Book Review: Being Mortal: Illness, Medicine and What Matters in the End

Medicine has been slow to confront the very changes that it has been responsible for — or to apply the knowledge we have about how to make old age better.
— Atul Gawande

Being Mortal: Illness, Medicine and What Matters in the End, written by Atul Gawande, MD, MPH is the authors' personal account of how to deal with the inevitable process of death and dying. He poses many examples of patients, family members and friends transition to dying and the choices that need to be made at the end of life. It is not a happy read, but an informative one and definitely a book to be read for all healthcare practitioners and people with loved ones coming to the end of their lives. 

“Medicine has been slow to confront the very changes that it has been responsible for — or to apply the knowledge we have about how to make old age better.” Gawande does not present any definite solutions in his book, but offers many accounts and options that people choose in their last days. Not only a medical professional, but a son, husband, and friend to many, Dr. Gawande has a unique perspective on life and death. He highlights that In our culture we look at death with fear and try to fix things that sometimes need not be fixed. We have a hard time accepting the end is near, and are always looking for another option or surgery or medicine to prolong  life, instead of just accepting death and making life’s' last days the most comfortable and joyous as possible.

Some amazing questions are presented and challenging choices are faced. It brings up the idea that since death is the inevitable end for us all, why not make it comfortable and fill our last days with family and activities we are still capable of. “Arriving at an acceptance of one’s mortality and a clear understanding of the limits and the possibilities of medicine is a process, not an epiphany.” This quote sums up one of the main lessons that I learned from this book- that sometimes people need not be fixed, but acceptance of the situation they are facing is the best option. The reminder that medicine has limits is also a great reminder for so many people. That sometimes there are no answers but acceptance and being in the moment, however fleeting they may be.

I can see this book being helpful for my patients that are experiencing the aging and death of their parents, someone with a relative with a terminal disease, or even someone that is consciously deciding to face their own demise. This book will hopefully inform people that there are other options out there rather than fighting till the end, such as hospice care. It explains that sometimes it is less about survival than enabling well-being in ones final days. This book has also helped me in dealing with the death of a young friend diagnosed with stage 4 stomach cancer. It was challenging but insightful to use this book as a reflection of this situation at hand. This book made me cry, but also brought peace of mind to the inevitable end we all face, and how we can allow it to be as much a part of our blessed existence as all the joys of life. 

Gawande, A. (2014). Being Mortal: Medicine and what matters in the end (First edition.). Metropolitan Books/Henry Holt and Company.

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