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79th out of 724 books
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749 voters
How We Die: Reflections of Life's Final Chapter
New Edition: With a new chapter addressing contemporary issues in end-of-life care
A runaway bestseller and National Book Award winner, Sherwin Nuland's How We Die has become the definitive text on perhaps the single most universal human concern: death. This new edition includes an all-embracing and incisive afterword that examines the current state of health care and our r...more
A runaway bestseller and National Book Award winner, Sherwin Nuland's How We Die has become the definitive text on perhaps the single most universal human concern: death. This new edition includes an all-embracing and incisive afterword that examines the current state of health care and our r...more
Paperback, 320 pages
Published
January 15th 1995
by Vintage
(first published January 1st 1993)
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When I log on to my Goodreads home page I always see many notices saying things like
Brainiac the Magnificent is now friends with Death By Radiation
Is This Catching? is now friends with My Mother Has Turned Blue
Tiny Little Aardvark is now friends with The Biker who Eats Babies
The Seventeenth Beatle is now friends with Barkybarkywoofwoof
But really, that's got nothing whatsover to do with how we die. At least, I don't think so. Unless these are all the names of angels.
As regards the book itself, s...more
Brainiac the Magnificent is now friends with Death By Radiation
Is This Catching? is now friends with My Mother Has Turned Blue
Tiny Little Aardvark is now friends with The Biker who Eats Babies
The Seventeenth Beatle is now friends with Barkybarkywoofwoof
But really, that's got nothing whatsover to do with how we die. At least, I don't think so. Unless these are all the names of angels.
As regards the book itself, s...more
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For some parts of this book its helpful to have an anatomy/physiology background of any sort, but even if you don't Nuland explains really well. His detail is great, he says he has a photographic memory, and I believe it. I was astounded at the details of his memories as a child, jealous really, since my memory is crap. I like his theories even if unproven or unscientific (in the sense that they have not been proven, but there is evidence of its distinct possibility). Nuland basically takes the...more
a well-written book. Dr. Nuland writes from years of experience on the topic of death, and how really there is no dignity to it. he explores this myth of 'ars moriendi' (the art of dying) and both the pathophysiology and mental/emotional states that accompany it. he argues against the modern 'hospital' death devoid of feeling, he reproaches biomedicine for it's mistakes in prolonging the lives of their patients for their benefit in solving the Riddle, and not for the patient's best interest... "...more
This book is an attempt by the author, a surgeon, to de-mystify the process of death. He feels that our modern expectation of a "death with dignity" leads to increased suffering when we confront the ugly reality: most people don't experience a peaceful, pain-free death; they don't die at home surrounded by their loved ones; they don't utter profound last words of comfort to those they leave behind.
He offers detailed, technical descriptions of the most common mechanisms of death, including vivid,...more
He offers detailed, technical descriptions of the most common mechanisms of death, including vivid,...more
6 likes · like · see review
Super interesting in the beginning, but then petered out. Some quotes:
The chief ingredient of the [“good death”] myth is the longed-for ideal of “death with dignity.”
I had read that the sensation imparted by a fibrillating heart is like holding is one’s palm a wet, jellylike bagful of hyperactive worms, and that is exactly the way it was. – p7
Nowadays, very few of use actually witness the deaths of those we love. Not many people die at home anymore….approximately 80 percent of Americans who die...more
The chief ingredient of the [“good death”] myth is the longed-for ideal of “death with dignity.”
I had read that the sensation imparted by a fibrillating heart is like holding is one’s palm a wet, jellylike bagful of hyperactive worms, and that is exactly the way it was. – p7
Nowadays, very few of use actually witness the deaths of those we love. Not many people die at home anymore….approximately 80 percent of Americans who die...more
I felt compelled to reread HOW WE DIE, starting with the chapters on Cancer, after my wife passed away from an aggressive form of breast cancer. Doctor Nuland is right on when he talks about how the specialists, for whom a disease such as cancer becomes a great riddle to solve, somehow withdraw from the patient's presence when the disease they are trying to interdict cannot be stopped with the assortment of chemo drugs and radiation therapy they have in their tool box. Yes, tool box seems like a...more
It’s not new (1993), but Sherwin Nuland’s How We Die is a timely treatise on what’s going on under the hood when humans die. We all have to leave this world sooner or later, whether by heart attack, stroke, cancer, or accident, but in our culture, it’s not that common to think about or speak of our own demises. Most of us act, instead, as if we will live forever.
In these days there is also a tendency to hide death from view, particularly in nursing homes and hospitals. (As of 1993, 80% of Americ...more
In these days there is also a tendency to hide death from view, particularly in nursing homes and hospitals. (As of 1993, 80% of Americ...more
On the back of "How We Die" Doris Lessing writes it's a must read for anyone over 50. I say anyone over 35. Because you might still have time then to internalise all the dying lessons Dr. Nuland has to teach, and you're past those forever twenties.
We've got three score and ten years and most of that could be healthy, but after that, the remainder of our body life is borrowed and breaking down. Towards that end, Dr. Nuland urges us to measure quality of life against mechanical extensions of life...more
We've got three score and ten years and most of that could be healthy, but after that, the remainder of our body life is borrowed and breaking down. Towards that end, Dr. Nuland urges us to measure quality of life against mechanical extensions of life...more
In an attempt to discredit the notion of "death with dignity," Nualnd's book is a straightforward look at the physiological processes of disease and death. What makes the book more interesting is Nuland's discussion of the ethics of both doctors and patients as the final moment approaches.
The physiological descriptions of the effects of diseases such as Alzheimer's, AIDS, cancer, and heart disease are harrowing, but also fascinating. With most deaths these days occurring in hospitals and nursing
...more
The book covers the ways in which different terminal events cause the body to shut down. Nuland uses technical language to discribe the events occurring but has an underlying theme about the ways in which people die and how the medical practice of solving the “Riddle” at the heart of the terminal event may lesson the patients likelyhood of dying naturally. He goes through many cases and found the myth of “death with dignity” missing. Most deaths occur after long periods of pain and continued los...more
The purpose of this book is to help people have reasonable expectations about death and is a plea for more empathetic doctoring; namely more family practitioners and hospice workers.
The author explains the physical processes that occur during death, starting with the process of aging. He then goes into detail about the ways the body can shut down and why. This may be too much information for some and although a little morbid, I found it well worth understanding. He also covers some of the most...more
The author explains the physical processes that occur during death, starting with the process of aging. He then goes into detail about the ways the body can shut down and why. This may be too much information for some and although a little morbid, I found it well worth understanding. He also covers some of the most...more
The mechanics of death from instigation to final loss of consciousness is a chain of causes where we most often consider the first and the last steps. This book helps fill in the middle. We know cancer kills, but how? Some block digestion, some prevent blood from being processed, some merely act as roadblocks to the primary circulatory system. This book also dispels a few myths regarding departure like:
1)Death hurts - a heart attack is essentially a charlie horse of the heart and is not terribly...more
1)Death hurts - a heart attack is essentially a charlie horse of the heart and is not terribly...more
Mar 21, 2010
Δx Δp ≥ ½ ħ htgkvkkviholmvobsvzighxofyyzmw
rated it
4 of 5 stars
Shelves:
i-do-not-want-spoil-the-party
Apakah kematian itu? Bagi seorang saintis yang kukuh, mungkin jawabannya adalah proses berhentinya aliran listrik dari sel-sel syaraf. Bagi para teologis, mati adalah proses kembalinya ruh menuju Tuhan. Bagi para filsuf, mati adalah proses terbebasnya jiwa dari raga.
Begitu "rumit"-nya konsep kematian, bahkan orang lebih cenderung menghindari pembicaraan tentang hal ini. Selain menimbulkan sensasi ngeri yang menggelitik juga bahasan tentang kematian biasanya berputar diantara sains-filsafat-agama...more
Begitu "rumit"-nya konsep kematian, bahkan orang lebih cenderung menghindari pembicaraan tentang hal ini. Selain menimbulkan sensasi ngeri yang menggelitik juga bahasan tentang kematian biasanya berputar diantara sains-filsafat-agama...more
How We Die is a sometimes raw look at the different ways we will all face death and End of Life issues. The author, a surgeon, doesn't hold back, even when it means facing his own failings as a doctor and brother (his brother died of colon cancer a few years before the book was written).
The Dr. Nuland's discomfort with the vast amount of intervention at the end of life often mirrored my own thoughts and concerns as my convictions on childbirth have migrated to End of Life decisions.
“Beyond the...more
The Dr. Nuland's discomfort with the vast amount of intervention at the end of life often mirrored my own thoughts and concerns as my convictions on childbirth have migrated to End of Life decisions.
“Beyond the...more
I'm glad I read this book. I'd recommend it for any one who expects to die at some point.
Things I got out of it:
+ An idea of why people die--the disease processes of the major killers;
+ An idea of what it is like to die from many causes, ranging from violent attack to cancer;
+ A better understanding of aging
+ An understanding of why I will die no matter how healthy I try to be;
+ A good argument for assisted suicide
+ A good understanding of why your doctor won't try to help you die peacefully,...more
Things I got out of it:
+ An idea of why people die--the disease processes of the major killers;
+ An idea of what it is like to die from many causes, ranging from violent attack to cancer;
+ A better understanding of aging
+ An understanding of why I will die no matter how healthy I try to be;
+ A good argument for assisted suicide
+ A good understanding of why your doctor won't try to help you die peacefully,...more
I found it fASCINATING!
When I was working at Columbia Med Cntr (Columbia Presbyterian to long-time New Yorkers. I went to a lecture he gave. Very clear, but compassionate.
If you like MD lit, I would recommend Healing from the Heart by Mehmet Oz. I bought in the med school bookstore when he was a heart surgeon and co-founder of the Complementary Care Center Center, and before
Oprah made him a celebrity.
One more, My Own Country by Abraham Verghese. He wrote it when he was a young Indian doc in th...more
Dr. Nuland's superb knowledge and easy prose make this book number 9 on my list of most influential. Death is a nearly forbidden subject in our America of eternal youth, yet it is an event we shall all face either by the natural course of human events or by unnatural causes, intended or accidental. This work deconstructs the process and by doing so dispells the unknown and with it the fear of the unknown. Some societies revere the elderly and make death a family evenr, like a loving rite of pass...more
A truly enlightening read for those who want to either know more about the physiological processes of terminal diseases, those with a family member or loved one suffering from one of the six common pathways to death Nuland outlines, or even those who simply wish to expose themselves in a relatively removed environment to the mysterious process of their ultimate fate, How We Die explores just that- the physical, mental, and emotional processes one goes through on the journey to the other side. Nu...more
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p 62 Those among us who think most clearly about death are usually such as philosophers or poets, not physicians.
1643 Thomas Browne "Religio Medici" "He came to be almost half himself and left a great part behind him which he carried not to the grave." "I am not so much afraid of death, as ashamed thereof; 'tis the very disgrace and ignominy of our natures, that in a moment can so disfigure us, that our nearest friends, wife, and children, stand afraid and start at us." "With what strife and pai...more
1643 Thomas Browne "Religio Medici" "He came to be almost half himself and left a great part behind him which he carried not to the grave." "I am not so much afraid of death, as ashamed thereof; 'tis the very disgrace and ignominy of our natures, that in a moment can so disfigure us, that our nearest friends, wife, and children, stand afraid and start at us." "With what strife and pai...more
This book will change the way many readers view the inevitable final stage of human life. Dr. Nuland paints a much grimmer picture than the peaceful "slipping away" we might imagine (or hope) death is. Through detailed analysis and eye-witness account of the various common pathways to death (heart disease, cancer, AID's, Alzheimer's/dementia, accident) the reader is left with the underlying truth: death is awful and there is no way to avoid it. Also, cross your fingers that you don't get Alzheim...more
Dr. Nuland describes in physiological processes that occur in people dying from common causes of death including heart failure, Alzheimer’s, suicide, cancer, AIDS, and trauma. He also discusses the natural and inevitable processes of aging that we will all experience as our bodies mature.
I believe that he is writing this book in order to make the public more familiar with death which has become as he explains shrouded in myth. Ultimately, learning about “life’s final chapter” is intended to make...more
I believe that he is writing this book in order to make the public more familiar with death which has become as he explains shrouded in myth. Ultimately, learning about “life’s final chapter” is intended to make...more
Some pretty rough descriptions, which illustrate the author's general point that death is rarely the serene, dignified experience for which we hope. It was not the prospect of my own death that motivated me to read this, but I couldn't help thinking about that as well. Though much of the book is taken up with describing at various levels the processes of death, the author also wanted to emphasize the difficulty and the importance of patients and their families taking some control of the process...more
I give this book 4.5 stars, not because it was a thoroughly entertaining book. In fact, it's difficult to read to say the least, but I've not read a book so honest and unapologetically real when it comes the act of dying. I've lost a mother to cancer and I'm now the legal guardian of my grandmother who is in the relentless throes of Alzheimer's, and while devastatingly painful to be witness to both demises, I'm so grateful that I had read this book prior. It gave me a keen sense of control in th...more
In the course of his long professional career as a physician, the author has walked with thousands of people dealing life’s final chapter. His concern in this book is to de-mystify the actual physiological process of death in the hope that knowing what happens when we die will help us wisely face this sure certainty. The question of balancing extraordinary end-of-life medical procedures with quality of life-at-the-end is sensitively and helpfully considered – as well as the often unrealized hope...more
Emotionally difficult to get through, but worth it. It will change your views of death for better AND worse. The author is a genius... your vocabulary will improve... and you will be in greater control when you and those you love reach life's final chapter.
I am only giving this book 4 stars because I am not the most medically/scientifically minded, so sometimes it made me say "huh?" and I had to go back and reread certain things to really get a grasp. Lots of big words and new ideas here for me.
That being said, since having a life now touched by death, I have looked to solace in the biological (as opposed to the spiritual) aspect of what it means to die and be dead, so this book was pretty good for explaining how death happens physically (if you...more
That being said, since having a life now touched by death, I have looked to solace in the biological (as opposed to the spiritual) aspect of what it means to die and be dead, so this book was pretty good for explaining how death happens physically (if you...more
1 like · like · see review
A remarkable book which my mother, my husband and I all read when my mother developed the heart condition from which she eventually died about 8 years later. Sherland combines scientific knowledge, medical experience, ethical concern and emotional sensitivity as he describes the stages people go through when they are dying of the most common conditions that kill us. It helped us all live with Mum's condition, has since helped through the passing of other close people and I hope will help us in t...more
One of my favorite books. Mr. Nuland does a great job at explaining the exact process and causes for a certain way to die and does this whithout using too many medical terms or complicated phrasings. The fact, that he added real life examples of people who suffered and died from the portrayed diseases adds an additional level of credibilty to this book.
While this book takes a very sober look at our last moments before we step into the next plain of existence, it still manages to not make the rea...more
While this book takes a very sober look at our last moments before we step into the next plain of existence, it still manages to not make the rea...more
Though not quite as accessible as other medical writers like Atul Gawande or Abraham Verghese, Sherwin Nuland's book is definitely very thought provoking, even if a bit depressing at times. The description above does a pretty good job of explaining what the book is about. There are some rather dry parts here; for instance, when he explains how the heart/blood circulation works. On the other hand, it's one of the best BRIEF descriptions of the working of the heart written for a lay audience (albe...more
1 like · like · see review
Jan 05, 2009
Mike
rated it
4 of 5 stars
·
review of another edition
Recommends it for:
realists
Shelves:
science,
philosophy
This book takes a hard look at our death as physical beings, the state our bodies come to, the multiple ways that our systems break down, the phenomenon of near-death experiences, the way palliative care can sometimes slip into euthanasia, and the contrast between the way death is portrayed (or nearly always ignored) in our culture and its actuality. I found the experience of reading it to be sobering, interesting, slightly frightening, but in the end refreshing for its honesty and clear-headedn...more
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Dr. Sherwin Nuland (born December 1930) is an American surgeon and author who teaches bioethics and medicine at the Yale University School of Medicine. He is the author of The New York Times bestseller and National Book Award winning How We Die, and has also written for The New Yorker, The New York Times, The New Republic, Time, and the New York Review of Books.
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“Though biomedical science has vastly increased mankind’s average life expectancy, the maximum has not changed in verifiable recorded history.”
—
3 people liked it
“The belief in the probability of death with dignity is our, and society’s, attempt to deal with the reality of what is all too frequently a series of destructive events that involve by their very nature the disintegration of the dying person’s humanity. I have not often seen much dignity in the process by which we die.”
—
2 people liked it
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