There is no more universal truth in life than death. No matter who you are, it is certain that one day you will die, but the mechanics and understanding of that experience will differ greatly in today’s modern age. Dr. Haider Warraich is a young and brilliant new voice in the conversation about death and dying started by Dr. Sherwin Nuland and Atul Gawande . Dr. Warraich takes a broader look at how we die today, from the cellular level up to the very definition of death itself.
The most basic aspects of dying―the whys, wheres, whens, and hows ―are almost nothing like what they were mere decades ago. Beyond its ecology, epidemiology, and economics, the very ethos of death has changed. Modern Death, Dr. Warraich’s debut book, will explore the rituals and language of dying that have developed in the last century, and how modern technology has not only changed the hows, whens, and wheres of death, but the what of death.
Delving into the vast body of research on the evolving nature of death, Modern Death will provide readers with an enriched understanding of how death differs from the past, what our ancestors got right, and how trends and events have transformed this most final of human experiences.
As a physician, writer, and clinical researcher, Haider Warraich wears many hats that have come together in his new book, State of the Heart - Exploring the History, Science and Future of Cardiac Disease, launched July 2019 by St Martin's Press/Macmillan.
He writes most frequently for the New York Times but also contributes to the Guardian, the Atlantic, the LA Times and the Boston Globe amongst others. He writes about all things that fall within the purview of healthcare, from health policy to the daily interactions between patients and their physicians.
Haider Warraich completed internal medicine and cardiology training at Harvard Medical School and Duke University and will be the Associate Director of Heart Failure at the Boston Veterans Affairs Hospital, Associate Physician at Brigham and Women’s Hospital and Instructor at Harvard Medical School in the Fall of 2019.
Dr Warraich is also an avid clinical researcher and has published in the New England Journal of Medicine and Journal of the American Medical Association amongst many others.
I am definitely on a death kick, mortuaries, forensic psychologists and psychiatrists discussing murder cases, hospitals and now this. I get like this sometimes, just want to read about one subject. And then.. I move on. I wonder if everyone does this at times? One of the best obsessions I had was Anthony Trollope - hhe wrote loads of books, but I'm not into fiction any more and there is a limit to how much one author can write about their speciality. Especially perhaps, death. The great unknown.
(3.5) Haider Warraich, a physician originally from Pakistan, trained at Harvard and is now a fellow in cardiovascular medicine at Duke University in North Carolina. Like Ed Yong’s I Contain Multitudes or Atul Gawande’s Being Mortal, Modern Death is a learned but engaging book that intersperses science, history, medicine and personal stories. Warraich addresses death as a biological phenomenon – perhaps more complicated than one might expect – but also as a social one that has undergone great changes in recent decades.
“The vast majority of people die in places where inert tones provide the palette, disinfectant the aroma, alarm bells the soundtrack, and open-back johnnies the wardrobe.” So Warraich describes a typical hospital or nursing home decline. Compare this to a century ago, when most births and deaths occurred in people’s homes. Although dying at home is on the rise, the author notes that patients’ wishes often have to cede to circumstances. Moreover, there’s inequality at work: affluent whites are more likely to die at home. In the United States, a disparity is seen in life expectancy as well, with just 300 miles separating the nation’s longest (Fairfax, Virginia – 82 years for men) from its shortest (McDowell, West Virginia – 64).
The very definition of death has become less straightforward as medicine has advanced, Warraich notes. Cases like that of Karen Ann Quinlan in the 1970s made the average person aware that physical life can continue even after the brain has died. Yet there is still much we don’t understand, and the idea that brain death could be reversible hasn’t been completely ruled out. The author recounts his own experience of treating a patient who collapsed of a heroin overdose but temporarily regained a pulse (known as the “Lazarus phenomenon”).
The first half of the book is about death as a medical reality, while the second focuses on particular social aspects of death: religious beliefs, the burden on families and other caregivers, the debate over euthanasia and physician-assisted suicide, and the pros and cons of using social media to share one’s journey towards death. Relatives of the ill or dying will find plenty of useful information here on designating a health-care proxy and setting up a living will and/or DNR order – just bear in mind that much of this may be specific to the United States.
If the book is reprinted it could do with more careful proofreading as there are numerous minor errors, whether typos or wrong word choices (“deference” in place of “deferral,” for instance). In some places Warraich mixes his metaphors and ends up with unintentionally awkward phrases, like “decapitation has digestible parables” and “the raison d’être of religion stems from the existential curve ball imbued so deep within us.”
Nevertheless, this is quite a fascinating book with a vital message that Warraich delivers passionately: we must bring death into the public conversation so that it holds less fear for patients and doesn’t equate to failure for doctors. After all, it’s inevitable for each of us.
I wanted to write a comprehensive review but I don't think any review does justice to this excellent and well researched book. Consider this lousy review the exact opposite of this wonderful (and sobering) book.
Думаю, для России книга совсем не подходит - у нас совсем другой подход к лечению и смерти - но очень интересно узнать, как работают и относятся к уходу из жизни американские врачи. Хайдер Варрайч родом из Пакистана, и видимо обладает прирождённым талантом рассказчика, потому что за всю книгу он касается ряда важных тем и не ходит кругами.
Почему клетки умирают? А почему не живут? Что вообще такое смерть? Когда останавливается сердце? Или когда мёртв мозг? Зачем проводить реанимацию? Надо ли вытаскивать людей с того света? Почему эвтаназия до сих пор не получила распространения? Вопросов много, на все будут даны ответы. Несмотря на мрачную тематику, Варрайч умудряется сохранять спокойствие и проявляет эмпатию как к пациентам, так и к героям своих историй.
Стала ли я меньше бояться смерти после этой книги? Да нет, конечно. Такое невозможно. Но было очень интересно.
Dad flushed dead turtles and goldfish down the toilet. From water pets we graduated to land mammals, such as cats and dogs. Then the day arrived when each of them died. Then a classmate of hers died, making my sister inconsolable. Uncle Wes died and I remember attending his wake as a little boy in a dark oaky Chicago living room parlor.
Death is part of life, as early lessons teach us. We also learn that life is for the living by remembering those who went before us and helping those behind us. It’s an endless parade of humanity.
Modern death means different things to different people, writes Haider Warraich. The current issue comes down to questions of extending life or prolonging death. This book explores the history and evolving thought on end-of-life care decision-making.
About two hundred years ago, life expectancy began to rise, with a reduction in child mortality accounting for most of the increase. This period also witnessed better public sanitation, hygiene and nutrition. Today, most Americans die of chronic diseases that sap the mind and body before the end arrives.
I found myself astonished at the story told here, especially the last fifty years, a period of medical advances that we take for granted today. Warraich consolidates these recent events to crystallize where we are today.
Cardiopulmonary resuscitation came together in the sixties. Also in the sixties, an emergency response system developed with trained paramedics staffing ambulances. With CPR, cardiac monitors and ventilation devices, the modern intensive-care unit came into prime time. Medicine, an art for thousands of years, became a science, writes Warraich.
Around this time, just fifty years ago, new discoveries altered our conception of life and end of life. But no one anticipated the long-term outcomes of these advances. Technology changed the patient-doctor relationship. Before the forties, we interacted at home or in clinics. Most of the action now takes place in hospitals.
Living wills of fifty years ago preceded today’s advanced care planning. Congress endorsed living wills in the Patient Self-Determination Act. The patient-autonomy revolution came at the right time to save patients rights. Now we can define our treatment preferences. Warraich’s research found that patients who wanted less aggressive treatment held to that preference. But those who wanted aggressive treatment kept changing their minds, which made them poorer and more depressed.
After all the tears, agonizing and hand-wringing, what does modern medicine do? Does it prolong death, or does it extend life?
Uncle Frank kept my aunt on life support way too long. Money was not an issue for him, but he was not going to let his wife go, even though members of the family quietly urged him to face the inevitable. Although there was life, the quality of life was long gone.
Me? I plan to take the least invasive path out of here. When my time comes, I just want to spend my final days and minutes laughing with familiar faces and voices with music, because hearing is the last sense to go.
This is really a 4.5 star review. Let's start with a few background facts that color this review. My family and in particular my mother has been very open in its discussion of death. I know my parents wishes when the end comes and they know mine. We're of the perspective that less is more at the end. I have also read "How We Die" (many years ago) and part of "Being Mortal." I was afraid this book was going to feel like a retread of those popular titles but it was anything but.
First of all, this is a well-written book. It is a nice read. I read it in 4 days. As for the content, it takes a wholistic approach to death and dying. It covers a lot of territory including a historical look at some issues. I often find the history chapters in nonfiction kind of boring but not this one. It gave nice context without bogging it down.
Overall this gave me a lot to think about on a subject I felt like I had already given a lot of thought to. I highly recommend, especially if you are uncomfortable about the subject matter.
Amazing to read from the perspective of a nurse who increasingly feels like she commits medical battery on the elderly every day in the course of her work because their families refuse to let them go. Stop asking "what else can be done for her medically?" when your mother is 95 and has dementia and a slew of comorbidities. It is awful to watch and even worse to be forced to participate in these torturous procedures, tests, and invasions thrust upon the dying. Get those advance directives done now...don't wait until it's too late.
Really 4.5 stars. I have not read this in a discussion group, but it's an important topic to talk about. Because it also touches on the role of religion and spirituality, on the definition of death, and on assisted suicide, it might spur some different viewpoints. Besides which, as the author and others have pointed out, death has been removed from a natural part of life to the technological world of medicine, and it needs to become normalized again so that we can talk about our preferences.
Thanks to reader Art, https://www.goodreads.com/user/show/1... who included the following links in his review. I copy them below in case Art’s review doesn’t come up when you search. He also included Terry Gross’s interview with author Haider Warraich on Fresh Air, which led me to this book.
The articles discuss ineffective or futile treatment, which relates to Modern Death: How Medicine Changed the End of Life. The author's conclusion is, not for the better in most cases.
In earlier times in more developed countries, and in the developing countries today, before medicine had advanced to its current state, most people died suddenly or after a brief illness. Their last days were spent in the homes of family members who cared for them. Now, most people die in hospitals, hooked up to machines, often in opposition to their expressed wishes. The end of life has been transformed into a limbo of prolonged dying.
Why does this happen? Insurance pays for it. Patients and their families, from hope or religious beliefs or lack of knowledge about the successes and risks of treatments, often want to try anything and everything. Physicians comply, from fear of being sued or from unwillingness to talk with patients and their families about what treatment can realistically accomplish and the side effects it will cause.
For another thing, the increasing sophistication of our tools has made it more difficult to say exactly when death has occurred. Machines can keep bodies breathing and their hearts beating when their brains will never function again; when life support is removed, death usually soon follows. Warraich talks about the cases of Karen Ann Quinlan, Nancy Cruzan, and others. Jahi McMath, a 13-year-old, experienced brain death after elective surgery. Though a court has declared her dead and her body continues to degrade, she was transferred to a nursing facility and her body receives “life support” (quotation marks by the author).
Critical by Tom Daschle, about our health care system, touches on the subject from a different perspective. If the U.S. had a body to set standards for what care is effective and what is wasted, would so much useless treatment be administered at the end of life? Warraich gives statistics for “an acute escalation of medical interventions” (of doubtful utility) near the end of life. (p. 264)
A byproduct of our system of prolonged dying is the toll it takes on caregivers. Warraich discusses the shortcomings of living wills and the strain on caregivers to make constant, countless decisions about care or, when the patient’s preferences are not known, to figure out what the person would have wanted. When there is more than one family member, there is the prospect of disagreement about what to do.
Warraich’s book covers similar territory to Being Mortal, though concentrating on the very end of life and not the declining years. Though not as elegant a writer as Gawande, he does speak affectingly and from the heart. These and other writings over the past few years urge us to demystify death and to talk with our families or potential surrogates about our preferences, should they be called upon to make decisions for us about our care.
I was surprised and pleased by this book. The author is a physician who appears to be in training in cardiology at Duke. The book is a collections of memoir and essay on the subject of how death is viewed in the context of modern medicine. The motivation is that death is perhaps the central topic of human existence in one way or another and yet it is an event that everyone undergoes but nobody knows anything about. Moreover, most of the common conceptions about death that are widely held are anecdotal and often flat out wrong and even if not wrong are often hopelessly out of date when looked at in terms of medical science and practice. The idea is that to get people talking about death and its related issues more openly will help patients and their relatives deal with end of life issues and will help physicians and health care professionals better serve patients.
In the interests of transparency, I am currently dealing with multiple situations these days in which parents, peers, and children are dealing with extended medical situations - increasingly common with an aging population - and I have spent far too much time in hospitals on various peoples behalf to not realize the importance of what Dr. Warraich is writing about.
The book seems like an odd collection of topics but it holds together well and the number of “aha” moments (I did not know that!) is large both in total and per page. There are lots of notes for those who wish to read more. The writing is superb. Some of the earlier chapters cover the micro level biology of how cells die, which sounds strange but which is crucial for understanding some of the later issues that get covered - “brain death” and DNR orders for example. Warraich also discusses the geography of death and how people are increasingly dying in hospitals and nursing homes rather than in their own homes. The discussion of resuscitation was an eye opener to me and I thought I was relatively well informed as a lay person.
All of this is fascinating, but the book gets even better as it progresses, when Dr. Warraich talks about the bordens of end of life medical processes on family and family representatives/proxies. Many are taking on these responsibilities just at the time that their own children have grown and it is important to clearly discuss what they are getting into. Related to this is the nature of family conflicts - and conflicts more generally involving the patient, family, and treatment team. Topics like assisted suicide and euthanasia round out the second half of the book.
...but then Warraich provided a last chapter about the increasing importance of social media in the lives of patients in these extended hospitalizations and institutional stays. The argument is not only that making use of social networks helps connect people to patients in beneficial ways to fight loneliness and isolation. There is also the possibility that having patients and family write/blog about their experiences can be helpful on its own and ease some of the concerns of those facing an inevitable death. This is one of the better uses for social media that one hears about these days.
This is a fine book and I hope Dr. Warraich continues to publish, and not just in his medical journals.
I picked up a copy of Haider Warraich’s book Modern Death as soon as I saw it advertised. This is a topic that I find fascinating and Mr. Warraich’s book was billed as the “follow-up” to Atul Gawande’s Being Mortal, so I didn’t think twice about the impulse purchase. While reading the first few chapters, I was a little disappointed. Mr. Warraich wasn’t presenting anything that I hadn’t already read or taught about as a professor of health law and ethics. I didn’t make my first earmark until page 91, but shortly after had to be careful not to earmark every other page. I quickly decided that Mr. Warraich had written a text that should be read by everyone – not just people fascinated with the legal and ethical issues surrounding end of life.
Modern Death begins with an overview of issues surrounding death, including the legal definition of “death” and methods of sustaining life. Landmark cases are explained and a detailed history of the development of CPR is included. After building a firm foundation, Mr. Warraich delves into the issues he sees most often as a physician. That first earmark on page 91? It was for this quote: “The reason people increasingly don’t want CPR is not that they are afraid it will fail but that they are afraid it will only partially work. Patients are afraid that if CPR makes their heart start beating again their brain will have to pay a huge cost.” In a society that values independence and self-reliance, this is so very true. Most people would rather not continuing living if they have to live in a vegetative or severally impaired condition. What is life in today’s world if you cannot continue to do the daily activities that you love?
After an excellent ethical analysis of death and resuscitation efforts, Mr. Warraich considers deeply the role of religion in the dying process. He states: “Physicians very frequently find themselves in difficult situations with patients who have a strong faith, but rarely do they talk about religion and spirituality.” One study estimates that only 10% of physicians broach this difficult but important subject. This number is extremely low considering a study of cancer patients showing that patients provided with “spiritual care had a better quality of life prior to their deaths, were more likely to pass in hospice, and were less likely to receive aggressive and unnecessary care close to death” when compared to patients not provided spiritual intervention.
Modern Death also examines the role of physicians assisting care-givers and surrogate decision makers. He proffers that physicians are usually at the center of the decision-making process and they are often required to buffer the various opinions of family members and caregivers. In addition, he states that the burden placed on surrogate decision makers (aka health care proxies) is seriously overlooked.
The topics of euthanasia and physician assisted suicide are also touched on in Modern Death. Mr. Warraich offers his own personal perspective and thoughts regarding this controversial topic. He provides a unique perspective regarding the shift in opinion over centuries, not just decades.
I have added this book to my list of texts that every healthcare professional should consider reading. Additionally, I will be giving it to my parents. Per Mr. Warraich’s suggestion, I will instigate the talk that everyone avoids, but everyone should have before it is too late and we simply have to guess.
Two end-of-life emerged on my lengthy library reserve list at the same time. Not pleasant reading, but important.
While MODERN DEATH is a sort of text book about death through the ages, with discussions of cell death, etc., EXTREME MEASURES is more of a handbook about what happens when one gets into the clutches of an ICU. And it isn't pretty.
I thought it was especially telling that healthcare workers -- nurses, doctors, and others -- don't die the way members of the general public often do. That's because healthcare workers avoid ventilators and extreme measures. The author of E.M. even cites a nurse who had DO NOT INTUBATE tattooed on her chest. More than a DNR is required to escape the extreme measures taken to preserve -- well, not to preserve life, but to preserve breathing and a beating heart even if useful brain function is gone forever.
In addition to a DNR/DNI, (these often do not survive a patient's transfer from one facility to another) people should have a POLST (physician order for life-sustaining treatment) which has the force of law. E.M. has many painful anecdotes and several pages of online resources such as polst.org and her own website jessicazitter.com which are useful for more information.
MODERN DEATH is more scholarly with many pages of bibliography. Clearly the author did a ton of research but I found Zitter's book to be much more practical and useful. Except I hope I never need to read it again and that I and everyone I care about (and for) just fall asleep one night and never wake again.
That's how it was with my mother. She fell and ended up in an ICU with big mitts on her hands to prevent her from pulling out tubes, etc. I invoked hospice and got her out of there in a hurry and back to her own bed where she died five days later with my husband and me with her. It was sad, but it was peaceful.
I am quitting after page 33. I cannot take seriously a book with this paragraph: "Stories of men and women who defied death abound in the history books. Perhaps the most famous of these figures is Methuselah, Noah's grandfather, who recently made an appearance in pop culture, played by Anthony Hopkins in Darren Aronofsky's film Noah. Methuselah, whose legacy remains as a synonym for longevity, is said to have lived for 969 years, and his death prompted God to unleash the great Flood (citation to Genesis)." There was also an earlier reference where the author gave examples of medical census taking like the one the Lord asked Moses to do, as a precursor to Thomas Cromwell's. I learned a few interesting things, particularly about cell death, but I can't read a supposedly scientific book about death that counts the Bible as a history book.
Recommended for: fans of body horror, anyone entering the medical profession, EMTs, people with terminal illness, civilization critics, anyone who is going to die.
Dr. Warraich is currently working Duke and I went to his hometown reading/discussion at the Regulator. This is a compelling, interesting read about, as the title says, modern death. I appreciate some of the historical and social background he brings in along with personal stories. He writes about legal battles related to withdrawal of life-sustaining treatment, right-to-die issues and perspectives from the ICU, none of which I ever see in an NC hospice. That said, I wish he would have explored a bit more about what a non-acute or critical death looks like to show people how it can be. He touches on it, but you can tell he really doesn't have experience in that arena. I would also argue with the idea, which Warraich repeats throughout, that death is a universally feared and fought concept. I'm not at all sure that is true, and sounds like a manifestation of our cultural death phobia rather than core part of human nature.
This is such a well-intentioned and earnest book, and it could be really important but the writing leaves a lot to be desired. Sentences like "Cancer, perhaps the most storied disease of our times, has also benefited immensely from advances in both prevention and treatment." or "Through much of time, writers and poets and philosophers have found parallels between life and death, and between birth and dying. The mirroring of life and death does not just provide lyrical flourishes, it is reflected in history. Back when human beings gave birth to their young'uns in caves, they also passed away in caves." -- just left me shaking my head. So I skimmed, focusing on the personal stories of how different people--doctors, patients, families-- handle death and dying.
There were a few times when I found this book a little annoying (such as when he says that he has never talked to his mother about what sort of life-sustaining interventions she would want, but he knows that she would always want more time; despite the fact that he says in another part of the book that surrogates tend to be more aggressive about treatment than patients would be, and the conclusion of the book saying that we all need to talk about end-of-life issues more in our everyday lives (i.e. not when you're in the ICU!)). But overall, I liked the book, and I appreciated that he recognized that over-aggressive care can count as "doing harm" (and thus going against the "first, do no harm" that guides most doctors), which seems to be a pretty rare insight for doctors.
Wow, I was blown away by this book. It was not what I'd expected, in the best way possible. Dr. Warraich writes with such humanity and compassion that it makes tackling a dark and frightening subject almost a pleasure.
The reader is guided through all the aspects of death in the modern age, from the difficulty in defining death in the face of medical advances over the past one-hundred years, to the legal and ethical challenges posed by modern death, to the spiritual and religious considerations one must take into account when dealing with death.
This book is a must read for anyone who wishes to prepare themselves for the inevitability that awaits us all. Five stars.
A valuable history of how medical advances have impacted the way people view death as well as how they die. I found the first chapter on death at the cellular level somewhat challenging to read, but it is worth continuing as there are excellent chapters on many other aspects of the dying experience including the use (or not) of CPR, the burden carried by health care proxies and the debates around the concept of death with dignity. The book shines when Dr. Warraich shares personal stories and experiences, but as a whole it is very readable and illuminating on a subject that many people find hard to discuss.
When I learned of this book I was curious...when I finished it, really a long essay on the art and science of death from a medical, philosophical and artistic perspective by obviously a very humane physician I was stunned at its beauty and depth. Who should read it? Well, anyone who will eventually face death, the families of anyone facing serious illness, caregivers, everyone in the medical profession - that I suspect means everyone should read it.
Found this on a shelf in the public library and thought it looked so interesting. I wanted to have an audiobook copy as well, and sadly, I paid for one because there was no library copy available. It is way over my head. Three chapters too complicated for me... The author doesn’t make it easy to understand for me like Mary Roach does. I learned my lesson to Read a few chapters of the print before paying for a copy whether it be in print or audiobook. I will not be finishing this.
The way we die has changed a great deal in the last century. Modern medicine can now prolong our dying which is something few people want. We want to live a long time but not spend a long time dying. Dr. Warraich does a good job of exploring questions around death. Lots to think about here.
Excellent book though admittedly a tricky subject matter. If it is a subject that interest you at all, and/or if you read and appreciated Being Mortal, I highly recommend this book. Well researched, well documented and eye-opening.
Well written and inciteful about the state of death in modern times. He explains cell death, the history of death, ethics, landmark cases, and more. A must read for everyone - especially every Doctor and Nurse.
GET YOURSELF A HEALTH CARE PROXY. NOW. AND TALK ABOUT YOUR WISHES RE: CATASTROPHIC ILLNESS AND WHAT YOU WANT DONE WITH YOUR REMAINS. THIS IS NOT A DRILL.
I thought this was a very well written and interesting book. The anecdotal stories were effective , and the history of death and its progression in medicine was well illustrated. I also really liked how other countries and Cultures were discussed. I would have liked a little more development into quality of life and factors helping to decide measures to prolong, but overall great book.
Along with Atul Gawande's Being Mortal this book has opened my eyes to the immediate, likely future looming before my grandmother and for me as her caregiver. After 4 years of caregiving with its ups and downs, there are days I feel like I have a form of PTSD. There are days I feel like I'm losing my baseline (sanity) as surely as she's losing hers (health). But this book gave me perspective and hope and a dose of the reality I suspected but was ultimately too ignorant to nail down. It also showed me that we have choices not typically, or ever, presented and we may have to fight to enact those choices. I'm ready for the fight. I'm better equipped for this marathon. "...the de facto mode of modern death looks something like this: Person falls sick, gets better, but never gets back to baseline, accumulating diagnoses and procedures until it becomes clear (usually quite belatedly) that more will not necessarily do any good. This makes sense for the vast majority of people, and perhaps with good reason, but a select few patients don't want to go down this trodden path."
The author talks a lot about fear of death itself (and all the attending suffering) and the fear of discussing death in families; that people don't broach the subject with their loved ones out of fear or respect, awkwardness or an unreadiness in themselves to face the thoughts. I don't know if we're a weird family in that way, but thankfully, none of my family members have any trouble talking about death, what they want for themselves at the end, and what our role will be as survivors (assuming the young outlive the old). There's no awkwardness, no stress, no fear. It's like talking about the weather. I didn't realize there was so much tension around this subject with most other families. "Awareness of our mortality does more than remove the shroud of fear from death--it makes us kinder. One study showed that people who thought more about death were more likely to participate in selfless activities such as blood donation. Other research has shown that people who reflect about dying are more likely to donate to charities and have enhanced gratitude. And lastly, thinking of death, almost counterintuitively, reduces stress, and reducing stress is known to lead to a longer and healthier life."
"EEG and ECG's don't give us any information about the life of the organism. A blip on ECG may mean that there are some cells in the heart that stubbornly continue to contract despite the annihilation of most of their brothers and sisters
This book is brilliant. Ada begitu banyak hal yang bisa dipelajari dari buku ini, sang Author, Haider Warraich menuliskannya dalam bentuk yang sangat baik -disertai begitu banyak jurnal dan pengalaman yang ia alami di rumah sakit. Sebagai tenaga medis, ada begitu banyak yang bisa di refleksikan dari buku ini. Perkembangan dunia kesehatan yang begitu pesat mulai membuat kabur batas antara hidup dan mati. Pesan utama dari kesehatan (jika kita hanya memandang dari sisi logika) adalah melawan kematian. Death is enemy, they said. Namun sampai batas apa kita akan melawan kematian. Kematian adalah fakta yang tidak bisa terelakkan, semua yang bernafas akan merasakan kematian. Jika kita berbicara tentang 'kematian' dalam sebuah obrolan ringan maka semua aura ceria berubah menjadi gelap, dingin, menyedihkan seakan Dementor datang menghampiri.
Kengerian dari istilah kematian ini membuat ilmu kesehatan terus meningkat dari waktu ke waktu. Sampai akhirnya setiap negara memiliki kriteria kematian yang berbeda. Buku ini menceritakan sejarah bagaimana kematian itu di definisikan, lalu timbul istilah baru seperti brain death, teknik CPR, istilah DNR/DNI sampai akhirnya membahas kontroversi dari euthanasia. Author menggambarkan bagaimana kompleksnya masalah di ICU, mengamati pasien-pasien yang mengalami koma dengan vital sign yang masih baik namun sama sekali tidak menunjukkan adanya tanda-tanda perbaikan, hanya bergantung pada sebuah mesin -ventilator- sampai akhirnya kriteria kematian yang telah ada sesuai undang-undang tiba. Aku rasa buku ini banyak membuatku dalam merenungkan hal-hal yang akan kutemui di masa depan nantinya.
When it comes to themselves, doctor certainly don't consider death the worst possible outcome. In fact, the vast majority of physicians value the quality of their life far more than the length or their life. This is reflected in the fact that physicians rarely want to have CPR performed on them if the need arises.
An excellent book about the way modern medicine has increased our ability to keep the Grim Reaper at bay (for a time), but at what cost? Medical interventions might keep a heart beating and might keep a person fed, hydrated, and breathing, but medical interventions cannot always prevent pain and suffering. The difference between life and quality of life can be hard to define.
The book's register is quite elevated, making it a challenging read at times. For this reason, I won't assign this to my undergraduate students taking my Death, Dying and Bereavement class. Nevertheless, I found this far-ranging book highly engaging. That being said, my students would probably benefit from reading a late chapter on the way people use social media not just for well wishes for the dying or memorials for the dead, but how the dying use social media to document their dying process.
Warraich looks at end-of-life care through historical, legal, ethical, and medical lenses, allowing the reader to consider the realities and implications of a number of trajectories through the end of life.
While Warraich does draw on a lot on statistics and evidence-based research, he balances his approach with anecdotes. The most challenging section was at the beginning where he describes death on a cellular level. I wish he had placed that deeper in the book. It almost scared me off. Having read about 30 books on death and dying, I do see Warraich as making a valuable contribution to the dialogue. Thoughtful and well informed.
This is an interesting book that talks about a topic most people tend to avoid and that is death. The book discusses death from medical perspective. It also tapped on different other perspectives like the spiritual, religious psychological and some cultural. The good thing that it also discusses some of the most important medical cases related to death and terminal diseases. The good thing that it does not support or highlight a single point of view but represents all the different ideas from different people. The author also focuses on euthanasia (Physician assisted suicide) with some real life cases. Ofcourse you have to make the decison whether you find this acceptable or not. Then there is the issue of whether a patient has a heartbeat but a dead brain and what is needed to be done. The book also talks about how CPR has changed life and death, how it was invented and how it advanced and was adopted eventually.
There are lots of useful information here, lots of real life cases and lots of statistics that make an interesting reading. I would have loved it if the author would have also tapped on NDEs (Near Death Experiences) and the medical views on those cases, because the book had nothing to say at all about that. There are many people who face death and make it alive, many people went in comma then woke up. Perhaps some talk about this subject would have made the book more interesting. Overall this was an interesting read.
Note: I have won a free copy of this book by participating in a giveaway.