Free Downloads Being Mortal: Medicine And What Matters In The End
In Being Mortal, bestselling author Atul Gawande tackles the hardest challenge of his profession: how medicine can not only improve life but also the process of its endingMedicine 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 asserts that medicine can comfort and enhance our experience even to the end, providing not only a good life but also a good end.
Hardcover: 304 pages
Publisher: Metropolitan Books; 1 edition (October 7, 2014)
Language: English
ISBN-10: 0805095152
ISBN-13: 978-0805095159
Product Dimensions: 5.7 x 1.1 x 8.5 inches
Shipping Weight: 14.4 ounces (View shipping rates and policies)
Average Customer Review: 4.8 out of 5 stars See all reviews (5,426 customer reviews)
Best Sellers Rank: #147 in Books (See Top 100 in Books) #1 in Books > Medical Books > Administration & Medicine Economics > Health Policy #1 in Books > Medical Books > Medicine > Hospice Care #1 in Books > Medical Books > Administration & Medicine Economics > Health Care Delivery
This book could be a game changer, if enough people read it and take it to heart. Atul Gawande addresses end-of-life care, and how we're getting it wrong, both within the medical establishment and in our families.Dr. Gawande's book focuses both on medical procedures and living conditions in later life. He addresses the reality that as people near the end of life, decisions about their living situation are primarily aimed at ensuring safety at the expense of retaining autonomy, especially when adult children are making the decisions. "We want autonomy for ourselves and safety for those we love," a friend tells the author. We mistakenly treat elders as children, Dr. Gawande says, when we deny them the right to make choices, even bad choices. People of any age want the right to lock their doors, set the temperature they want, dress how they like, eat what they want, admit visitors only when they're in the mood. Yet, nursing homes (and even assisted living communities) are geared toward making these decisions for people in order to keep them safe, gain government funds, and ensure a routine for the facility.In addition, Dr. Gawande shows how end-of-life physical conditions are most often treated as medical crises needing to be "fixed," instead of managed for quality of life when treatment has become futile. Life is more than just a stretch of years; it must have meaning and purpose to be worth living, he says. This is a familiar concept (in fact, I read parts of this book in
I became a fan of Atul Gawande upon reading his first book in 2002: Complications: A Surgeon's Notes on an Imperfect Science. In reading many of his previous books I found he always asked questions: Why do we do things; for what purpose; is this working to achieve the best results for the patient in his physical and cultural circumstance? Gawande tackles the dilemmas of medical ethics by approaching them with sagacious common-sense. I think most of his books should be required reading in medical schools.In this new book Being Mortal: Medicine and What Matters in the End, Gawande looks at the problems of the aging population and inevitability of death. He points out that you don't have to spend much time with the elderly or those with terminal conditions to see how common it is for modern medicine to fail the people it is supposed to be helping. In speaking of elder care he sadly points out that "Our reluctance to honestly examine the experience of aging and dying has increased the harm and suffering we inflict on people and has denied them the basic comforts they need most". Many physicians are so hell bent on preserving life that they cause horrible and unnecessary suffering.Gawande points out that sometimes in striving to give a patient health and survival their well-being is neglected. He describes well-being as the reason one wishes to be alive. He looks at the "Dying Role" as the end approaches describing it as the patient's ability to "share memories, pass on wisdom and keepsakes, settle relationships, establish legacies and make peace with their God. They want to end their stories on their own terms." He feels that if people are denied their role, out of obtuseness and neglect, it is cause for everlasting shame.
As a fan of Gawande's previous books and someone whose personal life is currently very much about the topics covered here, I found this a much-needed and absorbing read. Its honesty is sobering (and possibly shocking to those not intimately familiar with what passes for "healthcare" today in the United States).Until you or a loved one are dealing with the healthcare/medical "system" these days, you can't imagine how much it can negatively affect your quality of life, no matter what your actual medical condition is or your life expectancy. We will all face aging, illness and death...sooner or later. But inevitably. We need more humanity and compassion from each and every person in the healthcare/medical system today. (If only they WOULD read this and get trained in how better to deliver the experience that patients---aka "customers" if you want to use the lingo of business, which healthcare has turned into.)Getting the care you need, care that supports one's independence (as much as possible) and autonomy when health-challenged, as I've learned in my own life, is incredibly challenging, even if you have good health insurance and access to "good" doctors. So much of what is needed is obvious to those who are ill and aging--and to some (though certainly not all) of their families. But getting what you need? Difficult beyond belief.It is encouraging to see someone of Gawande's success/influence taking on these issues. Real-life stories and experiences fill this book and they are important. You have to believe things can change for anything to actually begin to change. Just reading about the individuals striving to make life better for those in their care is encouraging.
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