Twenty-nine years ago, my mother and I sat in a hospital room watching the medical staff attend to my father. He looked to be in only mild distress and we thought we’d be taking him home in a day or two as we had in the past. After a few minutes, the doctor took us outside the room and said, “I don’t know if you’re aware of this, but Mr. Brown is dying.” We weren’t aware of that. We returned to the room.
The doctor asked my dad if he wished heroic methods to save him. He said to ask us. My mother looked at me and I shook my head no. He died a few minutes later.
In 2005, I sat in another hospital room with my mother. She too had been to the hospital several times and we expected her to be discharged the next day. When the nurse visited, my mother complained of a cough and was given medication. I sat with her as she slowly relaxed and eventually fell asleep. Her breathing slowed, and soon became erratic. The gaps between breaths become longer. I thought about my dad, and my mom, wondering what to do. Her breathing soon stopped.
Being Mortal (2014) by Atul Gawande is about these things, about people being ill, about people dying, and about the people who love them. He focuses on understanding the patient and the patient’s understanding of what is happening and the potential outcomes, their fears and hopes and what tradeoffs they are willing to make.
Gawande’s message is clear, we can and should do much better helping the ill live out their last days in comfort, doing as much as they can to enjoy and feel meaning in their closing moments. Doing everything possible to extend life no matter what the human cost is a fool’s errand, but is what medicine is designed to do. Assisted suicide or death with dignity is possibly giving up too soon.
Gawande is a surgeon, teacher and writer. He is well positioned to teach us what is important in this last stage most of will face in slow, often painful motion.
If you have concerns about your own mortality, or have loved ones you worry about, this is a sobering and important book to read.