Sunday, December 13, 2015

The 2nd Half of Being Mortal - Almost as Good as the 1st Half

Although the 2nd half of Being Mortal - Medicine and What Matters in the End, by Atul Gawande, was a little more technical and philosophical than the 1st half, it's still excellent. It still had a bunch of poignant stories, including a few that were very personal to Atul.  It still had humor, tears, statistics, and good writing like the 1st half had.  But rather than give you any of that, I want to quote a few short sections of the book that I think are very important for all of us to hear.  And since this is non-fiction and deals with how the disabled elderly live their final days/months/years, there's really no spoiler alert issue.

"...assisted living isn't really built for the sake of older people so much as for the sake of their children." - pages 105-106

"... the Three Plagues, of the fact that people in nursing homes are dying of boredom, loneliness, and helplessness..." - page 119

" help people in a state of dependence sustain the value of existence." - page 128

"The terror of sickness and old age is not merely the terror of the losses one is forced to endure but also the terror of the isolation.  As people become aware of the finitude of their life, they do not ask for much.  They do not seek more riches.  They do not seek more power.  They ask only to be permitted, insofar as possible, to keep shaping the story of their life in the world-to make choices and sustain connections to others according to their own priorities.  In modern society, we have come to assume that debility and dependence rule out such autonomy.  What I learned...was that it is very much possible." - pages 146-147

"We've created a multitrillion-dollar edifice for dispensing the medical equivalent of lottery tickets-and have only the rudiments of a system to prepare patients for the near certainty that those tickets will not win.  Hope is not a plan, but hope is our plan." - pages 171-172

"The less seems almost Zen:  you live longer only when you stop trying to live longer." - page 178

"...about two-thirds of patients are willing to undergo therapies they don't want if that is what their loved ones want."

"Endings matter, not just for the person but, perhaps even more, for the ones left behind." - page 252

And, finally, here is Gawande's take on what palliative care is all about:

"Whenever serious sickness or injury strikes and your body or mind breaks down, the vital questions are the same:  What is your understanding of the situation and its potential outcomes?  What are your fears and what are your hopes?  What are the trade-offs you are willing to make and not willing to make?  And what is the course of action that best serves this understanding" - page 259

We all need to be a part of this extremely important discussion.  And one of the best ways that you, the reader, can be a part of it is by reading Being Mortal.


  1. Oh my, many of those quotes strike a chord with me since my mother will be 89 in January. Of course, she's still independent and living a full life but she knows the majority of her life has passed. The quote about undergoing unwanted therapies strikes a chord, too, because I'm convinced my mother-in-law did that because of my father-in-law. It affected the quality of the life she had left in a negative way. I need to pick this book up soon - maybe after the holidays.

    1. It's definitely a must-read for all of us - but especially for those who have elderly parents or who will be facing this situation not so far down the road. At 66, I want to have a conversation with my 3 kids (39, 36, 31) about where I would like to be when I reach that stage of my life. Better now than when I can't make my desires known! It's a bit heavy, but I don't think it has to be a negative thing. And, surprisingly, the book is not a downer.

  2. After reading these quotes I really do need to get my hands on this one (with highlighter in hand!)

  3. I marked so many passages with sticky notes, but then had to take them all out to return the book to the library, so I lost most of my saved quotes. There were so many of them! I'll probably end up buying my own copy of this book!