"Being Mortal: Medicine and What Matters in the End" by Atul Gawande (published 2014)

“At least two kinds of courage are required in aging and sickness. The first is the courage to confront the reality of mortality – the courage to seek out the truth of what is to be feared and what is to be hoped. Such courage is difficult enough. We have many reasons to shrink from it. But even more daunting is the second kind of courage – the courage to act on the truth we find. The problem is that the wise course is so frequently unclear. For a long while, I thought that this was simply because of uncertainty. When it is hard to know what will happen, it is hard to know what to do. But the challenge, I’ve come to see, is more fundamental than that. One has to decide whether one’s fears or one’s hopes are what should matter most." - Atul Gawande

The value of reading “Being Mortal: Medicine and What Matters in the End” (2014) is in the disclosure of one special surgeon’s experiences, trials, and research. Today, there is the tendency to to take for granted that death is a part of life. And furthermore that it isn’t necessary to dwell upon the human condition daily. That is why this book is important. It speaks to those who *think* they are ready for the last stages of life but may not be. It is a reminder that most people still have choices to make up to the very last days of life, and that this requires preparation. Mostly, it speaks to the author’s wisdom on how professional doctors can aid their patients even more, by realizing that one good day or two might be much more important than months of pain and suffering - and how in some cases - maybe not. 

Gawande sheds light on the growing necessity for trained geriatrics professionals, quality assisted living homes, and hospice and palliative care all over the world. More broadly, Gawande writes about the language of doctors. The language of doctors is a particularly fascinating topic running throughout the book - Gawande writes about the difficulties and mistakes doctors make when they must talk to their patients about their certain conditions and disabilities, complications, and considerations when their death is imminent. Are doctors just providing information? Are doctors just trying to prolong life rather than truly take into consideration their patient’s hopes and fears? Gawande has beautiful answers to these questions, and he writes from a place of genuine concern. His own personal story is shared nearer the end, which he dedicates to his father’s passing. 

Gawande’s self-reflective narrative does not neglect history. He goes over the history of institutions for the elderly, sick, and dying. He goes into detail about the terrible conditions of poorhouses prior to the addition of hospital space for the aging and sick. He talks about the addition of the hospital spaces, the building of nursing homes, and the creation of assisted living – a positive progression in both the treatment of patients and the conditions of the institutions themselves. Gawande makes the argument that while these institutions were and are good, at times they do not truly help their tenants. He writes candidly about how many times doctors think about a person’s safety first (according to Maslow’s hierarchy of needs), rather than focusing on the quality of life of their patients, and why this must change.

“Being Mortal” raises awareness for both the patient and doctor. It is amazing that Gawande writes a story so authentic that it has the possibility to bring everyone – layperson and professional – male or female – young or old – of one race or another – to a powerful standstill specific to the 21st Century:

“A few conclusions become clear… 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 opportunities to refashion our institutions, our culture, and our conversations in ways that transform the possibilities for the last chapters of everyone’s lives.”