Being Mortal: Medicine and What Matters in the End is a book I wish I had 5 years ago. My mother died of pneumonia in 2012 after a long and debilitating bout with dementia and dependent living in a care home. Ann, a friend of mine in her eighties, introduced me to the Being Mortal book. She was half way through the book at the time, and she wanted to finish reading and give it to her son at his next dinner visit.
Middle-agers lived through the experience of our fathers and mothers passing away. We witnessed the last years, months, and days of those loved ones. Many are left with feelings of guilt and regret, wishing we would have done more or made better decisions to ease their suffering even for a tiny amount.
The advancement of medical technology has prolonged human life expectancy. In 1900, the average life spans for an American man and woman were 48 and 51 respectively. Fast forward a century, in 1990, the corresponding numbers were 72 and 79. The book traced the shifting of society’s view and practice of aging and dying. Our grandparents probably aged and died in their homes while cohabiting with their family members. Our parents though might live their last years in a care home, and passed away in the hospital. We, their children, were tasked with making hard decisions, sometimes collaboratively with them, or in some cases, for them, that would affect their well-being in the home stretch. The choices we make would grant us peace or agony for years to come.
Atul Gawande, the author of Being Mortal and a successful practicing surgeon, opens up about how doctors were trained primarily to prolong life with modern medicine and technology. But the reality is that people still age and die. Doctors were not trained, and undestandably not comfortable with talking about aging and dying with their patients. Medical decisions over treatment options were made often with the false hope of extending life, but almost always at the expense of more excruciating pain and suffering in the interim. Being Mortal advocates an open conversation among the aging, their family members, and the medical profession about what the aging person really wants when death is inevitable. What kind of sacrifices or trade-offs are they willing to make to potentially prolong life?
The death of our parents invariably reminded us of our own aging and mortality. Have you had the hard conversation with your family about what you really want in your old age? How much value do you place on the extra security offered by a care home or even an assisted-living home? What risk are you willing to put up to live independently? Have you made preparation for the day when you need some help in order to live independently?
Recently, I learned of Joe, a friend at church, whose father was in the hospital’s intensive care unit, and would soon move to a hospice. Not knowing what I could say to comfort Joe, and more importantly support him in the decisions that the family had to make, I promptly handed over a copy of Being Mortal.