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Summary & Analysis of Being Mortal by Atul Gawande
This review of Being Mortal: Medicine and What Matters in the End by Atul Gawande provides a chapter by chapter detailed summary followed by an analysis and critique of the strengths and weaknesses of this book.
Gawande draws on clinical studies, case histories and stories from his own experiences as a doctor and a son to illuminate the subject of mortality relative to modern medical systems. His treatment of the subject covers a broad range of institutions and individuals that shape the lives of the aged and terminally ill. The central thesis of the book is that the experience of the end of life has been problematized and addressed by medical models that place extending life over quality of life and institutional frameworks that place safety and efficiency over the ability for people to have autonomy over the last part of their lives.
Gawande is a surgeon at Brigham and Women’s Hospital and a professor at the Harvard Medical School. He is a writer at The New Yorker magazine and author of three New York Times bestselling books.
Gawande draws on clinical studies, case histories and stories from his own experiences as a doctor and a son to illuminate the subject of mortality relative to modern medical systems. His treatment of the subject covers a broad range of institutions and individuals that shape the lives of the aged and terminally ill. The central thesis of the book is that the experience of the end of life has been problematized and addressed by medical models that place extending life over quality of life and institutional frameworks that place safety and efficiency over the ability for people to have autonomy over the last part of their lives.
Gawande is a surgeon at Brigham and Women’s Hospital and a professor at the Harvard Medical School. He is a writer at The New Yorker magazine and author of three New York Times bestselling books.
31 pages, Kindle Edition
First published May 22, 2015
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Displaying 1 - 30 of 43 reviews
February 5, 2021
Perhaps the best book I have ever read regarding end-of-life care... perhaps the best book regarding medical care in general. Atul Gawande has a way of figuring out what matters most in every situation, much like a good reporter. And he covers a lot of ground in this book: not only (many) individuals' personal stories, patient and physician alike, but also research that demonstrates that the subjects in the stories he shares are not alone in what they are going through and how they would benefit if and when given the opportunities to have some more focused, personal conversations about their wishes and more personalized, or individualized, care and treatment--or the termination thereof, or even some help finding a middle ground between the two that best accommodates both their hopes and fears.
November 2, 2016
This is the best end of life with being able to decide to live the time one has left and not to be kept alive when you have no life. I am 79 and have had several bouts with cancer and have young oncologists ask me what I would like to do in the time I have - to do anything I want. This gives all of us a future no matter what age and joy. I have read this book three times and have given copies to children and close friends
June 25, 2016
2016 Book #19 -- I found this book on a top books list in the newspaper and added it to my hold list at the library. The book is written by a surgeon and provides interesting and important insights into the aging process. The doctor explains how doctors often push patients too far in their quest to make the patient better. As they strive to make the patient improve, the reverse can occur and the patient gets sicker and loses quality of life. In this book he examines important questions about stopping treatments, finding quality treatment centers and arranging for hospice. He resells stories of some of his patients, friends and even his own father and how to help make important decisions. The doctor included questions that people can ask about life goals and trade offs. He doesn't agree with helping someone die faster but pushes to help patients live their own life to the fullest.
July 1, 2024
Not an easy book but an important one. In here there are learnings for how we deal with our elderly or people requiring any level of care. I loved the historical aspects of how our western care / palliative movements have evolved. Thought provoking. I wish I’d read it some years ago as it would have informed and given word to my own care experiences
June 6, 2022
What matters in the end? That simple question is one that very few dying people contemplate, and we are all dying, and even fewer medical doctors take into account. Gawande tells scores of stories and case studies that illustrate our allergy to death, the unnecessary suffering that accompanies the final days of so many people, and the innovative exceptions that enable some people to die a good death. Because we have ceded control of our last days to medical doctors, we suffer needlessly and tragically. “Over and over, we in medicine inflict deep gouges at the end of people’s lives and then stand oblivious to the harm done” (p. 249).
So what does matter in the end? Gawande’s research identified at least two things that matter: We all seek a cause beyond ourselves and we give our life meaning by pursuing that cause, even if it means sacrifice. The cause is often our family. Secondly, we all value autonomy, the ability to control our own actions and make our own decisions. These two values usually conflict with what medical science considers to be the ultimate goal: safety and physical survival.
Both doctors and patients avoid talking about death, and doctors are typically overly optimistic about treatments that might delay death. In contrast, the data shows that patients who have end-of-life discussions with their doctors live longer and experience a much higher quality of life at a greatly reduced cost. Much of the book is an explanation of the does and don’ts of such discussions. Doctors tend to be authoritative and/or informative, but need to be empathic and interpretive. This means that listening to the patient is the priority.
The book could be taken as a comprehensive argument in favor of Hospice. Not to mention living wills and DNR directives.
I was somewhat disappointed with the book. It only scratched the surface. Those of us who have eternal life know that physical death is not the end, and therefore not to be feared. We’ve already made our living wills and are open to hospice, for our loved ones and for ourselves. It’s sad to think that so many people reading this book are considering their end for the first time. There is so much more that can be learned and applied to end-of-life issues. “Jesus said, I am the resurrection and the life. He who believes in me will live even though he dies; and whoever lives and believes in me will never die. Do you believe this?” (John 11:25).
So what does matter in the end? Gawande’s research identified at least two things that matter: We all seek a cause beyond ourselves and we give our life meaning by pursuing that cause, even if it means sacrifice. The cause is often our family. Secondly, we all value autonomy, the ability to control our own actions and make our own decisions. These two values usually conflict with what medical science considers to be the ultimate goal: safety and physical survival.
Both doctors and patients avoid talking about death, and doctors are typically overly optimistic about treatments that might delay death. In contrast, the data shows that patients who have end-of-life discussions with their doctors live longer and experience a much higher quality of life at a greatly reduced cost. Much of the book is an explanation of the does and don’ts of such discussions. Doctors tend to be authoritative and/or informative, but need to be empathic and interpretive. This means that listening to the patient is the priority.
The book could be taken as a comprehensive argument in favor of Hospice. Not to mention living wills and DNR directives.
I was somewhat disappointed with the book. It only scratched the surface. Those of us who have eternal life know that physical death is not the end, and therefore not to be feared. We’ve already made our living wills and are open to hospice, for our loved ones and for ourselves. It’s sad to think that so many people reading this book are considering their end for the first time. There is so much more that can be learned and applied to end-of-life issues. “Jesus said, I am the resurrection and the life. He who believes in me will live even though he dies; and whoever lives and believes in me will never die. Do you believe this?” (John 11:25).
July 8, 2020
I know I read this book before but it appears I neglected to write a review. As the title says, the book is about being mortal and addresses medicine and what matters in the end. Looking at the inside cover, there are a ton of positive reviews on this book. One I appreciated was written by Malcolm Gladwell, "American medicine, Being Mortal reminds us, has prepared itself for life but not for death. This is Atul Gawande's most powerful - and moving - book. " Malcolm Gladwell.
I'm going to share just a few passages that really spoke to me.
On page 146 and 147, The terror of sickness and old age is not merely the terror of the losses one is forced to endure but also the terror of the isolation. As people become aware of the finitude of their life, they do not ask for much. They do not seek more riches. They do not seek more power. They ask only to be permitted, insofar as possible, to keep sharing the story of their life in the world - to make choices and sustain connections to others according to their own priorities.
From page 115: The choices don't stop, however. Life is choices, and they are relentless. No sooner have you made one choice than another is upon you.
From page 179: A series of important questions.
1. Do you want to be resuscitated if your heart stops?
2. Do you want aggressive treatments such as intubation and mechanical ventilation?
3. Do you want antibiotics?
4. Do you want tube or intravenous feeding if you can't eat on your own.?
From page 232: 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. ... But even more daunting is the second kind of courage -- the courage to act on the truth we find.
From page 238: For human beings, life is meaningful because it is a story.
Finally, from page 252: As a person's end draws near, there comes a moment when responsibility shifts to someone else to decide what to do.
This book is a powerful read, and one I would suggest for everyone. The author is a doctor, and he has written it with intellect, insight, and compassion.
I'm going to share just a few passages that really spoke to me.
On page 146 and 147, The terror of sickness and old age is not merely the terror of the losses one is forced to endure but also the terror of the isolation. As people become aware of the finitude of their life, they do not ask for much. They do not seek more riches. They do not seek more power. They ask only to be permitted, insofar as possible, to keep sharing the story of their life in the world - to make choices and sustain connections to others according to their own priorities.
From page 115: The choices don't stop, however. Life is choices, and they are relentless. No sooner have you made one choice than another is upon you.
From page 179: A series of important questions.
1. Do you want to be resuscitated if your heart stops?
2. Do you want aggressive treatments such as intubation and mechanical ventilation?
3. Do you want antibiotics?
4. Do you want tube or intravenous feeding if you can't eat on your own.?
From page 232: 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. ... But even more daunting is the second kind of courage -- the courage to act on the truth we find.
From page 238: For human beings, life is meaningful because it is a story.
Finally, from page 252: As a person's end draws near, there comes a moment when responsibility shifts to someone else to decide what to do.
This book is a powerful read, and one I would suggest for everyone. The author is a doctor, and he has written it with intellect, insight, and compassion.
January 9, 2018
This isn't an enjoyable read but an essential read. Required reading for doctors, I'd say, and instructive for all mortals.
This book might depress you. It talks frankly about the mechanics of death and does not shy from impressing upon readers that we're all going to die of something at some point, and that that point will be reached at the conclusion of dying process that will not be clearly mapped out for us by some benevolent force, but may well be a confusing, complex series of health crises characterized by pain, suffering, loss of dignity, privacy, autonomy and physical funtioning. More to Gawande's point, the journey toward end of life will very likely involve difficult choices about our medical options. His aim is to get doctors and patients to think in a more honest, forthright and holistic way about how we want the end of our lives to go: to partner with doctors not just to gain information but to strategize for the best outcomes that will allow us to live with some purpose and meaning so that longevity is not the only consideration.
Very highly recommended for pastors.
This book might depress you. It talks frankly about the mechanics of death and does not shy from impressing upon readers that we're all going to die of something at some point, and that that point will be reached at the conclusion of dying process that will not be clearly mapped out for us by some benevolent force, but may well be a confusing, complex series of health crises characterized by pain, suffering, loss of dignity, privacy, autonomy and physical funtioning. More to Gawande's point, the journey toward end of life will very likely involve difficult choices about our medical options. His aim is to get doctors and patients to think in a more honest, forthright and holistic way about how we want the end of our lives to go: to partner with doctors not just to gain information but to strategize for the best outcomes that will allow us to live with some purpose and meaning so that longevity is not the only consideration.
Very highly recommended for pastors.
April 7, 2023
This is an interesting book. I picked up on a Good read. It’s about how to cope with ageing, chronic illness and death. It talks about how children and medical staff tend to want to make old people 100% safe and that care homes can seem very institutionalised and almost prisonlike, and that old people want meaning and are prepared to sacrifice safety for maintaining their independence. It talks about the medical profession is able to extend life for long periods of time, and that that is always their priority. But it may not be the best thing. What is the point in extending a life for a very long time if the quality of it is so poor. So he recommends that it is very important for people to discuss their treatment when it comes towards the end. Things like resuscitation, antibiotics fake feeding et cetera as he has witnessed so many people suffer so much to extend the life for a day should have been let go. he makes some very interesting points about medical insurance. It is set in America where by doctors are afraid not to prescribe the latest experimental drugs or they’ll be sued by patients for not being given every single chance, when in fact many times with cancer patients, people are just going through horrendous treatments with very little chance of actually improving and it is probably not worth the little time they would gain for the invasiveness and suffering they will have to endure with their families. The end of the book is very moving because we witness his dad dying, who has been a surgeon for 75 years. He knew he had an incurable cancer and he knew the risks of the operation he could have, but he decided not to have the operation and he managed to live a couple years without it is affecting his work.
December 12, 2022
I borrowed this book from the library. The narration is good. This book forces you to think about end of life issues. Exclusively about medical and social issues. It talks about the care for people who have cancer, cardiac issues or respiratory diseases and how debilitating the treatments are in some cases forcing a person to die in a fluorescent lighted hospital room alone. This book covers so much. It explains how places changed to assisted living which can be so much better than a nursing home if it’s done right.
This book covers issues no one wants to talk or think about but of course we will all be there. The reason I took off one star is because he didn’t address spirituality. He really should have addressed a person’s need for spiritual comfort.
This book covers issues no one wants to talk or think about but of course we will all be there. The reason I took off one star is because he didn’t address spirituality. He really should have addressed a person’s need for spiritual comfort.
February 10, 2024
An absolute MUST READ. This book profoundly affected me and my preparedness for illness or end of life. (I am neither sick nor aged).
I gave away many copies to family, friends, and anyone facing the challenge of becoming the decision maker for the sick and/or elderly.
Atul Gawande is a wonderful writer and, it seems, an amazing doctor.
It is only fair to the people you love that you be explicit and clear about what kind of life you want to lead when you can no longer make your own choices. Doctors are taught to do all they can to keep a person alive. They do not know what quality of life you are prepared to accept, so you need a o make it clear to your caregivers what you are willing to endure before you get dragged into a situation you don’t want to be in.
I gave away many copies to family, friends, and anyone facing the challenge of becoming the decision maker for the sick and/or elderly.
Atul Gawande is a wonderful writer and, it seems, an amazing doctor.
It is only fair to the people you love that you be explicit and clear about what kind of life you want to lead when you can no longer make your own choices. Doctors are taught to do all they can to keep a person alive. They do not know what quality of life you are prepared to accept, so you need a o make it clear to your caregivers what you are willing to endure before you get dragged into a situation you don’t want to be in.
March 16, 2021
The book discussed the fact that we all will face at some point in our lives, seeing our loved ones age through their lifetimes and being out of our capacity to taking care of them...
Or even when we are the one who is old, or sick...
It's important to know when is the time to start accepting the death...
It was great to hear about the other side of the story, to know what seniors think while they are living in senior places and so on...
Or even when we are the one who is old, or sick...
It's important to know when is the time to start accepting the death...
It was great to hear about the other side of the story, to know what seniors think while they are living in senior places and so on...
January 14, 2022
Nothing prepares you for role reversal. Nothing inspires the patience to keep your tongue in check and listen with careful nodding, repeating back the same phrases, and just be a sponge for the same story. Nothing in memory stays the same as in the moment when your parent has another tantrum.
This book provides a guide.
You must garner strength from things you consider holy, be it music, the woods, or your garden.
This is a test.
This book provides a guide.
You must garner strength from things you consider holy, be it music, the woods, or your garden.
This is a test.
June 24, 2019
Being able to be the author of you own life to the end, to choose how you want to die, and have the best life (under the circumstance) right to the end is everybody's desire. This book will help you in that journey, for yourself or a loved one. If I live a long and full life, I would like to choose the terms how I live and how I die.
June 8, 2021
Just beautiful. Wonderful balance of lovely language and empirical information. I carry with me in my practice and personal life the story he relates beginning the conversation with "I'm worried". The intentionality behind the deployment of that phrase with a patient floored me.
November 9, 2022
A good book on how to handle last few years and the medical business of squeezing dollars during last few months of one’s life.
See chapters summary at https://itsthesway.com/mortal-book-cl...
See chapters summary at https://itsthesway.com/mortal-book-cl...
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January 23, 2023A crucial read in my opinion, for all of us. Certainly if you work in the medical field, and especially in the end of life area of practice, take the time to read and see the movie as well. Great resource and so approachable for a topic so many are afraid to talk about.
June 9, 2023
This is the second time I read this book; the first time 5 years ago, this time for a Book Club discussion. It was every bit as compelling, with great writing and significant information. It is a “must read” for everyone.
January 1, 2018
Very helpful if you are dealing with these issues in your family.
January 12, 2020
Essential reading for adults.
August 3, 2020
Informative Elder Care situations regarding Hospice care options for end of life comfort.
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January 26, 2021Phenomenal and scary
July 13, 2021
Absolutely love this book, only wish I had read it before both my mother and grandmother passed away... highly recommend to anyone and everyone!
July 25, 2021
It was ok, a bit depressing and I felt I had a number of deadly conditions through out
November 12, 2021
This was for me an extraordinary and unique insight . May also be a book we should all read on a subject many or us avoid be it for ourselves or those we most care about. Brilliantly written .
November 25, 2021
The need to consider, and discuss with loved ones what one wants as the end approaches
December 2, 2022
I had a lump in my throat for almost the entirety of this, but so good and so important.
March 20, 2023
Excellent writing on a challenging subject. I believe this should be recommended reading for everyone, of any age, but certainly 50+ and those dealing with aging family members.
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December 21, 2025non-fiction
August 4, 2015
This book makes you think deeply about choices we will all be faced with for our lives as we age and our bodies and minds break down. The medical community tends to focus on keeping the elderly "safe" and at times extending our lives beyond what is reasonable. We all need to ask ourselves is the additional time we are afforded worth the price we have to pay? This book looks at options of care for the elderly and how our society is slowly moving back to dying at home and maintaining our dignity as much as possible in our last days. A very thought provoking book and one that anyone in the health profession should be required to read.
October 29, 2015
This is an important book about how the medical system often ignores talking about end of life choices with patients in favor of more treatment. Well written by a doctor, the book shows that most people are happier and actually live longer than expected when they opt for hospice care over further treatment. Everyone should read this book.
Displaying 1 - 30 of 43 reviews