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Being Mortal: Medicine and What Matters in…

Being Mortal: Medicine and What Matters in the End

by Atul Gawande

Other authors: See the other authors section.

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2,0471553,258 (4.45)420
  1. 00
    Final Exam: A Surgeon's Reflections on Mortality by Pauline W. Chen (BookshelfMonstrosity)
    BookshelfMonstrosity: Written by experienced and dedicated physicians, these compelling books question American health care's emphasis on management and technique to the detriment of human relationships between doctors and patients, especially when the patient's mortality is an important consideration.… (more)

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I listened to this book on CD whilst commuting. Its effortless prose unencumbered by unnecessary jargon or excessive use of metaphors/similes allows this reader (listener) to peer behind the stats and figures highlighting the overtreatment/overdiagnosis of old age and gain an appreciation for the root cultural drivers of these trends. As with most healthcare stories, whilst the US stands out as an outlier, there are similar trends across much of the developed and developing world.

One powerful anecdote that has stuck with me is Dr. Gawande relaying the reduction in mortality amongst those patients managed by a geriatrician-led multi-disciplinary care team (cf. std. of care). He rightly notes that had this same benefit been achieved by a pill or a medical device, lawmakers would be clamouring to expand access to it.

Ultimately, Bring Mortal is a tale of human nature being shaped by a care system that incentivises quantity vs quality (of life).

- Manish Kar (Canada)
  Overdiagnosis | Oct 4, 2017 |
Everyone over 60 should read this book. ( )
  Deelightful | Sep 30, 2017 |
Being Mortal is a thought-provoking book by a physician about health care professionals (primarily doctors) and the way they treat (or mistreat, depending on your point of view) humans at the end of their lives. Atul Gwande did a lot of research, interviewing patients and family members as well as health care professionals and reviewing alternatives to nursing home care. It's obvious that he doesn't have the answers but he gave voice to those who are (or have been) in the fight and are the experts in end of life care. As Dr. Gawande states, "It's not death the very old tell me they fear, It is what happens short of death". ( )
  bogopea | Sep 22, 2017 |
Can I get my doctor to read this? ( )
2 vote MarthaJeanne | Aug 31, 2017 |
This is really interesting and a valuable read—not only about end of life issues but about quality of life issues, and where the two overlap. Gawande lays out some powerful questions to ask yourself or your loved ones about what's important; I think it's also useful information for navigating conversations with doctors, which has a weird learning curve even under the best of circumstances. It's a practical book but also something of a parable or a koan for life in general, not just dying, and as such I strongly recommend it. ( )
1 vote lisapeet | Aug 24, 2017 |
Showing 1-5 of 163 (next | show all)
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.”
added by melmore | editNew York Times, Sheri Fink (Nov 6, 2014)

» Add other authors (3 possible)

Author nameRoleType of authorWork?Status
Atul Gawandeprimary authorall editionscalculated
Petkoff, RobertNarratorsecondary authorsome editionsconfirmed
Pradera, AlejandroTranslatorsecondary authorsome editionsconfirmed
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I see it now—this world is swiftly passing.
—the warrior Karna, in the Mahabharata

They come to rest at any kerb:
All streets in time are visited.
—Philip Larkin, "Ambulances"
To Sara Bershtel
First words
I learned about a lot of things in medical school, but mortality wasn't one of them.
Modern scientific capability has profoundly altered the course of human life. People live longer and better than at any other time in history. But scientific advances have turned the processes of aging and dying into medical experiences, matters to be managed by health care professionals. And we in the medical profession have proved alarmingly unprepared for it.
In other words, our decision making in medicine has failed so spectacularly that we have reached the point of actively inflicting harm on patients rather than confronting the subject of mortality. If end-of-life discussions were an experimental drug, the FDA would approve it.
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.
… our driving motivations in life, instead of remaining constant, change hugely over time and in ways that don’t quite fit Maslow’s classic hierarchy. In young adulthood, people seek a life of growth and self-fulfillment, just as Maslow suggested. Growing up involves opening outward. We search out new experiences, wider social connections, and ways of putting our stamp on the world. When people reach the latter part of adulthood, however, their priorities change markedly. Most reduce the amount of time they spend pursuing achievement and social networks. They narrow in. Given the choice, young people prefer meeting new people to spending time with, say, a sibling; old people prefer the opposite. Studies find that as people grow older they interact with fewer people and concentrate more on spending time with family and established friends. They focus on being rather than doing and on the present more than the future.
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Amazon.com Product Description (ISBN 0805095152, Hardcover)

In Being Mortal, bestselling author Atul Gawande tackles the hardest challenge of his profession: how medicine can not only improve life but also the process of its ending

Medicine has triumphed in modern times, transforming birth, injury, and infectious disease from harrowing to manageable. But in the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit. Nursing homes, preoccupied with safety, pin patients into railed beds and wheelchairs. Hospitals isolate the dying, checking for vital signs long after the goals of cure have become moot. Doctors, committed to extending life, continue to carry out devastating procedures that in the end extend suffering.

Gawande, a practicing surgeon, addresses his profession’s ultimate limitation, arguing that quality of life is the desired goal for patients and families. Gawande offers examples of freer, more socially fulfilling models for assisting the infirm and dependent elderly, and he explores the varieties of hospice care to demonstrate that a person's last weeks or months may be rich and dignified.

Full of eye-opening research and riveting storytelling, Being Mortal asserts that medicine can comfort and enhance our experience even to the end, providing not only a good life but also a good end.

(retrieved from Amazon Thu, 12 Mar 2015 18:25:46 -0400)

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