Being mortal: medicine and what matters in the end, by Atul Gawande

 

This is a very moving book about what people need to think about as they approach end of life. Author Atul Gawande is a surgeon, writer, and public health researcher who currently works at Brigham and Women's Hospital in Boston, Mass., and teaches at Harvard Medical School. He also recently served for three years as an administrator of USAID. He writes early in the book about the history of nursing homes and the evolution of assisted living facilities before transitioning to discuss a number of cases of people dealing with terminal illnesses and how their cases were discussed by their caregivers. In many cases, the doctors were reluctant to face the inevitable outcomes and found it difficult to be honest with the patients about the often likelihood of failure of chemo and radiation to significantly extend life, for example, in the case of various cancers. In those cases, the instinct is to try everything, even when it seriously diminishes quality of life and barely (if at all) extends life. Gawande stresses the importance of finding out what your loved ones really want at the end, whether it's simply to reduce pain or die at home rather in an institution. He shares his own experience with his father's last illness, illustrating how difficult these discussions are even for professionals. I found this book to highly informative and thought-provoking, but also quite moving.