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Being Mortal: Medicine and What Matters in the End by Atul Gawande
5/5. Discussion by a surgeon about how poorly we often handle mortality – care for the elderly in general, and death for both the old and young.
Excellent. I’ve had this book on my radar for over a decade, but the last time I went to pick it up, I found out literally the next day that my father was terminally ill, and I noped out. He lived another eleven months, which was about five months longer than he was expected to, but it’s taken me nearly eight years to come back to this book. I’m very glad I did, though this is depressing and infuriating and did make me cry.
It is also incredibly useful. There is an aging person in my life whom it is likely my wife and I will need to provide care for when it is needed, and this book was incredibly grounding on what that might look like, and in supplying an ethical framework to think about it. It would be oversimplifying to say that the book argues for privileging autonomy over safety, because there’s more to it than that, but the points it makes about how so many elderly care facilities are designed for the psychological comfort of the residents’ families at the expense of the residents’ comfort and happiness is sobering.
Also notable for some candid and messy examinations of how doctors do and don’t approach mortality with patients. There are no easy answers there, as patient need will vary widely. Some need to hear it to be prepared. Some don’t ever want to hear it. But he offers up some really good advice on frameworks for decisionmaking in life or death situations that can, if done right, make things vastly easier for the family making hard calls.
Highly recommended.
Content notes: Terminal illness, death of a parent, medical gaslighting