Being Mortal: Medicine and What Matters in the End

It’s not surprising to me that Being Mortal is rated in Bookmarks magazine’s top five of the “best of the best” nonfiction books of 2014. This list is created from 32 periodicals that feature their own best books lists, so placement there is no small feat. I would add that it is not only one of the best in terms of its critical reviews, it is also one of the most important to all of us who are going to die and who will make decisions for those we love who are dying.

It is also a book about aging and what choices we have in a society where the norm is no longer the elderly being revered members of the household who slip quietly into their last years, with family members available to care for them. While assisted living centers and nursing homes partially fill in the gap, we must acknowledge that creative ways for the aged to remain as independent as possible are needed and are encouraged to give thought to what we would want in our own circumstances.

But it all comes down to death. Many of us have studied the process for a loved one when a diagnosis is made, or when a fall, cognitive decline, or family caregiver overload demand that change must be made — when we acknowledge that time is growing short. How much better if we inform ourselves earlier and more realistically?

Being Mortal presents us with real people and their experiences. Dr. Gawande understands and cares greatly about his patients’ fears and desires and shows us the benefits of the conversations about our greatest concern and what is most important to us at the end of our journey.

He also helps us to understand medicine and the most productive relationship between doctor and patient, which has evolved over the years. The paternalistic relationship, where the doctor told us what procedure we needed or what medication we should take, evolved into the informative relationship, where the doctor presented options and we were expected to choose what would be best for us. The interpretive relationship provides information and guidance towards the best choice, arrived at by doctor and patient.

A book such as this introduces us to the interpretive relationship, shows us what it looks like in practice, and allows us to imagine how we can deal with the decisions that need to be made — sooner or later.