Fascinating and sobering: Being Mortal

Being Mortal: Medicine and What Matters in the End, Atul Gawande

Fast Facts

• Atul Gawande is a practicing surgeon, a professor at Harvard, a staff writer at the New Yorker, and in my opinion, a total rock star
• This book, his fourth New York Times bestseller, was just selected as one of NYT's 100 Notable Books of the Year (review here)
• Being Mortal runs 300 pages, or 9 hours of audiobook time
• Perfectly balanced mix of anecdotes and education on cultural approaches to caring for the elderly and dying over time
• Deeply moving and sad, but a great choice for a fiction lover looking for a foray into non-fiction
• Required reading for anyone who faces big end-of-life choices; or, everyone

Why Did I Pick this Up?

Typically, I steer clear of non-fiction in book form.  Other than trying to make it through the New Yorker every week, and clicking around newspaper sites as a respite/distraction from work, I rarely read non-fiction because fiction is typically so much more fun, enjoyable, and relaxing for me.  It's hard to view non-fiction as attractively escapist.

But lately, and the farther I get from those sweet years of formal education, I've been getting worried that my brain might turn to mush.  That's extreme, but work doesn't always give you the learning opportunities you were inundated with in school.  

So, I decided to dip my toes into the non-fiction pool, starting with an author whose long-form journalism I'd read before and loved.  Definitely check out:

• Gawande's brilliant and creative comparison of Big Medicine to the Cheesecake Factory, which is amazing
• Gawande's look at an incredible non-profit in Camden, New Jersey, which is trying to lower emergency room medical costs for low-income patients by targeting preventative care
• By the way - this article helped my incredibly inspiring friend/superhero Megan with her first job on the road to running the public hospital corporation in NYC - how cool is that?!
• For other recommendations, check out my friend Matt's blog.  He completed (almost!) a 100-books-in-a-year challenge - all non-fiction.  Maybe I'll follow in his awesome footsteps in 2015...

Summary, and Why You Should Read It

Many people who are brilliant in the sciences struggle to communicate their ideas effectively.  Gawande opens the book with this critique of doctors: just because they've made their way through tough medical schools and residencies does not mean that they are talented caretakers.  In fact, they may be ill-equipped address some of the most difficult choices that patients and their families must make.

It's a good thing this is clearly not Gawande's problem - I can't think of many writers who are more clear, compassionate, and fascinating.

He tackles the task of educating his audience on end-of-life care, both for the elderly, as well as for young people afflicted with terrible illness (a timely topic with the tragic activism of Brittany Maynard in the news).  Technological progress in medicine, and its associated high costs and social constructs, presents us with challenges that need to be considered, however sobering they may be.

Many of Gawande's topics were eye-opening for me.  As a child, I visited a grandparent suffering from dementia in a nursing home, but this book has made me consider the adult choices that must be made when considering care in Assisted Living or in nursing homes, and the history of how these methods of care evolved in America.

By way of illustration, Gawande describes how his grandfather in India experienced the end of his life, cared for by many family members at home and able to maintain his relative independence until age ~100.  This is contrasted with the story of Gawande's wife's grandmother, who lived in America: a fiercely independent woman who, after a series of falls, a car accident, and extortion by a home contractor, was put in a home that slowly sapped her will to live.

These are only two of the narratives that Gawande weaves throughout his explanation of how end-of-life care is administered.  The result is a well-paced, interesting, and personal account that manages to be informative, easy to understand, and difficult to put down.

Recommended as an Audiobook

I "read" Being Mortal as an audiobook (my first), while cruising in Maggie the Mazda around New Jersey, and commuting into the city.  I'd recommend this approach for someone like me, who usually reads fiction but likes public radio and podcasts.  What better way to start forcing longer non-fiction down my throat?  The only downside is that you might find yourself heave-crying on Sixth Avenue (to be fair, this only happened once).