Being Mortal: Medicine and What Matters in the End

This was fantastic. Notes in book journal. Had been on TBR list forever.

A stunning re-examination of the purpose of medicine. This book is excellent at questioning whether the treatment processes are antithetical to the patient's values.

Okay, I feel silly that I spent 10 years wringing my hands about reading this, because I worried it would make me anxious about my own mortality. How silly.

This made me anxious about getting old! Ha HA, zing.

Anyway, two main sections:

Section 1 is about getting old. Lots of really interesting stuff about multi-generational housing (and how it is NOT (just) individualistic WEIRD (Western educated etc) societies that hate living with the very old and very young, but that most people - once they get some money - don't want to all live together as a family), about a post-multi-generational system to managing the very old (nursing homes, aging in place, assisted living, etc). How getting old is a biological FACT, despite our attempts to hide it or will it away (90 year olds running marathons indeed). I also found it very touching how many parallels there are between caring for the very young and the very old; I remember thinking that when visiting my beloved grandmother in the hospital. Everyone was very very old, very sick, and thus close to death. The nurses shuttled to and fro. It reminded me of a newborn ward!

Section 2 is about dying, or rather modern dying. Modern dying is unpleasant and highly medicalized. You spend most of your dying time in denial that you are, in fact, dying, and thus many people kinda stumble into death after trying some last-ditch surgery, intubated and unconscious. If you have lost any loved ones, you may be familiar with this type of death. It is, indeed, very distressing and NOT AT ALL the calm, serene, wise deaths many of us hope for ourselves and our loved ones. The author, Gawande, talks about how this type of “kicking and screaming” dying is the product of both our nuclear family/medicalized culture (death is hidden, most of us have not seen people die) and the normal incentives patients AND doctors have to “hope for the best” and just keep trying medical interventions. It does take a lot of wisdom and courage to “let go”. Tons of interesting stats on hospice care (and how good it is for you, ironically), how overly optimistic even oncologists are about survival chances (especially if they know their patient quite well - aka if they've bonded a bit), and all that.

This book was amazing. It accomplished something that very few books can: to change my mindset in a complete 180. In my life I haven't truly had the need to engage with older people on a daily basis, but I know that's going to invariably change, and I feel like this book kind of prepared me for those coming times.

It gave me a new outlook on the importance of taking care of our elders, provided me with facts that show just how little we tend to them and how big of a taboo it is in our current societies.
Super important read that I would recommend to anyone over the age of 20.

Key takeaways:

- I probably view this as one of the most important books I've read so far. Few of us like thinking about what decline looks like. Fewer of us have plans for it. This book highlights the importance of doing that, and how big of an impact a good plan can have.
- We get to a point where medicine can't fix anything, merely push the problem down the road. We need to accept that.
- Medicine is surprisingly ineffective at lengthening life when it comes to terminal illnesses. Often life is only extended by a few months (sometimes it is even shortened) and the quality typically decreases by a disproportionate amount.
- Hospice care (focusing on how to enjoy today) can dramatically improve quality of life, often without any meaningful decrease in the length of time left.
- We need to ask ourselves: What are our hopes/goals? What are we willing to endure to achieve them? This takes the pressure off the caregivers to make difficult decisions. Example from the book, when his dad was sick, he said that as long as he could eat ice-cream and watch football, he wanted life to continue. If it came to the point where he couldn't do that, he didn't want further treatment. This way his kids didn't need to stress over whether further treatment was right or not.

I think everyone should read this book, especially if they have aging family or themselves are aging.

Compelling and deeply personal mix of personal anecdotes and statistics, this book was extremely well written and comprehensive. I felt like it had a good balance of content and was accessible but also full of good data.

This is a really beautiful, sorrowful book. I have lost both of my parents and so much of what is described here takes me back to those moments. The pleading of my dad that he never be put in a home. The exhaustion of taking care of my mother during her cancer. The despair of dealing with doctors who withheld information because they felt they knew best. Not knowing what the next day would bring. That was always the hardest thing. You never know, you simply endure. I'd recommend this to people with aging parents or people interested in medical nonfiction.

To start off, I'd recommend this book to anyone.

It offers an incredible perspective on mortality and what makes life truly worth living. I considered things because of this book that I never would have without it. The stories are personal and impactful and I found myself crying at multiple parts of the book.

I don't want to say this book was life-changing because it feels cliche. But this is one of the few books I've read that I can honestly say have influenced my outlook on life.

A remarkable book that cannot help but shape and form you and the rest of your life. It is honest, vulnerable, gracious, and wise. It will also shake you and bring out fear and pain while forcing you to face and think about the hardest parts of human existence. This book will not leave me for the rest of my life, and I am glad for that.

Essential reading for everyone.

Atul has a gift for seeming like he's reaching a definitive conclusion and then immediately adding more depth and nuance to it.

Amazing book exploring a topic we like to discuss with our children less than sex. Critical conversation

Like other books of Mr Gawande, this gives a nuanced and balanced narrative by focusing on particularities in last few months of life for terminal patients. This is a reality most of us would face sooner or later, either for loved ones or ourselves, being prepared for it and taking more parameters into account, rather than just focusing on prolonging life, would result in better outcomes both for the patient and the family.

This book is an absolute must read for everyone in our society. Any society. I cannot recommend it highly enough, because it is IMPORTANT. The topic is important, the discussion is important and most of all, it is important that YOU begin thinking about these things for you and your parents. As in right now.

Atul Gawande's Being Mortal explores the impact of aging on our bodies, our life experiences, our family dynamics, our societal structures, and our healthcare system. We as individuals rarely take time to think about our own future as we age and become more feeble and start having falls. What about our parents? What do you think about nursing homes? Is there a better option? Honestly, Being Mortal doesn't exactly give us discrete answers. But it's a very complicated problem and the first step towards getting better options and eventually a better answer is to start putting some thought into the situation. That is especially true for each of our individual families.

Okay we all really need to figure our shit out especially how to make sure that we don't fall EVER.

Wow. I am not certain what brought me to read this book, but it has a powerful message about planning ahead for a dignified end of life. Ultimately, the author compels the reader through narrative stories to think through what they want to do and what tradeoffs they are willing to take when they begin facing serious impairment to continuing basic care.
Since everyone will die at some point, I think everyone should read this book or at least take a few moments to research palliative care and plan for the eventuality. This is not planning for after the end of our days (burial, cremation, etc.) but for planning for our last days (years) before the end.

Very interesting, makes you think about death differently

I heard about this years ago through an interview Gawande did on The Daily Show (http://www.cc.com/video-clips/hz2xb6/the-daily-show-with-jon-stewart-atul-gawande). Having finally gotten to this, I wish I'd read it sooner. I listened to this from the library but I feel like I need to go buy a copy for myself and give copies to everyone. We do so much wrong medically in this country, elder and death care being just a part of it, but that part is so important. Out of the three grandparents I've lost, and the two I really remember, one had a lengthy decline that I don't think anyone would want to replicate. Even as a twelve year old I knew it wasn't right, even if he was at home. I wonder what he would have preferred in those last days, months. Now, with my last grandparent getting older and having more problems, I want to give this book to my mom and uncle and see what we can do for her. We can do so much better in this country and Gawande lays out some very basic ways of going about it.

I started reading Being Mortal nearly a year ago and somehow never got around to finishing it. It's admittedly a difficult read in the sense that it can be overwhelming at times. I finally finished it last night.

The premise focuses on the quality of life rather than the length of life and more specifically, the manner in which you choose to pass away. Medical science has advanced to such a degree that humans can be kept alive for a much longer time than you would imagine. But no one has stopped to ask the question of whether we should. Or as in Amitabh's immortal (no pun intended) words, yeh jeena bhi koi jeena hai. Gawande cites several examples from his professional and personal life that focuses on the individual's choice on care and ultimately, way to die. The Republicans' favorite chant ‘death panels' actually referred to the end of life counseling that doctors offered their patients. It's the ultimate decision you can take for your life.

You do not choose to be born in this world and as of today, most laws even prevent you from actively choosing to die but at least you can choose the way you die when and only when you're diagnosed to. The DNR is the most commonly known legal process in our pop culture and medical professionals are taught to honor it just as they're taught to honor the first do no harm principle. Others like hospice care are fraught with emotions that you may not be fighting back hard enough. But after a while, it's useless fighting nature.

Being Mortal will not only make you aware of your mortality but actually prepare you for it. I say that in the most humble and optimistic way. You aren't immortal. You're going to die. You're born in perhaps one or two ways but you can die in umpteen different and uncharacteristic ways. The worst I believe, waiting to die which can be a long and painful process not only for the person but also for their loved ones. Modern medicine can perhaps keep you alive for as long as it is possible today but it's entirely within your rights and choice to decide when enough is enough.

Reading this book helped me understand my mother-in-law's reluctance to move into independent living, helped me realize that what we as children want for our parents (safety, health) is not necessarily the most important for them (to have control of their own story/life), to value the first assisted living concepts and what people are doing to try to provide a place for the elderly that has life and autonomy and isn't designed for those who work there and the medical industry. To understand that whether it's because your old or because you've been diagnosed with a terminal illness, your perception about life often changes and you start to be instead of achieve, to value time with family more than new adventures, and to understand the value of hospice and the difficult choices we all face as we or our loved ones are forced to deal with end-of-life decisions. I learned, I cried, I loved this book.

Stories, and endings of stories, of one's life are important.
Dignity and one's own values are essential to one's sense of self, identity, true self.

Even if you think you're up on end-of-life issues (ethics, logistics, medical questions), or even if you're young-and-healthy and don't think this matters to you ... there's something in here for you to learn.

First, it's Gawande. I always learn from Gawande and always enjoy myself in the process. I bet you do too.

Second, there is important new material here. On perspective, on the history and current best practices in assisted-living facilities, on geriatric research and the sad dearth thereof. Even if you or I don't need this material right now, we can be better informed and speak to policymakers when opportunities arise.

Finally, there is a delicate personal component to this book, Gawande's story and others', which I found powerful and humbling. I think we WEIRDs could learn much from looking at aging instead of averting our eyes, and this book offers a gentle way to start doing so.

In essence, the idea is to make sure you kick the bucket at the right time, otherwise you have a high risk of getting the ODTAA syndrome (One Damn Thing After Another), some your friends and family members will die before you do, your frail body starts failing in ways you would've never imagined, you have to make tradeoffs that will be hard to endure and sooner or later you will become a burden to your close ones (given you have any) or get sent off to a nursing home where death lingers at every corner. The book is actually about more than that, but this is the most important conclusion I can draw from it at this point.

It took me over a year to get through it because I kept putting it down, because it's a difficult subject. But, that's the point. EVERYBODY SHOULD READ THIS.

If you love someone who is going to die, or if you yourself are going to die, you should read this. It's so important. Just read it. Stop avoiding it. You'll be glad you did.

This is not just a book for the people who are facing imminent death, or for those with loved ones who are approaching the end of life. This is a book for anyone who will die, namely every person. It discusses how modern medicine has transformed people and doctors' perspectives on death as a problem to be fixed, neglecting the very subjective and tricky topic about the quality of life at the end. Treatments lend hope to patients who often cling onto them, leaving them even less prepared to have the difficult thought-through conversation of thinking what truly matters to them, and when to let go. Bought a copy of this book because I know one day my time will come, and I hope the enlightenment from this book will give me the courage to know and let it be known the life I wish to lead in my final moments. An excellent book that advocates a paradigm shift, and I believe anyone's life decisions will be changed after reading it. I hope healthcare professionals who read this will also take it upon themselves to change the way illness, treatment and death are framed, and to guide patients to knowing and achieving what they truly treasure in their treatment journey.

One of those subjects the majority of us hide from in truth. On a personal level this book has clarified a recent decision that my family had to make. Thanks to this book I know we got that right. It has also made me realise that I am fast approaching an age I never gave much thought to. Now I am I just ain't enjoying these thoughts at all. Death is a statistic in all the history books I read, not the names of the authors daughters music teacher let alone his father nor, for that matter, anyone I know. Over the last few years this is all become too close to the bone for my liking. I think I am heading back to safer ground for a while and just might stick my head back in the sand.

My only complaint with this book was the author was inconsistent in use of Christian and surnames. Also non USA readers may notice some discussion on health care that may not be relevant in their neck of the woods though that will not detract from this very good book.

A must read for those that are confronted with some hard choices.