Summary
Atul Gawande's Being Mortal: Medicine and What Matters in the End is a groundbreaking exploration of end-of-life care and the medical profession's approach to aging and death. Published in 2014, this non-fiction bestseller challenges conventional healthcare practices and advocates for a more compassionate, quality-of-life focused approach to caring for the elderly and terminally ill.
Drawing from personal experiences, patient stories, and extensive research, Gawande presents a compelling case for reimagining how we handle life's final chapter. The book has garnered numerous accolades, including the British Medical Association Council Chair's Choice award and a place on several “Best Books of the Year” lists.
Being Mortal has made a significant impact beyond the literary world. In 2015, it was adapted into a PBS Frontline documentary, earning an Emmy nomination. More recently, a film adaptation was announced in 2022, with Aziz Ansari set to make his directorial debut.
Plot
In “Being Mortal,” Atul Gawande explores the challenges of aging and end-of-life care in modern medicine. He begins by examining various models of senior living, from traditional multi-generational households to contemporary nursing homes and assisted living facilities. Gawande shares personal stories and interviews with elderly individuals, their families, and healthcare professionals to illustrate the complex issues surrounding care for the aging population.
The author then delves into the medical aspects of aging, discussing how the healthcare system often prioritizes safety and longevity over quality of life. He highlights the limitations of nursing homes and hospitals in providing fulfilling experiences for elderly patients, arguing that these institutions frequently isolate and restrict individuals in ways that diminish their sense of purpose and dignity.
Gawande shifts his focus to end-of-life care, examining the difficult decisions faced by patients, families, and doctors when confronting terminal illnesses. He explores various approaches to palliative care and hospice, emphasizing the importance of maintaining a person's autonomy and well-being during their final days. The author shares poignant stories of individuals navigating these challenging circumstances, including his own experiences with family members.
Throughout the book, Gawande advocates for a fundamental change in how the medical profession approaches aging and mortality. He argues that instead of solely focusing on extending life, healthcare providers should prioritize enhancing the quality of life for patients, even as they near its end. The author concludes by offering suggestions for improving end-of-life care and encouraging readers to have open, honest conversations about their wishes and priorities as they age.
Themes
Limitations of modern medicine in end-of-life care
Importance of quality of life over longevity
Challenges of aging and loss of independence
Need for better models of elder care and assisted living
Value of hospice and palliative care approaches
Importance of having difficult conversations about mortality
Preserving dignity and autonomy at the end of life
Setting
Being Mortal is set against the backdrop of modern medicine in the United States, focusing on the challenges faced by an aging population in the early 21st century. Gawande explores various healthcare settings, including hospitals, nursing homes, and hospice facilities, to illustrate the current state of end-of-life care.
The book delves into specific locations, such as Mount Auburn Hospital in Cambridge, Massachusetts, where Gawande works as a surgeon. He also visits innovative care facilities like NewBridge on the Charles in Dedham, Massachusetts, and the Zen Hospice Project in San Francisco, California, to showcase alternative approaches to elder care and end-of-life support.
While the primary focus is on the American healthcare system, Gawande occasionally draws comparisons with practices in other countries, such as India, where he has familial roots. This broader perspective helps to highlight the cultural and societal differences in approaching aging and death, providing a more comprehensive view of the challenges faced by healthcare professionals and patients worldwide.
Key Figures
Atul Gawande: The author and narrator of Being Mortal. Gawande is a practicing surgeon who explores the challenges of aging, end-of-life care, and mortality through his experiences and research. He advocates for a shift in medical focus from mere survival to quality of life and well-being. Gawande's personal reflections and encounters with patients form the core of the book's narrative.
Keren Brown Wilson: A geriatric doctor mentioned in the book. Wilson is credited as an originator of the assisted living concept, which aims to provide a more dignified and independent living arrangement for the elderly.
Gawande's patients: Various unnamed individuals whose stories and experiences with aging, illness, and end-of-life care are shared throughout the book. These accounts provide real-world examples of the challenges and dilemmas faced by the elderly and their families.
Gawande's relatives: Family members of the author whose experiences with aging and illness are discussed in the book. Their stories offer a personal dimension to the broader issues explored in Being Mortal.
Quick facts
The book spent over 85 weeks on the New York Times bestseller list
It has been translated into over 30 languages worldwide
Gawande wrote much of the book while his father was battling terminal cancer
The book was inspired by Gawande's experiences as a surgeon and seeing how medicine often fails the elderly and dying
It took Gawande four years to research and write the book
The book has sold over 1 million copies globally
Gawande interviewed over 200 patients, doctors, and family members while writing it
The PBS Frontline documentary based on the book was nominated for an Emmy Award
Being Mortal was Gawande's fourth book, following his previous bestsellers
The book sparked national conversations about end-of-life care when it was published in 2014
About the Author
Atul Gawande is a renowned American surgeon, writer, and public health researcher. With a diverse career spanning clinical practice, academia, and public service, Gawande has made significant contributions to the fields of medicine and healthcare policy. He practices general and endocrine surgery at Brigham and Women's Hospital in Boston and holds professorships at both Harvard Medical School and the Harvard T.H. Chan School of Public Health.
As an author, Gawande has penned several bestselling books, including Complications, Better, The Checklist Manifesto, and Being Mortal. His writing, which often explores the complexities and challenges of modern medicine, has earned him critical acclaim and a wide readership. Gawande's work as a staff writer for The New Yorker since 1998 has further solidified his reputation as a thoughtful commentator on healthcare issues.
In addition to his clinical and literary pursuits, Gawande has been actively involved in public health initiatives. He served as the chairman of Ariadne Labs, a joint center for health systems innovation, and Lifebox, a nonprofit focused on reducing surgical deaths globally. His efforts in these roles demonstrate his commitment to improving healthcare outcomes on a global scale. In 2018, Gawande briefly served as CEO of Haven, a healthcare venture backed by Amazon, Berkshire Hathaway, and JP Morgan Chase.
Gawande's expertise and influence have been recognized through numerous accolades, including a MacArthur Fellowship and his inclusion in lists of the world's most influential thinkers. In recent years, his public service has extended to government roles, serving on President Joe Biden's COVID-19 Advisory Board and as the Assistant Administrator of the United States Agency for International Development. Throughout his multifaceted career, Gawande has consistently worked to address critical issues in healthcare delivery and policy.
