Gawande talks about patients with whom he worked during their struggles with ultimately incurable diseases. He carries us with him as he, despite his professional expertise, describes his sense of inadequacy when he accompanies his own father in his last years, months, weeks and days.
All the way through my reading of “Being Mortal,” my mind and heart were constantly flipping between the text on the page and the searing memories of the end-of-life for my parents, my partner Bill’s parents, my younger brother who committed suicide and Bill’s two weeks between his diagnosis with pancreatic cancer and his death.
Gawande has five themes, at least as I read his book. Firstly, we can do so much better than we are in facilitating an enriching lifestyle for aging persons so that they can retain autonomy and engagement in life-enhancing interactions with family, community and society, a key element in retaining a sense of purpose and meaning. This applies even to those with cognitive impairment as Gawande illustrates with detailed examples. Secondly, our social and health care systems need to retreat from trying to medicalize every problem utilizing extreme measures to keep people alive regardless of the quality of their living. Thirdly, families and professionals need to relinquish their fear of losing the dying person and refocus on helping them access whatever supports are necessary for spending their remaining time as they want to. Fourthly, in order to clarify for both the dying person and ourselves what their priorities are, we all need to have the courage to initiate THE CONVERSATION, asking the questions that surface what is most important to them for the amount of time that they have left. And fifthly, what we learn in helping shape options for sustaining the greatest possible meaning and engagement in life for our dying loved ones can help us prepare the ground for what we want for ourselves when our time comes.
And so, as I read through Gawande’s wonderfully thought-provoking and accessible contribution to this pressing societal issue, my mind was being cast not only backwards to my experiences with all those family members whose dying I accompanied but also forward to what I will want for myself and what I need to put in place to increase the likelihood of having as a good a quality of dying as possible.
That is not to say, obviously, that I can determine everything in advance. But as Gawande writes, “you many not control life’s circumstances, but getting to be the author of our life means getting to control what you do with them.”
* * *
Info on Atul Gawande’s “Being Mortal” at: http://atulgawande.com/book/being-mortal/
Info on my memoir “August Farewell” and my novel “Searching for Gilead” at: http://DavidGHallman.com