Being Mortal: Medicine and What Matters in the End

A well-written book about a difficult topic that is necessary to confront yet all too easily skated around: one’s death, and the terms on which to face it. Gawande discusses the lack of training that he only recently received on how to ask questions that get people to recognize the severity of their condition and to outline their goals (“I’ll deal with anything as long as I can eat chocolate ice cream and watch football on TV”). There’s a lot of detail on how exactly the body falls apart, the loss of 40% of muscle in your jaw, the loosening of teeth, the shrinking of brain (so that it rattles about if you hit your head). A great section on assisted living’s focus on helping the infirm LIVE rather than nursing homes that were the offshoot of hospitals trying to free up beds after poorhouses stuck so many elderly in the hospital (1954 federal funding to build separate custodial units for patients needing extra recovery time – “nursing” homes); the successful transformation of one assisted living facility with an influx of dogs, cats, and 100 birds. Another option discussed is the idea of hospice– trying to help people live the best possible day, not sacrifice today for the fantasy of 20 more years, to control the pain, and ultimately to die at home.