Being Mortal: Medicine and What Happens in the End is a book by surgeon Atul Gwande. The book addresses end-of-life care, hospice care, and also contains Gawande's reflections and personal stories. Throughout the book, Gawande follows a hospice nurse on her rounds, a geriatrician in his clinic, and reformers overturning nursing homes.
Students were also presented with a case study regarding physician assisted suicide. We discussed this as an viable medical option to our elderly or extremely ill patients.
We are half way through the book and after a group discussion, these are our students thoughts:
Maria Andrade:
Being Mortal by Atul Gwande is a book that is comprehensible, but also very difficult to come to terms with due to the realness of the writing. Gwande makes the claim that in our modern age, we are unwilling to accept that we are mortal beings and therefore when death approaches we are unprepared to face it. This, as I have read, can become a real problem in the medical field. Medical students are not being trained to treat people who are nearing death; in the words of Gwande “the purpose of medical schooling was to teach how to save lives, not how to tend to their demise” (1). This type of education is flawed because it is indirectly teaching that if someone is dying then we have failed him or her, especially since technology nowadays enables us to do so many extraordinary things. When a patient comes to the hospital with a terminal illness, he or she is often succumbed to undergo so many exhausting and expensive treatments just to end up with the same unwanted result. He or she is doing so with the support of doctors and his or her family members who are stubborn to realize and accept that death is inevitable. It can be so easy to write about this stuff, but I am certain that if I was in a situation where my life or the life of a loved one was on the line, I would also be the stubborn person I have just described. The truth is death is terrifying; nobody wants to die. This book has reinforced my belief that our biggest enemy is not an illness, but rather hope – hope that we can defeat death.
This book also sheds light on how poorly we treat our elders. Throughout the book, Gwande provides many anecdotes about the lives of a selective number of elderly people, which helps further emphasize his message. Where I come from the elders are venerated and it is common to live in a multigenerational home. While reading this book, it was unfathomable at first how the norm in the United States is to send the elders to a nursing home when they can no longer take care of themselves. However, I do understand that life is much busier here, so it is very challenging to care for them. Though I do understand the means of putting an elderly person in a nursing home, I do not understand why nursing homes are structured the way they are. Gawande brings up an important point about autonomy. Just like anyone, the elders want to maintain their autonomy wherever they are living. The loss of this independence can result in a loss of dignity and self. Nursing homes should stop worrying so much about the elders’ physical safety and start worrying more about their mental integrity.
Anonymous:
The book has definitely opened a new door on a topic that I do not think much about because it is not common in my culture. When I came to America I heard about nursing homes and I've seen many of them but never really understood how the facilities are run, but even with the knowledge that there are such things as nursings homes it never occurred to me think about putting any of my family members in a nursing home. My exceptions were always that one of my siblings or I are going to take care of our mother at home. The reason that I would keep my mom home with me instead of putting her in a nursing home is because I know my mother best. If I were to put her in a facility that does not know her I would expect for the care takers to treat her just as any other patient. The experience for my mother would be different for my mother if she were home surrounded by the people that love her.