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June & July 2015 Non Fiction Group Read - Being Mortal by Atul Gawande
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Jenny
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May 20, 2015 03:24PM
This is the place to discuss our non-fiction group read for June/July Being Mortal: Medicine and What Matters in the End by Atul Gawande
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I've just downloaded this onto my kindle. it sounds interesting and have enjoyed other books by the author. Looking forward to getting started!
I've read this a few months ago, so I won't be joining in the read. However I thought I'd mention the book that I'm partway through reading currently, it seems to link in with this pretty well. It's called Where Memories Go.
Oh my. Serendipity? I have just mentioned this significant book in a personal statement on my profile page. I am not likely to ever forget it.
I had seen that, Jean. It sounds like a powerful read and very poignant
This is such a relevant read. Gawande took me by surprise with his passion for the living as well as the dying. Incredible bedside manner - would want him as a physician in my final chapter.
I have a copy of this but annoyingly I can't find it!
The house is only 635 sq. ft. so it can't be that hard to find! I know it's here because it was in one of the Book Riot Quarterly boxes.
Wow! This book was amazing!To the person that nominated this book, thank you! It gave me so much to think about and there was so much I did not know about the topics he covers. I really hope everyone else enjoys this book :)
I'm through the first two chapters and this book is fascinating. It makes me think a lot - my last three grandparents all died three years ago within months of each other, my father just retired on the weekend after his 65th birthday, and after some serious illness in my early thirties followed by a high-risk pregnancy, I'm starting to deal with the damages - like having my gallbladder removed and some liver function issues and diabetes. But having just had a baby makes me worry far more about the future than I did back when I was more immediately ill. I think this is one of those books that you can't help but see yourself and your family in. It's got a lot of emotional impact already.
Emotional impact yes, but with solid academic backing and research too. Atul Gawande is both a scholar and a people person - very sensitive and compassionate. That's what hit me most - it's very rare to find.
I agree. I've added all his other books to my TBR, even though other than The Checklist Manifesto, the other subjects don't really catch me. But he's such a good writer I think I'd enjoy anything he wrote.
Good idea Chinook! I may do the same!
I have reserved a copy at my library, so hopefully it won't take too long, but someone has booked it out until 22nd June, so...
It's three in the morning and I'm finished - at this stage of my reading life, staying up to read just doesn't happen any more, but I had to finish this because it was just so compelling. I am contemplating giving the book to my parents when they visit. With any luck, these conversations won't need to happen for some time, but I think this book could help once they do. My parents four years ago moved in with my paternal grandparents and lived there a year as my grandmother was dying. In that time my grandfather had to be moved to a nursing home and my maternal grandmother died suddenly, in her early 90's. Though she moved to a smaller house after Henry, my step-grandfather died, she lived independently until the end. My mother had also moved in when he was dying so he could remain at home. During all of this, I was always overseas and the book helped me understand better what things at home must have been like.
I'm about 100 pages in, halfway through Chapter 4. Chinook, I think your plan is very wise. I'm just into my 60s, but I've had a lot of health issues. In my working life I was an RN, and I spent my last 20 years working in nursing homes--dementia-specific nursing homes for the last 10 years. (Before that, I was a hospice nurse.) My son is 32 years old, and he's a social worker in a hospital dialysis unit, and one of his master's degrees is in bioethics. I'm getting this book for him. As his father and I further enter the aging process, I think this book gives crucial information on quality of life issues. My grandparents both lived to their mid-nineties, and I was their caregiver for 6 months toward the end of their lives. This book would have helped my family understand what was going on.
This book is a treasure!
This book is a treasure!
I'm just about to start this one and I think it will be helpful. My mother-in-law just passed away at 90 and my husband was able to be there with her. My dad is 91 and I think as his memory fails and he ages even more, this book will be well worth the time and emotional engagement.
OK, all these positive reviews have pushed to read this book.
If anyone wants a fiction book that links with some of these issues, I'd recommend The Way Of The Women, a book that some of us are reading currently.
I just read the part about Mt. St. Helen's. I have such strong memories of this volcano and Harry Truman's story and it was emotional and heavily debated. We followed it closely. My dad flew in that morning and we drove up to the airport without knowing it had happened. He got off the plane and said something about giving him quite a show and we didn't know what he was talking about. Memorial Day weekend we went camping on the coast and woke up to a car covered in ash from the second eruption. The memories are so clear, it's hard to believe it was so many years ago!
Karen Michele, thanks for the personal touch. I thought Harry Truman's story was very moving and in many ways inspiring. He reminded me of my greatly loved grandfather.
I will be reading this one next.
Picking this up from the library today.
I just started too.
Finished and feel the same way Jean does about this book. Hard but real subject matter, which everyone should read.
On page 36 now, I found it interesting that longevity is not genetic, I had always placed more emphasis on this, but obviously I was wrong.
I was surprised by that too.
I was left unsure who to believe about longevity being or not being genetically determined. Statistics can often bu used to prove opposite theories. I am glad I am reading the book. Probably I am kind of typical in preferring to just pretend that by ignoring the issue it will go away. That is of course wrong. Already the book has made me focus on what I want from the remaining years of my life. It has forced me to think about how much I value independence versus safely caring for medical / physical problems. Of course we want both but if you have to choose, I think I would prefer to independence until I simply cannot at all manage alone. I am the Harry Truman type, I guess. I do think it is important to ask yourself what you want.
How do you others weigh the two? The real problem is that not until you are given definite alternatives and choices can you say which you would really prefer. Still it is good to think about theoretically.
ETA: Like here is an example right now: it would probably be safer for me to live near a hospital given my diabetes and all, but instead I choose to live far out in the country. I choose to work out on the property, yanking up trees and pushing myself to the limit rather than carefully choosing the safe alternative. I mean this morning I thought, be careful don't fall and break a bone, don't get a stick in your eye. Did I stop? No, I didn't. By pushing yourself you may hurt yourself but you also keep yourself fit and it gives you satisfaction. When does careful turn into harmful? If we only had a glass ball.
Actually this book is not hard to read. In fact there is humor thrown in. I laughed a bit about how we elderly people do NOT like being told what to do. (But why should we? Even when we have difficulty caring for ourselves we remain adults, we don't go back to babies mentally!) I LOVE the part about the living where the boss (Bill Thomas sp?) insisted on animals. It is well told. Oner cat? No, four. One dog no two. And birds and birds and birds, followed by rabbits and kids and plants. That is the way to go. Yes, we need life in these homes not stillness and death and rules that tie us. What is good about the book is it helps you clarify for yourself what is important to you and what you want when you get older. Some of the statistics, as all statistics, are debatable. Things like privacy (being able to lock your door and open windows and set the temperature) and pets and children and small units built around a kitchen and living room and being able to decide things yourself EVEN if it isn't so darn smart. I really like the idea that you have to have something other than yourself to think about. You have to feel your own life has an effect on other living beings.
I still have about half left.
I finished late last night. What a brilliant book. I will collect my thoughts today and post later when I'm on the laptop and not my phone.
Heather, that was quick! I wish people would discuss the book!
I started it a few days ago bit it is a quick read. I think it has had an impact on my personal and professional life.
I understand, Heather.
My adult son was home for the weekend, and we discussed this book extensively. (I'm sending a copy to him today.) It was great! He's a social worker, and I used to be an RN, so we had a good basis for discussion. My husband and I have been clear about our wishes; we have wills and living wills and health care POAs, but this book raises issues we hadn't discussed in detail.
Finally getting a chance to sit down and right my thoughts about this book.
Firstly, I think this book should be required reading on every medical school syllabus. Gawande is correct when he says that dealing with ageing, death and dying is just not dealt with at university. We had a couple of sessions in how to break bad news to patients (usually a cancer diagnosis) and a bit about legal issues and do not resuscitate paperwork. I was never taught how to talk to a dying patient or how to deal with my own feelings around death and dying.
I found the first half of the book fascinating. Although I knew the biology, I had never sat and read how we age and I actually felt a bit uncomfortable. I have worked as a carer in a nursing home for patients with dementia before and I certainly feel the loss of independence and autonomy for our residents was a huge problem. Even choosing a meal or which clothes to wear was taken away from them as it took too long. Unfortunately, as an 18 year old in my first real job, I never felt confident enough to challenge my seniors on these issues and as I have grown older this is something I regret.
I was particularly struck by the comments about the elderly being less interesting to doctors as instead of one diagnostic problem there are a pile of less interesting, more common diagnoses to manage. I admire the work of geriatricians immensely but it is my personal feeling that it is not an area for me as I enjoy more of a scientific approach to medicine.
In my current job we come across a lot of 'do everything doc' even in patients were everything is going to reduce their quality of life to a significant level. It isn't necessarily going to give any extra time either. I think cancer charities and the media are guilty of significant overuse of battle and war imagery when we are talking about cancer. These leaves patients who elect not to have more chemotherapy feeling like they are 'giving in' and 'losing the battle' which I think is unhelpful.
I have recommended this book to a number of colleagues particularly those with palliative care interests. I have thought extensively about how I can change my practice having read this book. I want to have those conversations about the future with my patients and get honest answers about their hopes and have honest discussions about what treatments can achieve. I'm too junior in my career to be responsible for decision making but I can certainly start to allow my patients to talk to me about these issues and I can certainly encourage my colleagues to read this wonderful book.
Firstly, I think this book should be required reading on every medical school syllabus. Gawande is correct when he says that dealing with ageing, death and dying is just not dealt with at university. We had a couple of sessions in how to break bad news to patients (usually a cancer diagnosis) and a bit about legal issues and do not resuscitate paperwork. I was never taught how to talk to a dying patient or how to deal with my own feelings around death and dying.
I found the first half of the book fascinating. Although I knew the biology, I had never sat and read how we age and I actually felt a bit uncomfortable. I have worked as a carer in a nursing home for patients with dementia before and I certainly feel the loss of independence and autonomy for our residents was a huge problem. Even choosing a meal or which clothes to wear was taken away from them as it took too long. Unfortunately, as an 18 year old in my first real job, I never felt confident enough to challenge my seniors on these issues and as I have grown older this is something I regret.
I was particularly struck by the comments about the elderly being less interesting to doctors as instead of one diagnostic problem there are a pile of less interesting, more common diagnoses to manage. I admire the work of geriatricians immensely but it is my personal feeling that it is not an area for me as I enjoy more of a scientific approach to medicine.
In my current job we come across a lot of 'do everything doc' even in patients were everything is going to reduce their quality of life to a significant level. It isn't necessarily going to give any extra time either. I think cancer charities and the media are guilty of significant overuse of battle and war imagery when we are talking about cancer. These leaves patients who elect not to have more chemotherapy feeling like they are 'giving in' and 'losing the battle' which I think is unhelpful.
I have recommended this book to a number of colleagues particularly those with palliative care interests. I have thought extensively about how I can change my practice having read this book. I want to have those conversations about the future with my patients and get honest answers about their hopes and have honest discussions about what treatments can achieve. I'm too junior in my career to be responsible for decision making but I can certainly start to allow my patients to talk to me about these issues and I can certainly encourage my colleagues to read this wonderful book.
Heather, I too think the book should be read by all in the medical sector. Since I am not of the medical sector what I hoped to get from the book was a bit different. I will just link here to my review which explains in more detail: https://www.goodreads.com/review/show...
Great review
I definitely think I am seeing it from a different perspective as a medic. The book was a bit too simple from a medical perspective for me. I think you raise an interesting point about the target audience of the book. It would be a book I would advise A level students thinking of applying to medicine to read
I am also not at the stage in my life where I am thinking of these decisions for myself. I do know my dad's wishes although not in as much detail as this book. My mother died when I was 10 and I know she had chemo to extend life which could have potentially lost quality. Luckily she was reasonably well and at home until the day before she died so we were spared the long process that some of the examples in the book had.
I definitely think I am seeing it from a different perspective as a medic. The book was a bit too simple from a medical perspective for me. I think you raise an interesting point about the target audience of the book. It would be a book I would advise A level students thinking of applying to medicine to read
I am also not at the stage in my life where I am thinking of these decisions for myself. I do know my dad's wishes although not in as much detail as this book. My mother died when I was 10 and I know she had chemo to extend life which could have potentially lost quality. Luckily she was reasonably well and at home until the day before she died so we were spared the long process that some of the examples in the book had.
Heather, from my pov the biggest weakness of the book is that it seems to be written for BOTH medics and the general public, thus not being perfect for either. The strength of the book is its central message that medical care of the elderly and about to die must change. The point isn't to extend life if that life is not worth living. Medics must find out what the elderly / patients /terminally sick want and then go for that.My father had Alzheimer's. I saw what his dementia did to him. He tried to kill himself by climbing up on a roof out his window - in the hospital! My younger brother died of cancer. The choices they made were certainly not those that I think wise. But you have to let each one decided for them self. I think doctors must explain very clearly BOTH the advantages and disadvantages of each alternative.
It is good to hear about your mother. It is the long drawn out stays in care units that are the way NOT to die. My Mom died of pneumonia within one week and while this was terrible it was much better than a long, drawn out procedure.
It is kind of funny. My husband and I were discussing our current life. We live far from any hospital. If something serious should happen the chance that we could get to one soon enough is slim, but we figure a quick death is best anyhow.
I like the book. I think it should be read by many. I think it has an important message, but, no, it is not perfect. Who says it has to be perfect to be worth reading?!
I so think there is a mixed responsibility. It is incredibly challenging to have these discussions. Actually a person does not have a right to a treatment a doctor does not feel is suitable for them including chemo, intensive care as CPR.
Unfortunately, in the UK the media have decided that the NHS wants people to die and have made patients very scared of end of life care. As health care professionals we must have these conversations but our culture at the moment is not making the switch easy. In the US, private companies make more money from tests and treatment than palliative care. It is not wonder people find it hard to accept they are dying and always want more treatment.
Unfortunately, in the UK the media have decided that the NHS wants people to die and have made patients very scared of end of life care. As health care professionals we must have these conversations but our culture at the moment is not making the switch easy. In the US, private companies make more money from tests and treatment than palliative care. It is not wonder people find it hard to accept they are dying and always want more treatment.
Hopefully this book will bring attention to the changes that must occur.
I hope so. I think it is happening slowly here. Palliative care get involved early for symptom control in our patients (nausea and vomiting etc) even when the treatment aim is curative. That way they can become a more normal team rather than associated with end of life
I made a living will/advance decision a few months ago. It is now with my GP (doctor).,I thought the book was very interesting. As I read it I felt that things were 'better' here in the UK, so it interested me to read you comments, Heather. I think it's a book I'll read again some time.
I'm happy that my dad is in his own apartment (he's 91) and can have an independent life, but be watched over at the same time. He has to check in every morning, but other than that he can live however he wants on the schedule he wants. Housekeeping comes in on a regular schedule and no one barges in, etc. I didn't know it was a rare opportunity. There are quite a few facilities like his in our area (WA state).
Heather wrote: "I hope so. I think it is happening slowly here. Palliative care get involved early for symptom control in our patients (nausea and vomiting etc) even when the treatment aim is curative. That way th..."Heather, sounds like a good way of developing trust! What do others say that you have shown the book to?
Karen, how your father has it is SO good to hear. Independence and also you know someone is keeping an eye on him. :0)
Chrissie wrote: "Heather wrote: "I hope so. I think it is happening slowly here. Palliative care get involved early for symptom control in our patients (nausea and vomiting etc) even when the treatment aim is curat..."
I had it on kindle unfortunately so I'm just telling people to read it. One of my colleagues had just finished it as well and enjoyed the book
I had it on kindle unfortunately so I'm just telling people to read it. One of my colleagues had just finished it as well and enjoyed the book
Karen. that sounds like a fantastic arrangement. I'm glad to hear it
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Books mentioned in this topic
The Way of the Women (other topics)Being Mortal: Medicine and What Matters in the End (other topics)
Where Memories Go (other topics)
Being Mortal: Medicine and What Matters in the End (other topics)
