It’s been a while since I’ve done a longer book review here, but one of the books I just finished, Being Mortal, by Atul Gawande, really merits a few paragraphs.
I first learned about this book when I recently saw Dr. Gawande, a surgeon, as the opening guest on Real Time With Bill Maher. I was immediately intrigued by the book he’d written and its core topic: how we take care of (or do not, as the book also points out) people who are in the last days/weeks/years of their lives. In other words, how and where we make our inevitable progression toward death. It is not necessarily as you think it might be.
Yes, this—death and dying—is an uncomfortable topic for virtually everyone to talk about, myself included. But when it is something that is going to happen to each and every one of us, shouldn’t there be more compassionate treatment and open discussion of this ultimate life truth? I think so, especially if you are going to be involved in deciding how someone else has to spend that part of their life. And, more to the point, I think that these considerations should be made far earlier than in the thorniest, most heart wrenching parts of life’s ending.
But to do this, you also have to have an idea of what the current state of affairs is. You need context for how it was, how it is, and, thankfully, how it might all be better in the future if we have a collective shift in how we treat those we love most in their final days.
Dr. Gawande does this so eloquently in this important book. He lays all of this out there, including his own choices in the process, both as son and doctor. Admittedly, he achieves this by giving the reader ample yet often heartbreaking anecdotes in the process when he recounts various stories of patients and people he’s come to know while working on this book. Truth be told, I cried at a few points during this short book. Sometimes I teared up when I related to what I am likely to encounter at some point in my own life (not my own death per se, but the deaths of my family members), but often it was just the lives being described in the book. Do not let those difficult feelings stop you from reading this book.
Here is why I think this book is important: I think many of us are completely clueless about exactly what happens and what choices do/don’t exist when we are nearing the end of our lives. I certainly had no real idea. My only knowledge was based on seeing how my and my husband’s now deceased grandparents and great grandparents progressed through that phase of their lives. Some of those situations were representative of the current state of affairs, and the others fell on either side of that dividing line, but in the end there is much that I completely failed to take into consideration or understand.
I was also ignorant about how “medicalized” it all has become, particularly in the U.S., and it is not necessarily the best road to take. I was taken aback by how much of a loss of autonomy is forced upon the elderly when they enter a nursing home or even assisted living, and the drastic effects this can have. Just the aspect of who nursing homes are often designed for and marketed toward was eye opening. Children want safety for their elderly parents, but this comes at a cost to the parents: their ability to make choices for themselves is stunted if not removed wholesale. Even something as simple as deciding when (or what) to eat is taken away, purportedly in the name of safety. Yet, can you imagine life like that for yourself? It’s hard to do. In the same vein, I was encouraged by Dr. Gawande’s mention of more progressive ways that we are, as a nation and society, rethinking how the elderly should and can spend their lives at the end. Those stories offer hope.
I learned so much from reading this book and was forced to consider, at least for a moment, how the kinds of choices that exist, and those that do not, will play a part in my life as a daughter, wife, etc. At forty-one years old, I know that those decisions, discussions, and difficulties still lie ahead for me, and goodness I hope for a long while still. Obviously no amount of preparation can really make it easy. But by starting to think about them now, I can start to knit together the various aspects that will come into play and how they might be approached. It’s a responsible, though clearly difficult, thing to do as an adult.
I wish more of us were adept at talking about death and how we go through this process with loved ones or alone, as the case may be. This book helps us start those conversations, and it does so with a keen compassion and insight.
Incidentally, though I have not yet watched it, there is a PBS/Frontline documentary based on this book. I plan to watch it once I put a little heart space between myself and the book. There is something about seeing (versus reading about) people in this situation that I am not sure I can handle at this particular moment. But here is the link if you are interested.
Copyright (c) 2015 Kristen M. Ploetz