Being Mortal

Synopsis

AS HEARD ON BBC RADIO 4 'A GOOD READ' THE INTERNATIONAL BESTSELLER 'GAWANDE'S MOST POWERFUL, AND MOVING, BOOK' MALCOLM GLADWELL 'BEING MORTAL IS NOT ONLY WISE AND DEEPLY MOVING; IT IS AN ESSENTIAL AND INSIGHTFUL BOOK FOR OUR TIMES' OLIVER SACKS For most of human history, death was a common, ever-present possibility. It didn't matter whether you were five or fifty - every day was a roll of the dice. But now, as medical advances push the boundaries of survival further each year, we have become increasingly detached from the reality of being mortal. So here is a book about the modern experience of mortality - about what it's like to get old and die, how medicine has changed this and how it hasn't, where our ideas about death have gone wrong. With his trademark mix of perceptiveness and sensitivity, Atul Gawande outlines a story that crosses the globe, as he examines his experiences as a surgeon and those of his patients and family, and learns to accept the limits of what he can do. Never before has aging been such an important topic. The systems that we have put in place to manage our mortality are manifestly failing; but, as Gawande reveals, it doesn't have to be this way. The ultimate goal, after all, is not a good death, but a good life - all the way to the very end.

Summary

Chapter 1: The Denial of Death

Summary:

Atul Gawande argues that our culture denies the inevitability of death, which leads to inadequate preparation and poor end-of-life care. He advocates for embracing the finitude of life and discussing our wishes with loved ones.

Real-example: A man named David has advanced cancer and refuses to talk about dying, even though his family is aware of his condition. His denial prevents them from having meaningful conversations and planning for his care.

Chapter 2: The Tyranny of Hope

Summary:

Gawande challenges the idea that we should always strive for a cure, even when it is unrealistic. He argues that sometimes, the best course of action is to accept the inevitability of death and focus on quality of life.

Real-example: A surgeon named Dr. Benson treats a patient with pancreatic cancer who undergoes a high-risk surgery despite the low odds of survival. The surgery fails, and the patient suffers unnecessarily.

Chapter 3: The Transactional Model of Care

Summary:

Gawande criticizes the current medical system, which focuses on treating disease rather than addressing patient values and preferences. He suggests a shift towards a "transactional model," where doctors and patients collaborate to define goals of care.

Real-example: A patient named Alice has heart failure and is facing a difficult decision about surgery. Her doctor listens to her concerns and helps her understand her options, allowing her to make an informed choice.

Chapter 4: Knowing and Saying

Summary:

Gawande emphasizes the importance of communication in end-of-life care. He encourages patients to clearly express their wishes and doctors to listen attentively and respond with compassion.

Real-example: A nurse named Nancy has a patient named Emily who is dying from cancer. Emily expresses her desire to die at home, and Nancy works with her family to make her wishes a reality.

Chapter 5: The Caregivers

Summary:

Gawande discusses the challenges faced by caregivers of those who are dying. He argues that they need support and resources to cope with the emotional and practical demands of their role.

Real-example: A woman named Claire is caring for her husband, who has Alzheimer's disease. She experiences fatigue, isolation, and financial strain, but she also finds moments of joy and meaning in her caregiving role.

Chapter 6: Last Things

Summary:

Gawande explores the final moments of life and the importance of creating a meaningful and peaceful death. He emphasizes the role of medical professionals, family, and friends in providing comfort and support.

Real-example: A family gathers around the bedside of their dying mother, sharing stories, holding her hand, and creating a sense of peace and closure.