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How We Die: Reflections of Life's Final Chapter
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How We Die: Reflections of Life's Final Chapter

4.06  ·  Rating details ·  6,569 ratings  ·  496 reviews
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 relationship with life as it approaches its terminus. It also discusses how we can ...more
Paperback, 320 pages
Published January 15th 1995 by Vintage (first published January 25th 1994)
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4.06  · 
Rating details
 ·  6,569 ratings  ·  496 reviews

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Paul Bryant
Jan 02, 2008 rated it liked it
Shelves: science
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
Abeer Hoque
Sep 24, 2010 rated it really liked it
Shelves: i-recommend
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
Jamie Collins
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,
Chuột Thổ cẩm
Oct 03, 2017 rated it it was amazing
Rất khó khăn để đọc xong được cuốn sách này. Vì đọc thấy sợ; sợ bị già đi, sợ bệnh Alzheimer, sợ đột quỵ, sợ mất quá nhiều máu, sợ bị ung thư. Sợ chết. Nhưng hơn cả sự hù doạ không mong muốn, Nuland khiến suy nghĩ của mình về cái chết trở nên thay đổi. “Chân giá trị lớn lao nhất được tìm thấy trong cái chết chính là chân giá trị của cuộc sống đã có trước đó. (...) Hi vọng nằm trong ý nghĩa của cách ta đã sống cuộc đời mình.” Không hoa văn và màu mè, Nuland chỉ ra cách để không sợ cái chết, đấy l ...more
Paul Corrigan
Dec 23, 2012 rated it really liked it
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
Richard Kramer
Oct 12, 2013 rated it it was amazing
If you are alive, and might someday die, or know anyone who is alive and might someday
die, this might be one of those books you have to read. It takes the piss out of heroics,
and science, and the Dignified Death; it harshly regards the coldness of medical personnel dedicated to solving what
the author calls the Riddle and ignoring the needs of the person that provides it. He is hard on doctors, and hard on himself. Some books please, some entertain, some disappoint. Few,though, change you, and t
Jun 25, 2017 rated it really liked it
It's hard not to compare this to Kalanithi's When Breath Becomes Air. Like Kalanithi, Nuland is a surgeon who has written a book exploring themes/ideas surrounding death. Nuland's account is a lot less personal; for one, he didn't experience dying as he wrote the text. His inspiration for writing was not his own mortality but rather the result of decades upon decades of watching his own patients suffer through the so-called "hidden" process of dying. Nuland explores the more common ways that mos ...more
Larry Bassett
Dec 25, 2012 rated it it was ok  ·  review of another edition
Shelves: nonfiction
My Dad is ninety-three. I bought this book to share with him some time ago as we have been grappling with the Inevitably of Death for some time now. He is relatively healthy and he has always counted on living at least until ninety-six, the age his father died. But this past year his sharp mind has begun to notice his body lagging somewhat. He likes to have his “four wheeler” to help him get around and dozes more frequently sitting in his chair. “Maybe I won’t make it to ninety-six,” he says.

I t
May 15, 2017 rated it it was amazing
A beautifully written account by one who has witnessed many deaths, as a retired surgeon, in a hospital setting.

A scholarly and reflective depiction on the process of quietus.

Great insight for anyone who is concerned that one day they might die.
Apr 27, 2014 rated it really liked it
Shelves: medical-social
Sherwin Nuland, MD, was a well known and successful surgeon at Yale Medical Center for many years. In this book he begins to describe, literally, the way we die. In detail, he explains how infection and cancer and heart disease ravage the body and cause essential systems to fail. As a physician, I found it interesting, but I did not think I would finish the book if that was all there was to it.

Then the book began to hold my attention as it developed into an exploration of how people deal with dy
Dec 31, 2011 rated it really liked it
Shelves: medical
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
Michael Perkins
Lest there be any doubt, it was doctors who created the opioid epidemic. Big Pharma was there, ready to pounce, but it was foolish, god-like thinking that set it up....


My father practiced medicine for 40 years, retiring at the end of 1982. Subsequent generations of doctors now consider my dad's time the golden era of primary care. He was a master diagnostician (he loved to say that it was no accident that the author of the Sherlock Holmes stories an
Bob Hoffman
Jun 30, 2011 rated it really liked it
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
Jose Moa
Oct 22, 2016 rated it it was amazing
Shelves: meicine, favorites
As Adan was expeled from paradise for chosing freedom and knowledge ,paid a high price and was punished by his election so we being inteligent beings also have to pay a high price for our inteligence and be punished,our punishment is that we are aware of our inexorable future death and destruction as individuals that we will be departed of our loved ones and we will dont enjoy terrenal future life nor will know future world.
It is a cruelty of the evolutive path that create us inteligent and mort
Sep 05, 2007 rated it really liked it
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
Lyn Elliott
Jan 03, 2013 rated it it was amazing
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
Jan 20, 2019 rated it liked it
Interesting book, not what I thought it was going to be. A lot of technical information about death and the human body.
La Lin
Feb 23, 2019 rated it it was amazing  ·  review of another edition
Cái chết luôn là một nỗi sợ hãi thường trực đầy ẩn khuất đối với riêng mình. Đến khi đọc quyển sách này, bản thân lại có một góc nhìn khoa học hơn, phần nào đó, mang tính chấp nhận và nguôi ngoai hơn. Tác giả không chỉ chứng tỏ sự thông thái của một người xuất sắc trong ngành y mà còn ở cách viết còn vô cùng cuốn hút. Mình vô cùng hứng thú bởi các ví dụ được đưa ra. Thậm chí có một ví dụ về bé gái bị một gã đâm chết cứ ám ảnh mình tới tận mấy hôm sau... Hơn cả, bác tác giả có một sự nhạy cảm và ...more
Cyan Evans
Sep 26, 2017 rated it really liked it
Shelves: life-and-death
Đọc từ Hơi thở hoá thinh không sang thẳng quyển này luôn - tác giả quyển này là thầy của anh Paul Kalanithi (tội nghiệp cuốn Sapiens của em bị bỏ xó :'()

How we die - Chúng ta chết như nào? - mình thích tựa này hơn là "Hiểu về sự chết" vì sát với nội dung sách hơn.

Tác giả Sherwin B. Nuland đã viết nên quyển sách bằng tất cả những kiến thức về sinh lý giải phẫu lẫn kinh nghiệm hơn vài chục năm mang trách nhiệm của một bác sĩ lên vai. Ông giải thích khá dễ hiểu (đối với những người không làm nghề y
Mai Anh
Từ thế kỷ XV, nghi thức tôn giáo "ars moriendi" được miêu tả là nghệ thuật của cái chết (một cái chết đẹp) khi coi cái chết là sự cứu rỗi của linh hồn, nâng đỡ tinh thần cho người thân còn sống, nhưng ngày nay cái chết bị che đậy trong bệnh viện, trong sự ngột ngạt và xa lánh của mọi người.

Cuốn sách viết về giai đoạn cuối của con người, thông qua việc tìm hiểu những căn bệnh chết người, hoặc nguyên nhân dẫn tới cái chết:
1/ Bệnh liên quan về tim mạch: bệnh xơ vữa động mạch có thể do nhiễm
Jan 15, 2015 rated it it was amazing
Nuland died last year at 94 years of age. He wrote “How We Die” as a surgeon in New Haven Connecticut in his 70s looking back on his career and his life. What makes this book stand above most others, is Nuland’s wisdom and wonderful ability to write about how death has affected him both personally when dealing with family members’ deaths, but also outlining how his patients have died from different types of diseases, giving us a full, frank picture of the details and ways we could die personally ...more
Nov 24, 2018 added it
Shelves: abandoned, science
I read this book because I have started to work as a healthcare professional, and in particular with countless clients who are "palliative." What I wanted to know was why, when I review the medical history of some of my clients (patients) with Chronic Heart Failure, and a history of a Cerebrovascular Accident (CVA), and Hypertension, and a CABG (bypass) in 2013, and kidney failure, and... what have these diagnoses done? Are they really dying of all of these things?

I don't know how to explain it.
Feb 04, 2018 rated it liked it
Shelves: human-body
It’s no secret or surprise that much of my processing and understanding of life happens through reading. I’ve been a bibliophile since birth (literally– one of my dad’s proudest moments as a father was reading to me on the day that I was born); books are the primary way in which I explore the world, grapple with emotion, and make sense of the human condition. So, naturally, after the death of my grandfather on January 26th, one of my first instincts was to find the right story for this time in m ...more
María Paz Greene F
Otro libro que trata el tema de la muerte, y esta vez de modo muy bien organizado. El autor divide en capítulos lo que son las causas comunes y luego trata por separado cada una de ellas. Como se publicó en el '95, se entiende que está un poco desactualizado, aunque hay cosas que siguen. Las conclusiones son generales, eso sí. Como la muerte.

El libro cumple. Las historias personales son buenísimas, las citas literarias excelentes, pero luego la parte médica un poco árida. Mucha terminología, muc
Tran Hiep
Liệu có quá trẻ để đọc cuốn sách thế này?
Liệu có quá điên rồ để tìm hiểu về cái chết?
Một sự thật là chúng ta cố gắng tránh né cái kết tất yếu lắm bi thương này như một cách để ngăn chặn nó đến gần với ta. Nhưng dù ta có vờ như không để tâm đến nó thì định mệnh không thể tránh khỏi này vẫn sẽ xảy ra.
Thông điệp mà tác giả muốn truyền tải đến người đọc đó là con người cần chấp nhận quy luật tất yếu này của tự nhiên và cố gắng hiểu cách thức mà nó xảy ra với chúng ta để có thể đưa ra quyết định khôn
Peter Welch
Apr 06, 2018 rated it it was amazing  ·  review of another edition
Important book

I read this as my 80 year old mom was rapidly dying from brain cancer. Some of the technical descriptions of major bodily functions are gripping, especially from the underlying perspective of their eventual failure towards death. Reading this as we sat for many days in vigil as my mom went through the dying process gave me a unique comfort that I’m deeply grateful for. It was comfort in the brutal transparency and absolute universal reality of death as someone I loved so deeply was
Jun 06, 2009 rated it really liked it
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
Jim Gleason
Jul 15, 2017 rated it it was amazing
(Note: this author quickly became my all time favorite writer, leading me to buy all of his wonderful books, enjoying each and every one of them!

1. Surgeons view of death from personal, physical and emotional views
2. Even if you don’t read all of the various death descriptions, be sure to read the final two chapters, The Lessons Learned and Epilogue to see what he summarizes from all the details provided in the earlier chapters
3. Lot said about extending life beyond what is reasonable, due to dr
Atila Iamarino
Sep 12, 2016 rated it liked it
Shelves: medicina, saude
Um livro bem curto e bem denso de um médico falando sobre a morte, de pacientes e de entes queridos. Tem um tom de desabafo bem grande, de alguém que escreveu aquilo por passar pelo processo, o que deixa o livro bem tocante. Mas me parece acrescentar mais para profissionais da área de saúde (e em um tom pessoal) do que para o público em geral, ao contrário do Mortais: Nós, a medicina e o que realmente Importa no final.
A very well-written, unsentimental account of how it is that we actually die, what happens in our bodies, and which ailments are most likely to kill us. As Dr. Nuland points out, waxing eloquent about death is a very common theme among artists, but it is rare that we get to hear about death from someone whose actual business is living and dying. A thoughtful and important perspective. Recommended.
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Sherwin Nuland was an American surgeon and author who taught bioethics and medicine at the Yale University School of Medicine. He was 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.

His NYTimes obit:
“The greatest dignity to be found in death is the dignity of the life that preceded it. This is a form of hope we call all achieve, and it is the most abiding of all. Hope resides in the meaning of what our lives have been.” 16 likes
“-when the human spirit departs, it takes with it the vital stuffing of life. Then, only the inanimate corpus remains, which is the least of all the things that make us human.” 14 likes
More quotes…