Being Mortal

Medicine and What Matters in the End

By: Atul Gawande

Narrated by: Robert Petkoff

Length: 9 hrs and 3 mins

Publisher's Summary

Number one New York Times best seller

In Being Mortal, best-selling author Atul Gawande tackles the hardest challenge of his profession: how medicine can not only improve life but also the process of its ending Medicine has triumphed in modern times, transforming birth, injury, and infectious disease from harrowing to manageable. But in the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit. 

Nursing homes, preoccupied with safety, pin patients into railed beds and wheelchairs. Hospitals isolate the dying, checking for vital signs long after the goals of cure have become moot. Doctors, committed to extending life, continue to carry out devastating procedures that in the end extend suffering. 

Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families. Gawande offers examples of freer, more socially fulfilling models for assisting the infirm and dependent elderly, and he explores the varieties of hospice care to demonstrate that a person's last weeks or months may be rich and dignified. 

Full of eye-opening research and riveting storytelling, Being Mortal shows how the ultimate goal is not a good death but a good life - all the way to the very end. 

©2014 Atul Gawande (P)2014 Macmillan Audio

Required Reading!

Yes, this book should be required reading for any medical professional of any kind who may ever have to help any patient make good decisions for themselves and their families against terminal or very debilitating illness. It should otherwise be read by well, anyone. We are all going to die. We either need to know what expectations to give those around us for those end times, either family or medical professionals or we need to know how best to guide our loved ones through the process of the end of their lives, because it will happen for all of us. Past that, this is a remarkably entertaining read. Oh, the parts about the history of nursing homes and assisted living made me yawn, but the rest had me spell bound. Dr. Gawnde's accounting of his own father's illness and death left me awash in emotion and even tears. The narration was perfect.

Definative book regarding end of life choices...

What an interesting and clear overview of aging and end of life issues. Gawande covers the process of aging and end of life, what fragile elderly means, history and trends of their care, how other cultures do it, case studies, his own choices with his father and... the best discussion of these issues I have ever read. My MD son enjoyed the information as well.

Rather than provide what he thinks is the "right" way to face EOL issues, Gawande gives us questions to ask the individual to help them determine their "right" way. He encourages us to have the hard conversations in advance so that an individual's wishes can be respected. Excellent book for healthcare personnel, families and aging adults.

I adored "One doctor" by Brendan Reilly and some of the content is similar... even if you have read Reilly, I still feel this book is well worth reading.

An Important Topic!

What an incredible book! I really think everyone should read it. I wouldn’t have picked it up if it weren’t a book club choice, but I’m so grateful now that I read it. It’s about a “difficult” topic - end of life issues and quality of life at that time – but the book itself is not difficult to read at all and is, in fact, very interesting. Atul Gawande handles the topic beautifully.

He explains, basically, how medicine needs to focus more on a patient’s wishes at the end of his/her life and not the family’s fears or wishes for the patient. Sometimes families want to go to extraordinary lengths to protect and prolong life, while the patient is really not willing or even physically capable of withstanding the treatments that the family wants to subject them to in the name of love. Sometimes, time has run out, and quality of life is the most important thing at this point. These are certainly tough decisions.

Gawande says that doctors are not really trained to talk to patients about dying. They are trained to try and CURE at any costs. The easy part is talking about all the treatments and drugs that can be used. The hard part is talking about and dealing with a realistic timeline and quality of life. Accepting that life can be shorter than we want can be extremely difficult! Gawande holds out hope that doctors might eventually be better trained to talk to patients about these issues.
Other topics relating to end of life issues are covered as well. There is a fascinating section on assisted living and various newer models which, again, hold out hope for the future in this area.

I was trying to remember the basic questions Gawande asks a person who has a terminal diagnosis. The website NextAvenue had the list for me:

“ It’s really a series of questions that we need to be comfortable asking one another. It needs to be normal to ask these questions, especially when someone is faced with a serious illness, and especially when we know that we’re aging and becoming frail.

We need to know:

1. What is your understanding of where you are and of your illness?
2. What are your fears or worries for the future?
3. What are your goals and priorities?
4. What outcomes are unacceptable to you? What are you willing to sacrifice and what not?
And later,
5. What would a good day look like?

Asking these allows everybody to understand what the goal really is — what are you really fighting for? It’s for a life that contains certain things.”

I also learned that there is a PBS Frontline video of Dr. Gawande and his work. I’m watching it now. It is perhaps even more powerful than just reading about his work. In any case, this book has opened a dialog for doctors, patients, and readers about needed changes in an important area!

You must read this book

Because you - like me - are going to die one day. Because maybe you - and maybe I too - will become one day old and frail.
Because maybe you too - like me - have an old parent to care for. Maybe you too - like me - have lost a parent to a terminal illness.
And we have a lot of doubts, and hopes, and fears. This author helps us a bit, with his compassionate interest for unpleasant and important questions that concern us all.
Don't miss this book, it's important.

A Walk through the Valley of the Shadow

A masterpiece of medical journalism. It is not an easy listen. Parts are unbearably sad. Contemplation of one's mortality in preparation for the inevitable, is something that most of us would just as soon put off thinking about until close to the end. This book is most recommended for those confronting life threatening illness, and for those with loved ones or family members doing so. It is also for those interested in first rate writing regardless of topic. This is that rare work that addresses life's most painful subjects with utmost lucidity, objectivity and sensitivity. It is a book that you come away from feeling as though you are, for reading it, better prepared to cope with the approaching end of life. It makes you feel as though you are better equipped to support loved ones. It is a masterful critique of contemporary medical practice and its approach to aging and dying. It offers a new vision of what medicine can and should offer the aged and the terminally ill. The patient narratives are gripping and yet painful to read and to contemplate. What would you do in similar circumstances? The narration is also first class.

scathing review of nursing homes

As a nursing home employee who read this book in the hopes of finding help in ways to transition the people I work for into palliative care and hospice and help they and their families cope with what it means when life cannot go on... this was crushing. It will be forever burned in my ears when he says... why haven't we burned these place to the ground... I believe there is some clear misunderstanding to think that there is no one who is in need of these facilities. I should have checked when this was written. Maybe its dated. I hope it is dated. Not everyone has the family support or financial support to live out their days in the way he expects. Nursing homes are not evil. They may be far from perfect but parts of this book were soul crushing to think that the caring I do for humans in these situations every day is viewed this way. Overall I liked and agreed with most of his beliefs. I did learn ways to have the hard conversations that I value. But the utter hatred of nursing homes was disheartening and wrong.

A Basic

I started to write that anybody over 50 ought to read this book, but that isn't true - everybody ought to read this book and wrestle with the idea of the end of life either for ourselves or our parents. Gawande is a superb researcher, a clear writer and he never loses the reader as he educates us about the american way of the end of life. A must read.

Honest look at aging in America

Any additional comments?

I have been an RN for 30 years and have watched the decline of our care for the elderly. This book is a must read for everyone. Families and the medical community needs to take a second look at how we care for the people who have made our lives possible. It is an honest and compassionate evaluation of long term care I gave a copy of this book to everyone for Christmas.

Everyone should read this

I will update later but I think everyone should read this book. It should also be a standard textbook for pastors, chaplains, and social workers. Death is inevitable. We need to learn how to do it better.

Worthwhile book about dying

BEING MORTAL is a best selling book by a top surgeon about dying from the perspective of those dying, their loved ones, and medical professionals. It is well written and well narrated. The book contains excellent advice for those facing earlier than expected death from terminal diseases as well as those dying from the maladies of old age. Being Mortal was published in 2014 but remains topical today. I very highly recommend it.