Courtesy of Beaverdale Books
Review by Sally Wisdom
Oct. 7, 2014
Are doctors and families too afraid to discuss death to ask the right questions of end-of-life patients? Cancer surgeon and Harvard professor Atul Gawande thinks so and examines the issue in his book, “Being Mortal.”
With medical education focused on “fixing” what is wrong with the patient, medical professionals can be reluctant to acknowledge that all humans will eventually succumb to the inevitable. Too often death is a medical experience that takes place in a hospital, taking advantage of all available technology intended to prevent it. Gawande calls this “an experiment” that did not exist even a half century ago when most people died at home. “It is young,” he says, “and the evidence is that it is failing.”
Surgery such as joint replacement that promises long-term gain for short term pain is an easy choice for many. But a doctor discussing treatment options with a terminally ill patient may think of “extending life” in terms of months while the patient is thinking of years or even decades. Fully informed patients who opt for palliative care experience a greater sense of well-being in their final days and, ironically, sometimes live longer.
Gawande touches on the pros and cons of assisted suicide. He is sympathetic to its advocates but points out that where it is legal, fewer advances have been made in palliative care and he worries that it could become an expectation for those with little chance of recovery.
Nursing homes that were developed using a medical model frequently focus on safety and routine over quality of life. The facilities he describes with pets, flexible schedules and a wide range of choices for the residents sound downright inviting. While the topic isn’t exactly cheery, Gawande’s refreshing, compassionate approach is far from depressing and ultimately encouraging and comforting. CV
Sally Wisdom retired from the Des Moines Public Library in 2011 and found her dream job at Beaverdale Books soon after.