Being Mortal: Medicine and What Matters in the End

Gawande pieces together a collection of anecdotes to weave together a narrative on what aging and the final years of life are like. The stories shocked me with how much suffering comes with old age, and especially how much apathy there is toward the elderly in the US in particular. As more seniors live longer and hit the limit of our natural lifespan to the point that every part of their body starts to break down, Gawande presents a medical system that tries to ignore the patients’ feelings and end-of-life desires in order to sustain their life, however miserable, longer, because that was what the technology was meant to do. The work is haunting and looking at the elderly, and to me it’s also been a provocative catalyst for thinking about what fulfillment in life means and how much, or how little time every single person really has.

At so many points of the book, Gawande seems to plead to the medical system to have more empathy. He argues that doctors who just present cold, hard facts and give the patient the most accurate options are missing the most important part, which is helping them understand the choices and empathizing with the patient’s tremendous amount of anxiety and bewilderment when faced with the possibility of suffering and death. Solving a particular problem with surgery may have side consequences that make the quality of life so much worse than if an elderly patient simply lived out their days in passable health, and died years later having spent quality time. Perhaps it has to do with the doctors’ themselves having trouble confronting and making sense of death? Or just the emotional energy needed to talk with each patient is more taxing than to simply give the patient cold, hard options? The empathy that I had to develop to do my job, arguably the most important skill for my job, seems to also be one of the most important for doctors too - all the more saddening that a course on empathy has never made its way into my formal education, and not for many doctors either as Gawande noted; perhaps at the core, schools of all levels could actively teach empathy and it will produce not just better doctors as Gawande wishes for, but better citizens in general.