Book Review: BeingMortal by Atul Gawande

“Death, of course, is not a failure. Death is normal. Death may be the enemy, but it is also the natural order of things . (Loc. 133)

The legal system instituted estate planning and wills to avoid confusion after one’s death and execute the his wishes. Atul Gawande, in Being Mortal: Medicine and What Matters in the End challenges us to enhance the way we handle end of life medical practices.

Dr. Gawande explains, “I am in a profession that has succeeded because of its ability to fix. If your problem is fixable, we know just what to do. But if it’s not? The fact that we have had no adequate answers to this question is troubling and has caused callousness, inhumanity, and extraordinary suffering.” (8-9)

When a person is not fixable, we have a new set of questions: How much pain are you willing to endure in order to live longer? What risks are you willing to take? What quality of life are you willing to forfeit? What expenses are you willing to incur? and more.

Gawande warns, “Medical professionals concentrate on repair of health, not sustenance of the soul.” (128)

Gawande argues that for most humans, it is important to be the author of their own lives:

“Whatever the limits and travails we face, we want to retain the autonomy— the freedom— to be the authors of our lives. This is the very marrow of being human.” (140)

To know what story the human wants, we need to ask him.

In closing, Gawande discusses Plato’s Lache “in which Socrates and two Athenian generals seek to answer a seemingly simple question: What is courage? (231)

Gawande summarizes,

Courage is strength in the face of knowledge of what is to be feared or hoped. Wisdom is prudent strength.

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. (232)

 Gawande concludes that there is no right choices but there are better ones. The most important one, he argues, is to be courageous enough to have the conversation.

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