It’s a publishing sensation. Doctor Atul Gawande has written a book about how our children move away, our powers diminish, we become sick, our friends die, we become isolated, with limited scope for purposeful activity, and then we’re poked by doctors and filled with drugs in the belief that maybe we might never have to to let go of our mortal coil. And it’s selling well!
Gawande’s mixture of biography, storytelling and comment journalism reveals the mind of the C21st ‘elite’ doctor. He can work miracles with material medicine, but the harder he tries, the more he begins to question whether his miracles are actually helping us do what we’re here to do: live.
We can keep cancer patients alive, but the suffering and indignities they have to endure are sometimes repulsive.
We have superb assisted care facilities for the very old, but the fact that they’re safe and comfortable, makes living in them tedious and depressing.
Doctor have knowledge and expertise to deal with disease, but they can’t initiate honest conversations with patients about the thing that really matters - treatment can’t go on forever, and sometimes it’s better to do without and face the inevitable.
Atul Gawande has humility and tells many sad stories about how solutions to problems devised by doctors have created institutions like old people’s homes that don’t necessarily provide us with what we need. Old religious societies often provided better solutions.
He writes very well, and this book was so easy to read I finished it in a few days.
We need to think harder about how we look after people at the end of their lives and Gawande offers some preliminary thoughts on where that discussion should lead.
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