensics competitions in school, which he included, he says, because he had learned that teens have been using his work to read in front of panels of judges for these competitions. In each of the six monologues, he takes on a different persona, each one more offensive than the last. So these missed the mark for me as comedy, but maybe I took them too seriously.

This collection has several essays dealing with aging, travel, learning foreign languages, doing book tours, and living abroad. It also includes a special addition to the audio edition of Pimsleur phrases in Japanese that were not taught on the Pimsleur language learning CDs.

If you’ve enjoyed other David Sedaris audiobook collections in the past, you will probably enjoy this one. If not, probably not. If you’ve never listened to any before, I would recommend starting with one of the earlier collections, maybe Holidays on Ice or Naked, to get a feel for his humor and the personality he takes on in his essays (which I assume is a more highly concentrated version of his own actual personality).

Let’s Explore Diabetes with Owls
Sedaris, David
Narrated by the author
Hachette Audio
April 2013
9781619696990
$29.98 US/$32.98 CAN
7 hours on 6 CDs

Disclosure: I borrowed this audiobook from the public library.

Sound Bytes badgeThis review is linked up to Sound Bytes, a weekly link-up of audiobook reviews at Devourer of Books.

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