Book Review of 'Being Mortal'

Book- Being Mortal; Medicine and What Matters in the End
Author- Atul Gawande
Pages- 282

Being mortal is about the struggle to cope with the constrains of our biology, with the limits set by genes and cells and flesh and bone. Medical science has given us remarkable power to push against these limits. But again and again, the damage we see in medicine when failed to acknowledge such power is finite and always will be.

There are some people who know what losing someone means. What it feels like watching a person die each day. How it stirs our soul seeing them in pain. How we want them to live normally again, without any pain, without any sufferings. There are some countries having Euthanasia in their policy wherein, slowly the person would be drifted towards death withdrawing them from the ventilator or by giving them an overdose of morphine or as per their policy guidelines.

The book, ‘Being Mortal’ comprises of stories of many lives which the author has witnessed. Although, the stories the author depicted in the book, none of them could win from the nature. Life is quite unpredictable if you think. People who never have smoked a single cigarette gets cancer while the one who is a chronic smoker lives longer. People who have never had a family history of cancer catch hold of a chronic incurable form of cancer wherein people having history of cancer in their family stays safe. People who have been an active person in youth become quadriplegic and wheel chair bound due to some kind of tumor growing inside the spine which has high mortality rate even if a surgery is performed whereas people with paralysis are slowly drifting towards well being through physical therapy. The continuum of health keeps on drifting towards both positive as well as negative side.

Ruth developed health issues. A lifetime smoker, she was diagnosed with lung cancer, she survived, and kept smoking. Three years after, she had a stroke that she never wholly recovered from. She became increasingly dependent on her husband – for transportation, for shopping, for managing the house, for everything. Then she developed a lump under her arm and a biopsy result revealed metastatic cancer and then at the age of seventy three, she died.

Jewel Douglass, suffered from ovarian cancer wherein she was operated by removing the ovaries and then followed by total hysterectomy. Just when she thought she is well into life, her cancer reappeared. The metastasized fragments of the cancer cells have developed bigger that was causing her problem. The constant bouts of pain, nausea, intestinal obstruction made her difficult to carry on her activities. She didn’t like narcotics because they made her feel drowsy and weak that’s why she was just taking Tylenol. Then after few months, Atul gets a note from Douglass’s daughter which read ‘Mom died on Friday morning. She drifted quietly to sleep and took her last breath. It was peaceful. My dad was alone by her side with the rest of us in the living room. This was such a perfect ending and in keeping with the relationship they shared.’ Thus, she ended her life which she wanted since the inception of this disease.

Sara Thomas who was just thirty four and pregnant with her first child when the doctors learned that she was going to die. It started with a cough and pain in her back. Then a chest X-ray showed that her left lung had collapsed and her chest was filled with fluid. A sample of the fluid was  drawn off with a long needle and send for testing. Instead of an infection, as everyone was suspecting, it was a lung cancer and had already spread to the lining of her chest. The oncologist broke that she had a non-small cell lung cancer that had started in her left lung. Nothing she had done had brought the disease on. More than 15% of lung cancers occur in nonsmokers. Hers was advanced, having metastasized to multiple lymph nodes in her chest and its lining. The cancer was inoperable but there was an option of chemotherapy which she was started with. But, the chemo failed and the lung cancer had spread from the left chest to the right, to the liver, to the lining of her abdomen, and to her spine. Time was running out and later on after successive failure on using three different regimen of chemotherapy, she died.  

Again, howsoever you live a happy life by the progressing old age, a person becomes forced to take assistance. Independence is lost. Willingly or unwillingly a person has to accept what others think is best for him/her instead of the person himself taking a decision himself/ herself. Sometimes old age is a curse and sometimes it is not.  

  

One morning, Alice had a fall while alone in her apartment. She was not found until many hours later when Nan, who was puzzled at not being able to reach her by phone, sent Jim to investigate. He discovered that Alice laid out beside the living room couch, nearly unconscious. There was no explanation for her fall beyond general frailty.

Though the concept of nursing homes and assisted living homes have improved and helped people in getting the care they actually required, family support and home treatment still serves as a satisfaction in old age.

The book Being Mortal not only teaches the importance of time but also the fate of medicine and the limitation of medical studies. No one wants to die with pain. Everyone of us will want to live a happy life without any stress, without any problems, without any diseases or without any insecurities. Although we do not want any of them, Life is tragic and unpredictable. Sometimes it is too late when we learn we have an chronic incurable disease and sometimes it happens that we are lucky enough to get cured of them.

The book also describes about the hospice and palliative care team and the care provided by them to the terminally ill patients so as to provide them as much as comfort as possible.

This book is among one of those books I would like to recommend everyone to read.

Go and grab it if you haven’t read it yet.

P.S.- Depends on the taste you have on books.

Overall rating- 4.5/5