"Our reluctancy to honestly examine the experience of ageing and dying has increased the harm we inflict on people and denied them the basic comforts they most need" Atul Gawande
This is a post that I have been wanting to write for some time. However, due to the very nature of this book's topics it has been one that has taken me a significant amount of time to get through. By no means is this book boring, it is the complete opposite and dare I say it is to date my favourite book that I have read associated with medicine. It is a remarkable book that tackles the subject of mortality, one that many fear, and addresses ideas of ageing, dying and medicine's role in all this.
"The simple view is that medicine exists to fight death and disease, and that is, of course, it's most basic task"
Throughout the book Gawande has changed many of my views on medicine, before reading this book I was certain that the role of medicine is to prolong life. However, through Gawande's telling of many different patients who faced terminal cancers of many kinds has persuaded me quite easily that the role of medicine ought to be to enable people to live the best quality of life possible. In many cases this seems counterintuitive when sometimes the best quality of life is in fact not continuing chemotherapy or treatment. Gawande explains the importance of conversation, how regardless of how hard the conversation may be to talk about death, what people want in their last days, what their priorites are, is in fact extremely beneficial, and also proves how important communication is as a doctor.
However what intrigued me the most in this book was the beginning section on nursing homes. I knew that they were possibly not the best place in the world, having visited one for a relative and also volunteering in a hospice. However, I did not understand their sheer horror for many of the elderly who stay at some, in the sense they are often denied the right to do what they really want. I loved reading of the pioneers who are attempting to change the stereotype of a nursing home and the weird and wonderful experiments they conducted as a result (a personal favourite being when Bill Thomas, a medical director of a nursing home, proposed the idea of introducing 2 dogs, 4 cats and 100 birds as pets into the home, with extradorinaiy results).
“A few conclusions become clear when we understand this: that our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to shape one’s story is essential to sustaining meaning in life; that we have the opportunity to refashion our institutions, our culture, and our conversations in ways that transform the possibilities for the last chapters of everyone’s lives.”
However, the book overall has given me a new perspective on mortality, yes it is a scary thought, dying is something I fear greatly, but the idea that with the help of medicine one can try and die peacefully is reassuring. I am young, I haven't even started university, but this book to me is of great relevance, it has not only changed my perspective of the role of medicine, but it has also changed my perspective on life. Whether Gawande's aim of the book was this or not he has shown me to live for quality of life not quantity.
I end that this book is insightful and moved me significantly, it is important and everyone should read it, to change their ideas on ageing and mortality.
"In the end, people don't view their life as merely the average of all its moments—which, after all, is mostly nothing much plus some sleep. For human beings, life is meaningful because it is a story."
*quotes all taken from Being Mortal by Atul Gawande*
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