Summary Of Being Mortal By Atul Gawande
Atul Gawande’s book Being Mortal and the corresponding Frontline Program described many examples of individuals being diagnosed with terminal illnesses and how they and the medical professionals responded to their diagnoses (2014). I was surprised to learn that Gawande, who is an oncologist, and many of his colleagues did not want to tell their terminally ill patients that they are dying. Informing someone that they are dying would not be a pleasant task to undertake, however I thought that doctors were comfortable engaging in these difficult conversations because it is part of their job. Instead it seems that doctors are perhaps slightly in denial of what their profession can do to cure patients, which is understandable. Many people probably
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become doctors because they want to heal people, unfortunately sometimes that is not possible. Doctors need to be more open and honest with their patients about their prognosis, even if it is difficult and uncomfortable. Death should be discussed openly, especially with our family members. We all know that everyone is going to die, and these difficult conversations are important to have, no matter how uncomfortable they make us feel, so we can let others know what medical interventions we would and would not want. Gawande wrote about a woman named Sara who was young and expecting her first child when she was diagnosed with cancer (2014). She and her husband were determined to do everything to beat her cancer, unfortunately she did not respond to treatments and instead of talking to her about the possibility of her dying, Gawande pushed for different drugs and types of therapies in an attempt to cure her, or prolong her life (2014). The treatments greatly decreased her quality of life and if she had been informed that treatment would not substantially increase how long she lived, and that stopping treatments would significantly improve her quality of life, perhaps she would have chosen to stop and try to savor her last months (Gawande, 2014). Most people view doctors as completely knowledgeable and believe their recommendations should be followed precisely. A doctor once prescribed a treatment for me that I didn’t think it was necessary and the cost was not covered by my insurance, however I accepted it because it was what my doctor recommended. Doctors are viewed as experts and authority figures who are capable of curing all medical deficiencies. While sometimes that is true; treatments are successful and the cancer is removed, other times they are just trying to do what they think the patient wants. Doctors should be required to inform patients of their chances of survival as well as the toll of treatments. The differences of quality of life versus quantity before proceeding with treatment of terminal illnesses should be stressed by physicians. Currently, my practicum placement is in a hospital. Patients are informed about advance directives, but are not required to complete one. People are often resistant when they are told they are required to do something. Requiring every person to complete an advance directive and share their preferences of treatment and end of life with family members would be beneficial, however I don’t know if that is feasible. Perhaps if a required form for medical treatment was an advanced directive then more people would complete one. After the advance directive is completed and in an individual’s medical chart, subsequent visits would require reading over the document and updating any desired changes. Another idea is requiring individuals to fill out the form when signing up for insurance and encouraging discussion with family members about medical preferences. If people were required to make these decisions and have conversations about end of life with their families death and dying would become a less taboo subject. People with terminal illnesses would have more knowledge about their prognosis and already have written their treatment decisions. Having difficult conversations before being faced with death takes the responsibility away from family members and fosters peace of mind in knowing they are following their loved one’s wishes. Perhaps people lack awareness of what an advanced directive is, and if more people were informed of what they entail then more individuals would have one and discuss their wishes with their family. We see billboards and commercials about the importance of various health screens, it’s possible that public service announcements about advance directives would increase awareness and encourage more people to write one. In order to determine if requiring everyone to have an advanced directive is helpful, a brief survey could be distributed to individuals who are near the end of their life and their family members after they’ve passed away to evaluate the effectiveness. Questions could be asked to the individuals about the quality of their life currently, if having an advance directive was helpful, and family members could evaluate the ease of decision making and if their loved ones treatment preferences were followed. Being Mortal also described alternative skilled nursing facilities with some places operating more like apartment buildings (2014). Some had pets on site, a garden, or allowed children to receive child care services at the same place (Gawande, 2014). Independence is very important to older adults. It is strange that people who design skilled nursing facilities, or assisted living communities, don’t ask their potential residents how they would like the environment to be. I can imagine how upset I would be if I had to live in a small room, with limited possessions, and had no input on the activities or menu.
If I could design an assisted living community, I would ask every potential resident what would help make the facility a home for them and do my best to accommodate.
Pets, the option of preparing their own meals, input on the menu with various options of what to eat and when, and their choice of activities could all be available. Another idea is to run the facility more like an apartment building or community with a homeowner association instead of a medical facility. Perhaps there could be a physician and nurses available, but they allow the residents more flexibility in their care. For example, the residents could choose whether or not to follow diet restrictions. I feel that if a person has survived into old age, they should be allowed to eat whatever they want, whenever they want. I know I would be upset if I wasn’t allowed to have something sweet and fatty every day, even though I know it isn’t healthy.
In Aging Matters, sections of the text described the benefits of older adults volunteering in elementary schools and being adoptive grandparents (Hooyman, Kawamoto, & Kiyak). Fostering relationships between the elderly and young is a great opportunity for older adults to feel that they contribute to society, form connections with the younger generation, improve mental capabilities, and increase the younger generations awareness, relationships, and positive attitudes towards the …show more content…
elderly.
A sentence that stood out in Atul Gawande’s book was, “Our ultimate goal, after all, is not a good death, but a good life until the end (2014).” This was very powerful and encompassed the main idea of his book. The American culture is terrified of death. We do many things to try to live as long as possible, such as eating healthy, exercising, not smoking, and medical interventions. The medical system offers false immortality. Many individuals diagnosed with cancer do survive, however, our society seems to believe that if we fight long and hard enough and obtain the most cutting edge treatments we can be healed. Perhaps even doctors believe that if they keep trying various treatments that eventually they can add time to patient’s lives. However, we are all mortal, and eventually we all stop living.
No one wants to address the fact that every person dies.
I don’t even like to consider the fact that one day I will die. Death is such an unknown. We all hope to live a long, high quality, and healthy life, but we don’t consider the alternative. We don’t talk to our family and fill out advance directives because we don’t want to face death. We don’t want to have difficult conversations, even though we all know that someday we will die. If we were more open and accepting of death, perhaps we would not fear it as much. We might be more willing to talk about the quality of our final months instead of focusing on the quantity. We would feel more comfort knowing our loved ones are comfortable and receiving the kind of care they desire instead of receiving treatments, such as chemotherapy, which have many negative side
effects.
I have had discussions with my family about the quality of life I would want if diagnosed with a terminal illness and the types of medical interventions I would, or would not want. One family member was very uncomfortable discussing my death, so I told him that I would write down my preferences for medical interventions and quality of life and informed him where to find the document on my computer if needed. I thought it was valuable to decide what medical interventions I did or did not want now, instead of during a stressful and difficult situation. I also thought this was important to complete now in case I happen to be unconscious or in a mentally impaired state when difficult decisions need to be made.
In conclusion, I found Being Mortal a very insightful and informative book that made me evaluate medical interventions, skilled nursing facilities, and I learned how to better communicate with physicians if a family member or I become diagnosed with a terminal illness. The book has led to a few “difficult conversations,” as Gawande called them, with my family. Yet, even though they were difficult, I feel at peace knowing that my family is aware of my preferences and they won’t be burdened with making those decisions, because I already have.
become doctors because they want to heal people, unfortunately sometimes that is not possible. Doctors need to be more open and honest with their patients about their prognosis, even if it is difficult and uncomfortable. Death should be discussed openly, especially with our family members. We all know that everyone is going to die, and these difficult conversations are important to have, no matter how uncomfortable they make us feel, so we can let others know what medical interventions we would and would not want. Gawande wrote about a woman named Sara who was young and expecting her first child when she was diagnosed with cancer (2014). She and her husband were determined to do everything to beat her cancer, unfortunately she did not respond to treatments and instead of talking to her about the possibility of her dying, Gawande pushed for different drugs and types of therapies in an attempt to cure her, or prolong her life (2014). The treatments greatly decreased her quality of life and if she had been informed that treatment would not substantially increase how long she lived, and that stopping treatments would significantly improve her quality of life, perhaps she would have chosen to stop and try to savor her last months (Gawande, 2014). Most people view doctors as completely knowledgeable and believe their recommendations should be followed precisely. A doctor once prescribed a treatment for me that I didn’t think it was necessary and the cost was not covered by my insurance, however I accepted it because it was what my doctor recommended. Doctors are viewed as experts and authority figures who are capable of curing all medical deficiencies. While sometimes that is true; treatments are successful and the cancer is removed, other times they are just trying to do what they think the patient wants. Doctors should be required to inform patients of their chances of survival as well as the toll of treatments. The differences of quality of life versus quantity before proceeding with treatment of terminal illnesses should be stressed by physicians. Currently, my practicum placement is in a hospital. Patients are informed about advance directives, but are not required to complete one. People are often resistant when they are told they are required to do something. Requiring every person to complete an advance directive and share their preferences of treatment and end of life with family members would be beneficial, however I don’t know if that is feasible. Perhaps if a required form for medical treatment was an advanced directive then more people would complete one. After the advance directive is completed and in an individual’s medical chart, subsequent visits would require reading over the document and updating any desired changes. Another idea is requiring individuals to fill out the form when signing up for insurance and encouraging discussion with family members about medical preferences. If people were required to make these decisions and have conversations about end of life with their families death and dying would become a less taboo subject. People with terminal illnesses would have more knowledge about their prognosis and already have written their treatment decisions. Having difficult conversations before being faced with death takes the responsibility away from family members and fosters peace of mind in knowing they are following their loved one’s wishes. Perhaps people lack awareness of what an advanced directive is, and if more people were informed of what they entail then more individuals would have one and discuss their wishes with their family. We see billboards and commercials about the importance of various health screens, it’s possible that public service announcements about advance directives would increase awareness and encourage more people to write one. In order to determine if requiring everyone to have an advanced directive is helpful, a brief survey could be distributed to individuals who are near the end of their life and their family members after they’ve passed away to evaluate the effectiveness. Questions could be asked to the individuals about the quality of their life currently, if having an advance directive was helpful, and family members could evaluate the ease of decision making and if their loved ones treatment preferences were followed. Being Mortal also described alternative skilled nursing facilities with some places operating more like apartment buildings (2014). Some had pets on site, a garden, or allowed children to receive child care services at the same place (Gawande, 2014). Independence is very important to older adults. It is strange that people who design skilled nursing facilities, or assisted living communities, don’t ask their potential residents how they would like the environment to be. I can imagine how upset I would be if I had to live in a small room, with limited possessions, and had no input on the activities or menu.
If I could design an assisted living community, I would ask every potential resident what would help make the facility a home for them and do my best to accommodate.
Pets, the option of preparing their own meals, input on the menu with various options of what to eat and when, and their choice of activities could all be available. Another idea is to run the facility more like an apartment building or community with a homeowner association instead of a medical facility. Perhaps there could be a physician and nurses available, but they allow the residents more flexibility in their care. For example, the residents could choose whether or not to follow diet restrictions. I feel that if a person has survived into old age, they should be allowed to eat whatever they want, whenever they want. I know I would be upset if I wasn’t allowed to have something sweet and fatty every day, even though I know it isn’t healthy.
In Aging Matters, sections of the text described the benefits of older adults volunteering in elementary schools and being adoptive grandparents (Hooyman, Kawamoto, & Kiyak). Fostering relationships between the elderly and young is a great opportunity for older adults to feel that they contribute to society, form connections with the younger generation, improve mental capabilities, and increase the younger generations awareness, relationships, and positive attitudes towards the …show more content…
elderly.
A sentence that stood out in Atul Gawande’s book was, “Our ultimate goal, after all, is not a good death, but a good life until the end (2014).” This was very powerful and encompassed the main idea of his book. The American culture is terrified of death. We do many things to try to live as long as possible, such as eating healthy, exercising, not smoking, and medical interventions. The medical system offers false immortality. Many individuals diagnosed with cancer do survive, however, our society seems to believe that if we fight long and hard enough and obtain the most cutting edge treatments we can be healed. Perhaps even doctors believe that if they keep trying various treatments that eventually they can add time to patient’s lives. However, we are all mortal, and eventually we all stop living.
No one wants to address the fact that every person dies.
I don’t even like to consider the fact that one day I will die. Death is such an unknown. We all hope to live a long, high quality, and healthy life, but we don’t consider the alternative. We don’t talk to our family and fill out advance directives because we don’t want to face death. We don’t want to have difficult conversations, even though we all know that someday we will die. If we were more open and accepting of death, perhaps we would not fear it as much. We might be more willing to talk about the quality of our final months instead of focusing on the quantity. We would feel more comfort knowing our loved ones are comfortable and receiving the kind of care they desire instead of receiving treatments, such as chemotherapy, which have many negative side
effects.
I have had discussions with my family about the quality of life I would want if diagnosed with a terminal illness and the types of medical interventions I would, or would not want. One family member was very uncomfortable discussing my death, so I told him that I would write down my preferences for medical interventions and quality of life and informed him where to find the document on my computer if needed. I thought it was valuable to decide what medical interventions I did or did not want now, instead of during a stressful and difficult situation. I also thought this was important to complete now in case I happen to be unconscious or in a mentally impaired state when difficult decisions need to be made.
In conclusion, I found Being Mortal a very insightful and informative book that made me evaluate medical interventions, skilled nursing facilities, and I learned how to better communicate with physicians if a family member or I become diagnosed with a terminal illness. The book has led to a few “difficult conversations,” as Gawande called them, with my family. Yet, even though they were difficult, I feel at peace knowing that my family is aware of my preferences and they won’t be burdened with making those decisions, because I already have.