I am indebted to Steve Dover, our next-door neighbour, friend and founder of the West Surrey Book Club.
For creating a blokes-only forum to discuss chosen books and drink ale in some otherwise unexplored hostelries. And most recently for his book selection – Being Mortal by Atul Gawande.
I rarely read non-fiction books. I’m sure it says something about my own life, but I enjoy lapping up a fiction writer’s imaginative plot and characterisations much more than reading about history, a biography or a book about the development of the motor bike engine during the 20th century.
But reading Being Mortal was a bit of a revelation.
It’s not a fun subject matter. It’s not written by a brilliantly creative writer. And it doesn’t provide any definitive answers.
But it does raise some very important and emotional questions about how we live the end of our lives. Particularly when we know that end is coming.
Atul Gawande is a US-based surgeon, and writer, with Indian roots. He questions whether the advances in medicine and technology actually provide the best solution for patients with terminal illnesses, or approaching death from more natural causes.
I’ve wondered myself whether a doctor’s obligation to keep a patient alive is always necessarily the best solution. Gawande goes further, and ultimately concludes that each individual should be consulted on how they want to spend the last period of life.
Of course each situation is different and far from black and white, but he suggests the medical profession should carefully discuss the outlook with the patient before an obligatory next chemo session, drug dispensation or injection.
If it’s possible you have only 3 months left, would you prefer to undergo non-stop medical efforts to extend your life marginally further, or would it be better to enjoy some final treatment-free time with your family, friends, doing what you enjoy and coming to terms that the end is close? What trade-offs are you willing or happy to contemplate in the dilemma of painful life extension v happier living?
As Gawande says: Medicine’s focus is narrow. Medical professionals concentrate on repair of health, not sustenance of the soul. Yet – and this is the painful paradox – we have decided that they should be the ones who largely define how we live in our waning days. For more than half a century now, we have treated the trials of sickness, ageing and mortality as medical concerns. It’s been an experiment in social engineering, putting our fates in the hands of people valued more for their technical prowess than for their understanding of human needs.
That experiment has failed. If safety and protection were all we sought in life, perhaps we could conclude differently. But because we seek a life of worth and purpose, and yet are routinely denied the conditions that make it possible, there is no other way to see what modern society has done.
Gawande highlights his conclusion through insightful – and emotional – cases he has experienced himself, or is aware of from colleagues.
I found the book uplifting and empowering. Surprising, given the subject matter.