Being Mortal was nothing like what I expected it to be. I thought it was going to be a philosophical discourse on the nature of aging. Instead I quickly discovered an anecdotal journey through the US aged care system.
However, interspersed amongst the anecdotes were loads of interesting facts and discussions about aging through the times and across cultures.
People die only once. They have no experience to draw on. They need doctors and nurses who are willing to have the hard discussions and say what they have seen, who will help people prepare for what is to come.
One of the ideas that caught my attention centred around the move from generational care and family groupings to independent living. The media, governments and social commentators usually lament the loss of this traditional form of family, but Gawande turned this on it’s head very quickly.
It wasn’t just the ‘selfish’ younger generation ditching their family responsibilities, the older generation also benefited from the break up of the extended family living arrangement. They were no longer unwanted burdens on their family who were waiting for them to die so they could inherit the land. In fact,
the fascinating thing is that, over time, it doesn’t seem that the elderly have been especially sorry to see the children go.
It turns out that the elderly also want to do their own thing and live their own lives and be responsible for their own purposefulness just as much as younger folk. It makes sense!
It’s just that their idea of purpose is different to those of their younger members of the family.
And it seems, this is where the problem lies in our current arrangements for looking after the aged and dying. Younger folk are making assumptions about what is important to the elderly and dying based on their own thoughts about what it might be like to get old as well as what is easy for them to manage and helps to make them feel good about the choices they make for their aged parents.
It turns out that none of these ideas are even close to what the elderly actually want or need.
All the teachers, social workers. nurses and psychologists out there will have come across Maslow’s hierarchy of needs at some point in their careers. All theories get refined with time and experience. The interesting section for me was the realisation that Maslow’s theory really only works for those of the younger generation.
This well-known triangle is a young person’s perspective on the life experience.
What’s missing from many of our current models for aged care is a hierarchy of needs that focuses on the perspective of the elderly.
Whatever the limits and travails we face, we want to retain the autonomy—the freedom—to be the authors of our lives. This is the very marrow of being human.
The later sections of Being Mortal save it from being nothing more than a sad reflection of our modern world unable to cope with its own mortality. Gawande researches all the options popping up throughout the States that offer something different, something special, something worth living for.
It was such a relief to realise that our fate does not necessarily have to be a depressing regimented soulless nursing home.
I have highlighted the section on the questions to ask someone who is dying in the hope I will never have any recourse for them. Another example of mortality avoidance perhaps?
A big thank you to Katie @Being Dewey for hosting this readalong. It wasn’t what I was expecting, but it was such a worthwhile, thought-provoking read that I recommend it to everyone. It will change your perspective on life and death.
The simple view is that medicine exists to fight death and disease, and that is, of course, its most basic task. Death is the enemy. But the enemy has superior forces. Eventually, it wins. And in a war you cannot win, you don’t want a general who fights to the point of total annihilation. You don’t want Custer. You want Robert E. Lee, someone who knows how to fight for territory that can be won and how to surrender it when it can’t, someone who understands that the damage is greatest if all you do is battle to the bitter end.
11 thoughts on “Being Mortal | Atul Gawande”
I read this book last year and although I found it difficult to read because of the subject matter it was so good. I actually worked in a nursing home for sometime a couple of years ago and so I found myself agreeing and nodding my head at some of his observations because I had seen similar situations. Great review!
Such an interesting review. I had presumed, like you, that it would be more essay form rather than anecdotal. I've bought Being Mortal, and now you make me want to read it even more…. Now I just have to find the time.
Thank you – I was also surprised by how often I nearly sobbed out loud in public places as I was reading this book. Gawande's choice of simple, une motive language was actually very moving and poignant in the end.
I think you'll find it fascinating Louise. Gawande's father was a doctor too and their story of his illness was quite confronting. A family of people who know the medical system intimately still found that it failed them so often during this time. It was only thanks to the research that Atul was doing for this book that they were able to insist on other options.
I have not read this book yet, but I'm sure it'd be an important read, as my parents age into their 80s and I age too. Nice review
I didn't participate in Dewey's book club because I too thought the book was going to be a philosophical discourse on aging and dying. Then at a year-end meeting with my financial planner he gave me a copy of the book. I started reading when I got home and haven't been able to put it down since. I think this one will end up on my list of 2016 favorites.
It was such a thought-provoking book full of stuff we should all be thinking about, I want to recommend it to everyone 🙂
I agree with so much of what you have to say about this one! I also expected the book to be less anecdotal, but I enjoyed the book anyway and appreciated the fun facts that were mixed in. I was also surprised and fascinated by the quote you shared about the elderly preferring to be independent of their children, as well as vice versa. I agree that we need to focus more on what the elderly want and not just health and safety, something I hope I'll remember when it becomes relevant to me. And I was very glad that the second half of the book was more optimistic than the first half!
This was one of my favorite books from last year. Actually, it's the book that inspired me to click my life back in place. I've been in a career limbo for a while after I realized that my PhD was pretty much useless (limited professorship opportunities and industry seems to want people less educated – and therefore worth less pay – than myself). This book inspired me to go into the healthcare field by getting a Physician's Assistant certification. It requires some work on my part just to get into such a program, but I think it's worth it. But I digress….
How wonderful! This was a very inspiring book.Good luck with your certification and job hunting.