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LIFE WORTH LIVING
Critical illness is a fact of life. Even those of us who enjoy decades of good health are touched by it eventually, either in our own lives or in those of our loved ones. And when this happens, we grapple with serious and often confusing choices about how best to live with our afflictions. A Life Worth Living is a book for people facing these difficult decisions. Dr. Robert Martensen draws on decades of experience with patients and friends to explore the life cycle of serious illness. He connects personal stories with reflections on mortality, human agency, and the value of cutting-edge technology in caring for the critically ill. Timely questions To what extent should efforts to extend human life be made? What is the value of nontraditional medical treatment? How has the American healthcare system affected treatment of the critically ill? And finally, what are our doctors' responsibilities to us as patients, and where do those responsibilities end? Using poignant case studies, Martensen demonstrates how we and our loved ones can maintain dignity and resilience in the face of life's most daunting circumstances.
238 pages, Paperback
First published September 2, 2008
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Displaying 1 - 30 of 33 reviews
September 26, 2012
I sped through A Life Worth Living: A Doctor’s Reflections on Illness in a High-Tech Era by Dr. Robert Martensen. The reason I sped through it was because I immediately realized that this was a book I’d probably want to purchase later just so that I could mark it up with notes. That in itself should give you an idea of how interesting I found this to be.
Martensen brought up so many fascinating and thought-provoking points that I don’t think it would be wise for me to attempt to discuss them intelligently at this point. What I can say, however, is that I wish he was my doctor. Many of the points he brings up in terms of quantity of years lived versus quality of years lived go hand in hand with my personal beliefs about life. He uses personal stories of former patients, friends, and family to demonstrate some of the toughest things people must think about when faced with serious illness. Likewise, he questions the American health system and the importance of careful and extensive dialogue between doctor and patient. I especially liked the emphasis he put on the responsibility people have as patients to become advocates for their own health.
If you’re looking for a thought-provoking read, then I would highly recommend this one. Also, if you’re anything like me, you might want to consider purchasing it and reading it with pen in hand!
Martensen brought up so many fascinating and thought-provoking points that I don’t think it would be wise for me to attempt to discuss them intelligently at this point. What I can say, however, is that I wish he was my doctor. Many of the points he brings up in terms of quantity of years lived versus quality of years lived go hand in hand with my personal beliefs about life. He uses personal stories of former patients, friends, and family to demonstrate some of the toughest things people must think about when faced with serious illness. Likewise, he questions the American health system and the importance of careful and extensive dialogue between doctor and patient. I especially liked the emphasis he put on the responsibility people have as patients to become advocates for their own health.
If you’re looking for a thought-provoking read, then I would highly recommend this one. Also, if you’re anything like me, you might want to consider purchasing it and reading it with pen in hand!
Want to Read
April 2, 2009Heard the authored interviewed on Fresh Air and will probably foist the book on my loved ones. Alternate title possibilities (mine): How to Avoid a Ventilator; Why Going Out on Morphine is a Good Thing. Well, you get the drift.
May 16, 2009
I first heard about this book on an NPR interview with the author. I believe there are two kinds of people who write books - those who are better writers than speakers and those who are better speakers than they are writers. This author definitely falls in to the latter category. He made a very good interviewee but his writing, although expressing the same views as in the interview is not nearly as compelling. That said, this is a book that tries to tackle several contentious issues in medical ethics and does so fairly well. From end-of-life care for those with terminal diseases to questions about genetic testing in the prenatal period to help parents make a decision about whether to have a child with Down's, I wonder if the book bites off more than it can chew. The result is a somewhat incongruent collection of essays on quite unrelated topics. The views themselves do not seem to have a common thread running through them either. I had a hard time telling if the author was for or against some things and how he could justify those views based on his take on the American health car system, cost of health care, his knowledge of medical history and so on. All that said, it is still quite an easy read for such a heavy topic and certainly thought provoking.
April 8, 2022
Really thought provoking with great -- albeit intensely sad -- examples of his points. Really good stuff to consider as I enter this phase of my life that involves elder care.
October 2, 2022
This joins the growing collection of books and essays devoted to the topic of dying, and how one should prepare for it. In most cases, various authors have stressed, it is better to die at home than in the hospital; the latter not only promises a horrible experience, but is financially ruinous as well.
Martensen, who is a doctor, professor of medicine and medical ethicist, also joins the group that points out that doctors and other hospital personnel are more likely, as a group, to avoid medical care in their final days. I don't disagree with his message, but others (notably Atul Gawande) have covered this same ground, and have done a rather better job of it.
One service Martensen does bring to the public is a clear explanation of what experimental drug therapies actually entail. He is troubled that trusting patients are not always fully aware of what they are signing up for. In Phase 1 trials, for example, patients may believe that they are first in line to get a potentially game-changing new drug that would otherwise be unavailable. The truth is the unlucky volunteers for a Phase 1 trial are simply determining how much of the new drug the body can handle without becoming even sicker than they were before. Most patients will get far too little of the drug to make any difference; an even unluckier few will get too much, and add to their misery.
I might have enjoyed this more if it were the first I'd read that addresses this topic.
Martensen, who is a doctor, professor of medicine and medical ethicist, also joins the group that points out that doctors and other hospital personnel are more likely, as a group, to avoid medical care in their final days. I don't disagree with his message, but others (notably Atul Gawande) have covered this same ground, and have done a rather better job of it.
One service Martensen does bring to the public is a clear explanation of what experimental drug therapies actually entail. He is troubled that trusting patients are not always fully aware of what they are signing up for. In Phase 1 trials, for example, patients may believe that they are first in line to get a potentially game-changing new drug that would otherwise be unavailable. The truth is the unlucky volunteers for a Phase 1 trial are simply determining how much of the new drug the body can handle without becoming even sicker than they were before. Most patients will get far too little of the drug to make any difference; an even unluckier few will get too much, and add to their misery.
I might have enjoyed this more if it were the first I'd read that addresses this topic.
February 17, 2019
I borrowed this book simply because it looked like the most 'fictional' book of the Science section in my school library. I was attracted to the title because it sounded similar to the popular When Breath Becomes Air.
First of all, I'm going to put it out there that I didn't have high expectations for this book from the start, since I typically do not massively enjoy non-fiction books; so 2 stars was a very much expected rating.
I suppose A Life Worth Living would be more suitable for people who are going through the loss of a loved one, since every chapter is about death and its impact on the family members of the dying/deceased. In the context of it being on the shelf of my school library, it would be insightful to potential medical students as well, since it touches on bioethics and contains a number of medical jargon.
First of all, I'm going to put it out there that I didn't have high expectations for this book from the start, since I typically do not massively enjoy non-fiction books; so 2 stars was a very much expected rating.
I suppose A Life Worth Living would be more suitable for people who are going through the loss of a loved one, since every chapter is about death and its impact on the family members of the dying/deceased. In the context of it being on the shelf of my school library, it would be insightful to potential medical students as well, since it touches on bioethics and contains a number of medical jargon.
March 31, 2025
I enjoyed the case studies, but the rest seemed to get a little long winded at times.
June 20, 2014
The author used case stories to illustrate points he wanted to make, and many of those points dealt with death and how to prepare for it. Perhaps it is merely a difference of opinion or he didn't make his point clearly, but the chapter that focused on organ donation disappointed me. He came off as strongly opposed to the process, expressing that the people from the organ donation organizations approached patients' families too quickly and that not enough effort was made to ensure the patient would not recover. Yet so much of the rest of his book was about making choices for your care and advanced planning in the event something was to happen, as well as not prolonging suffering, yet it seems to me that the patients who have 'Organ Donor' designated on their licenses did that advanced planning. Because he had one case where the patient whose family was consulted for him to be a donation after cardiac death donor actually recovered almost fully, the author's mind seems to be set.
I did agree with many of his other points, though when he strayed from the case studies and instead ventured into medical history and particularly religion, I didn't follow it as closely. From experience, I see how medicine has moved beyond the curative and is verging on going backwards, where the treatment attempts to cure one ailment instead introduces a whole host of others. His writings on the process to get a new drug therapy approved were enlightening, as people are often recruited into the trials with the experimental drug being the last hope for a cure, yet many of the patients in such trials end up in the first two phases, which don't measure the success of the drug but are instead used to determine toxicity and side effects, and unless it is a miracle treatment, often end up sicker with only a marginal improvement of their original condition. However, were it not for such trials, especially since animal testing has become strictly regulated (not that I think that is a bad thing, since I'm not sure I trust the results of treating mice or dogs to be equivalent to how humans will react), no new drugs would ever be produced, or worse, many new drugs would be on the market and no one would know which might help and which would only harm.
Overall, an interesting read, but I would have liked more case stories, less of a tangential history, and perhaps a less depressing tone than the strong focus on death he has going on here.
I did agree with many of his other points, though when he strayed from the case studies and instead ventured into medical history and particularly religion, I didn't follow it as closely. From experience, I see how medicine has moved beyond the curative and is verging on going backwards, where the treatment attempts to cure one ailment instead introduces a whole host of others. His writings on the process to get a new drug therapy approved were enlightening, as people are often recruited into the trials with the experimental drug being the last hope for a cure, yet many of the patients in such trials end up in the first two phases, which don't measure the success of the drug but are instead used to determine toxicity and side effects, and unless it is a miracle treatment, often end up sicker with only a marginal improvement of their original condition. However, were it not for such trials, especially since animal testing has become strictly regulated (not that I think that is a bad thing, since I'm not sure I trust the results of treating mice or dogs to be equivalent to how humans will react), no new drugs would ever be produced, or worse, many new drugs would be on the market and no one would know which might help and which would only harm.
Overall, an interesting read, but I would have liked more case stories, less of a tangential history, and perhaps a less depressing tone than the strong focus on death he has going on here.
April 30, 2009
Elin gave me a copy of this for my birthday. ... I had not heard of Martnesen before this, but enjoyed the book. It is easy to read and extraordinarily well-informed. You finish the book imagining Martensen as a kind of ideal physician for a bright, thoughtful patient. However, I was not entirely sure for whom this book was intended: is it a kind of self-help book for alienated patients, a memoir, or a policy review? With respect to his policy recommendations, I found his diagnoses more trenchant than his recommendations. He is of course right that contemporary medicine cannot control costs because we lack a shared account of how to die, but his recommendation seems to be that we ought to hire interior decorators for ICUs. The problems with our current system are too profound to solve with decorations. Also, the audience he seems to assume is wealthy and well-connected, as you are often urged to consult your friends who are physicians. If you read it, I recommend chapter five as the best chapter.
February 14, 2009
For the last year I've been wholly focused on illness prevention, but with the passings of people I really cared about I wanted to read more about what happens when one is in a chronic or acute disease state. This book is such an elegant and humanistic overview of what happens to a person's care when they are in a state where people's wishes for a longer life, the aims of scientifc enquiry and of the economic market intersect with the personal need for truly valuable time with loved ones and on earth. I was really stuck by the profoundly humananistic perspective of the author and if you've ever lost a loved one or if you know someone who is going through illness I highly recommend this book. If you read it, you'll have a great perspective into the real questions to ask about treatment. Even if these aren't issues in your life, this book is so compelling - who hasn't thought about what makes life valuable and where you would draw the line?
December 16, 2011
As a family nurse practitioner, a previous trauma nurse, and a short stint as a hospice nurse, I could relate to much of what Dr Martensen wrote. He has a true sense of the humanity of each person, which can get lost in the machinations of serious illness, our convoluted health care system and complex medical care.There are beautifully told stories in this book which illustrate the importance of each persons own decisions and choices regarding end if life care.
It is so vitally important to have conversations, even when we are healthy, with our family, and with our health care providers. Addressing the end of our lives, rather than being morbid, can serve to create a sense of the beauty of each moment. When we thoughtfully consider what we would like to happen in the event of a catastrophic illness or injury, we give our family permission and confidence to make decisions for us, relieving them of the pain of having to say, 'if only she could tell me what she would like me to do'.
It is so vitally important to have conversations, even when we are healthy, with our family, and with our health care providers. Addressing the end of our lives, rather than being morbid, can serve to create a sense of the beauty of each moment. When we thoughtfully consider what we would like to happen in the event of a catastrophic illness or injury, we give our family permission and confidence to make decisions for us, relieving them of the pain of having to say, 'if only she could tell me what she would like me to do'.
April 14, 2009
I wanted this book to be longer. Having said that, it great hearing an honest physician perspective of healthcare. We have to remember that they are people just like us under those lab coats. And so do they.
I totally need to get my end-of-life paperwork in order. Personally, I feel our healthcare system is screwed up because we haven't all addressed the issues in this book: prevention and end-of-life-care. And just this morning I read about the minor decrease in cancer deaths in the US- most of which is caused by smoking cessation and earlier detection. Not the complex, dangerous and expensive (and painful) treatment plans. Just how this author described it.
I totally need to get my end-of-life paperwork in order. Personally, I feel our healthcare system is screwed up because we haven't all addressed the issues in this book: prevention and end-of-life-care. And just this morning I read about the minor decrease in cancer deaths in the US- most of which is caused by smoking cessation and earlier detection. Not the complex, dangerous and expensive (and painful) treatment plans. Just how this author described it.
July 16, 2009
In a few words, I love this book. Hardly a day goes by that I am not reminded of it in someway, and thus reminded how it changed the way I think about many medical issues.
It is about bioethics, but not the usual topics like cloning, and abortion, but about issues that effect all of us...like aging and cancer.
Absolutely thought provoking. Recommended.
Edited to add (Jan. 9, 2016): I can't believe it's been seven years since I read this book, because I still think about it frequently. To say this book has left a lasting impression on me would be an understatement.
ETA: Jan 2025...still thinking about this book.
It is about bioethics, but not the usual topics like cloning, and abortion, but about issues that effect all of us...like aging and cancer.
Absolutely thought provoking. Recommended.
Edited to add (Jan. 9, 2016): I can't believe it's been seven years since I read this book, because I still think about it frequently. To say this book has left a lasting impression on me would be an understatement.
ETA: Jan 2025...still thinking about this book.
October 27, 2009
This doctor questions the sanity of keeping someone alive at all costs, literally. He is not a proponent of euthanasia, but wants to help us think about why we would put people through painful treatments, debillitating chemotherapy, emotional and physical scarring, and questionable treatments that will not add longevity-- just because we have the technology to administer them. He urges a deep look at America's fear of aging, fear of dying, and our pride of thinking we have all the answers, when in reality we may just be adding suffering to terminal illness. He calls for a more rational search for treatment options and a clearer view of the end of life at any age.
November 30, 2012
After watching 2010 PBS documentary "Facing Death", I had got "interested" in end-of-life care, so I stumbled upon this wonderful book a year ago.
Robert Martensen, the author, is an emergency medicine/ICU doctor, but he does not bog the reader down with scientific terms. Instead, using poignant case studies and his own insights in this stage of life, he convincingly argues that the current end-of-life care is far from optimal. It's too costly and too focused using advanced technology on prolonging life - while neglecting the dying patient's humanity.
It's a excellent book. If you are at all interested in healthcare, read it.
Robert Martensen, the author, is an emergency medicine/ICU doctor, but he does not bog the reader down with scientific terms. Instead, using poignant case studies and his own insights in this stage of life, he convincingly argues that the current end-of-life care is far from optimal. It's too costly and too focused using advanced technology on prolonging life - while neglecting the dying patient's humanity.
It's a excellent book. If you are at all interested in healthcare, read it.
May 1, 2009
An important book to read - one that would be good for discussion. The first three chapters are interesting, but Chapter 4 (on medicine and the elderly) was compelling for me and most of the rest of the book was pretty compelling as well. The book has a lot of valuable information that gets hidden in medi-speak and politics. I predict this will be read by many medical school classes.
Martensen seems to be an angry older man - angry about the politics that seem to be more important than the medicine. I happen to agree with him.
Martensen seems to be an angry older man - angry about the politics that seem to be more important than the medicine. I happen to agree with him.
January 4, 2010
Beautifully written book about the evolving and troublesome issues surrounding biotechnology's abilities to keep the dying alive. What's great about this book is that Dr. Martensen writes to a reader who may be faced with important decisions about end-of-life issues and disease - it's not all academic or philosophical. Highly recommend it if you or a loved one is ill or being faced with difficult choices in health care.
March 6, 2014
End of life care choices can be difficult for everyone. What no one talks about is what the person dying is experiencing, what they would want, especially if that person is a child. How much do we put them through before we say enough is enough? The organ harvesting industry is also very politely examined for all the money they rake in and organs taken for less than due regard for the person in which they are harvesting from. A book everyone should read.
May 6, 2009
This book addresses many of the questions "healthcare practitioners" commonly ask of themselves in the treatment of the terminally ill and chronically infirmed. As an EMT, I found many of Dr. Martensen's insights poignant and relevant. I would recommend this book to persons seeking a career in medicine or healthcare administration!
May 12, 2009
Read this for my DLS Nonfiction RA SIG. A thought-provoking look at how our many medical advances enable us to prolong life, sometimes past the appropriate or humane point; and how the privatization of hospitals has left more people than ever without medical care. Makes me want to make sure my living will is complete.
Read
May 2, 2010This book is confirming my idea that it is better to not go to the doctor. One chapter is about an elderly woman who had shortnes of breath, so they did surgery which screwed with her mind and she spent the last/next two years of her life regretting she had had the surgery. If you live past eighty, you are going to DIE sooner now than if you lived two hundred years ago....
June 11, 2009
essays about illness and medical care: trials of the body, the less-traveled paths, illusions of control, elective choices. Real stories, thoughtful observations, reflecting limitations and giving permission to choose to opt out
August 28, 2009
Beautiful, thoughtful, grounded, compassionate insights from a doctor who's been there, on end-of-life issues. A must read for those of us who will someday die, and with loved-ones expecting to make the journey. It need not be an awful journey.
November 30, 2009
Thought the author would have more personal stories, but the ideas are relevant. Extension of "life" and the resultant suffering. However, there is the alternative where aggressive care can lead to successful outcomes. But, for how long? Quality of life must be considered.
December 13, 2009
A short (205 pages)thoughtful book by a physician on the patients' experiences with the "Medical-Industrial Complex". Among other things, Dr. Martensen addresses the issues of "battles" against diseases like cancer and when to pull the plug -- or not to.
January 18, 2011
While there were many interesting aspects to this book, mainly of which America has become a nation of keeping people alive "no matter what", I expected more personality. As a writer Martensen struggles, but I could honestly say that as a doctor, I would have been comfortable as a patient.
February 22, 2009
deals more with the technology issue than other physician perspectives
July 23, 2009
Profound is the word that comes to mind to describe this discussion of the ethics of medical practice related to end-of-life medical care.
Want to Read
December 2, 2009WRITTEN BY MY UNCLE!
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February 6, 2011A book that everyone should read
Displaying 1 - 30 of 33 reviews