“Being Mortal” by Atul Gawande

This book is essentially about how we take care of those who are about to die in contemporary society. And no surprise, we’re going about it in the wrong way. Medicine tends to push for patients to always try a different treatment, another surgery, keep doing something to attack the disease. However, if you aren’t strong enough for the continued treatment, this actually shortens your lifespan and increases suffering.

Now the alternative is to talk and come to terms with your inevitable death in order to plan for it. But no one wants to do that! We’d rather live with the illusion that we are going to live forever, and keep striving to maintain perfect health, even when our bodies are crumbling beyond repair. What with the fact that some patients are termed “fighters” it can seem as though the alternative is giving up and giving in to the disease. But we are all going to die at some point, and it is essential to recognize when this is going to happen and meet it with grace. It can be hard for doctors, and families, to have conversations about this and how to proceed, but they prove essential to dying on your own terms and in the way that you want to go.

Gawande gives several tips to facing this conversation. Don’t be Dr. Informative, presenting all the different options and letting the patient pick from them. Instead, be a doctor that sees the whole picture and tries to take the patient’s wishes into account for how they want to live. What does the patient understand about their situation? What are their fears? What would they define as a good life? What are they willing to compromise now for the chance of something better later? The answers to these questions probably won’t be obvious, even for those close to the patient, but they give clear directions on how to proceed with treatment.

Having watched my grandparents succumb to disease a few years ago, I now realize how well they had it, but also what we could have done better. I have no idea if my dad had them answer these questions, but maybe I should have talked to them on my own, and asked how I could make their end of life better. I was in high school and while I wasn’t scared of death I still didn’t want to face it. Taking care of them was on my list of things to avoid around the house, not embrace.

For all that though, my grandparents had it pretty good. They were not stuck in a hospital where they had no autonomy and couldn’t make any choices about their lives, they lived at home with us up until the end. My parents made sure that they had the help and support that they needed. They were able to maintain control and keep their family around them until the end.

I’m not sure how my grandparents wanted to spend the end of their days, but I think they were comfortable and happy. I just wish that I was there for them more. Having read this book, I think I will be there for whoever needs me next.