Being mortal: Illness, medicine and what matters in the end

Judging by the number of coffee tables I’ve spotted this book on recently, Being Mortal seems to be required reading for baby boomers, many of whom are still involved in the care of elderly parents. And in this era of unprecedented worldwide ageing, it is indeed a book that explores the important questions of inevitable mortality.

Surgeon, Harvard professor, staff writer for the New Yorker and 2014 BBC Reith lecturer Atul Gawande contends that life stories need to have, if not happy, at least dignified endings.

The first half of the book explores aged care in the US, with examples of brilliant initiatives and how they’ve been eroded, while the second looks at the dilemmas faced by doctors, families and patients, of managing bodily decline when there is no possibility of cure.

The irony of modern healthcare is that while people can stay alive for longer than ever before, longevity itself is prioritised over quality of life. Gawande concludes that society is not well-equipped to help people age with dignity and self-respect. The nursing home option is often pushed by the worried children of parents who “don’t want to be a burden” but who, with a bit more community support, could still function well enough in their own homes. Where institutions are necessary, Gawande argues that they need to be less preoccupied with risk and more about humanity.

When it comes to caring for the terminally ill, there are pitfalls in having too many choices of treatment. Doctors are often reluctant to give up, even in the face of the inevitable death of a patient.

Gawande gives a moving account of his own father’s decline and death from the perspective of a family member, rather than that of a detached medical observer, as he helps his father (also a surgeon) to a peaceful death at home.

This précis doesn’t do justice to the depth and overall readability of Being Mortal. You also need to bear in mind that Gawande is writing about the US healthcare system where the interests of insurance companies often prevail over those of patients. That said, there are ideas and options that are relevant to New Zealand and its ageing population.

Discover more: http://tinyurl.com/kcjal5f

Reviewed by Auckland writer, psychologist and baby boomer Katherine Findlay