Thursday, January 28, 2016

Being Mortal

The publisher's website with many reviews.  Pick one or two to read and report back here.  Let's not all read the same reviews...
http://atulgawande.com/book/being-mortal/

14 comments:

  1. http://www.bostonglobe.com/arts/books/2014/10/11/book-review-being-mortal-medicine-and-what-matters-end-atul-gawande/JwyaLEIAGOs5guUGBiG2YN/story.html

    I read The Boston Globe’s review of Gawande’s book and I thought it was a well-written review that spoke about several different aspects about “Being Mortal: Medicine and What Matters in the End”. The beginning of the review focuses on the story of Bill Thomas, who proposed the idea to treat old people like people. I think that there are people, whether they are health care workers or not, that just assume since old people are close to dying, that they do not really need attention as much as the young who have their whole life in front of them.

    The main point of Gawande’s book is to make the dying process as comfortable and peaceful as possible, and this should be true regardless of age. I enjoyed the story about Bill Thomas because he was trying to upgrade a nursing home to make it more of a lively place. Thomas ordered 100 parakeets for the nursing home, but the cages arrived unassembled, therefore all the birds flew around and the residents “laughed their butt off”. It is also noted that the death rates and use of sedatives in the nursing home had drastically decreased. This only proves that when the mind is stimulated and activities are provided for the elderly, it promotes living.

    I used to volunteer at a retirement home and it was so incredible to see how much of a difference I could make by just listening to a resident’s story or to sit with them while they did a puzzle. Gawande wrote about how his daughter’s piano teacher who was teaching piano until the day she died and how his grandfather was performing surgeries while dying from a spinal tumor. Nearly all the residents in any nursing home have or will die there, so it’s important that they spend their last part of their life being as human as possible and being happy. It’s all about the quality of life, man.

    ReplyDelete
    Replies
    1. I agree, we need to treat old people as people. There is just an overlying stipulation that they will die soon and we don't need to care for them as much. This is such a social blunder. We need to offer them the same compassionate and loving care as anyone else. They should have some fun too and enjoy the rest of their lives comfortably and peacefully. I hope that all people nearing the final moments of their life are enjoying and spending it the way they want to.

      Delete
  2. "“We have come to medicalize aging, frailty, and death, treating them as if they were just one more clinical problem to overcome. However, it is not only medicine that is needed in one’s declining years but life – a life with meaning, a life as rich and full as possible under the circumstances. Being Mortal is not only wise and deeply moving, it is an essential and insightful book for our times, as one would expect from Atul Gawande, one of our finest physician writers.” – Oliver Sacks"

    The review by Oliver Sacks for Gawande's book caught my eye. He talked about the same aspects of dying that we have gone over in class. The idea that the aging process is not just another medical diagnosis to treat. Its the meaning of the life that is dying. It is the quality of life that is more important. In the book description it points out that its about having a good life not a good death and that that is the medical fields biggest misconception of the dying patient. I believe this book would be a good story for all members of the healthcare field to read. It would transform how they deal with the dying patient and I believe that the quality of life for those in Hospice would increase.

    ReplyDelete
  3. The article I read was called Overkill by Atul Gawande. It focuses on how millions of people on medicare may have received care that was deemed 'simply a waste'. The researchers called it "low-value care". In just a single year, the researchers reported, twenty-five to forty-two per cent of Medicare patients received at least one of the twenty-six useless tests and treatments such as an x-ray, MRI, or EEG. Gawande goes on to say, "Millions of people are receiving drugs that aren’t helping them, operations that aren’t going to make them better, and scans and tests that do nothing beneficial for them, and often cause harm." Extra procedures can sometimes even cause more suffering than the success they were set out to do? Whos at fault here? The doctors? Our medically advanced society? The fact that all of these tests are so easily done with little to no second opinions if the test is really actually needed? Where is the quality care check our country so desperately needs to cut out of the useless spending we chunk up every day? I think that preventative care needs to increase as well as education on health risks being taken everyday. We need to cut down useless spending and start putting that money into check ups, education and preventative care. This is a huge problem today.

    ReplyDelete
  4. http://www.financialexpress.com/article/markets/mortality-matters-being-mortal/4351/

    The article I read was from The Financial Express. I thought it was an interesting review that covered some of the things we have discussed in class. For example, "But here’s the tricky bit—not to mention a trifle confusing one: modern medical regimes today are geared to keep a body alive (or prolong a life to put it more gently) for an indefinite period of time, or till the insurance dries up."
    This brings up the topic of the quantity of life versus the quality of life. The reviewer feels that modern day medicine is just trying to prolong our lives rather than maintain the quality of life. The author also mentions "or until the insurance dries up" inferring that it is all about money the medical institutions are making, rather than the quality of life for the patient.

    I also thought this quote from the reviewer was interesting: "Needless to say, he’s far too sensitive a writer to actually use the words ‘dying’, ‘death’ or ‘dead’. It’s almost as if he knows they might frighten the average reader, particularly those living in America"
    I found it so interesting because I do feel that our society is fearful of death and it is something that is very hard for us to come to terms with and accept it. As a result, instead of calling it "death" Gawande refers to it as "the modern experience of mortality". I think that we need to become more educated on death, it is not that we don't know it is coming one day, but I think if people were more aware then they would not be so fearful of dying.

    ReplyDelete
  5. The article I read was from Live Mint (E-paper).
    http://www.livemint.com/Leisure/t92j4Tfn3uAtj5qO83MVBN/Being-Mortal--Atul-Gawande.html

    I found this review interesting, it brought up many of the points that we discussed in class. It refers to Gawnade stating " I learned about a lot of things in medical school, but mortality wasn't one of them". I found this interesting, he went on to state that doctors are exposed to death but become used to it and never learn the truth of mortality. He ultimately says they learn to slow death from occurring. Its interesting that doctors don't truly learn the concept of mortality, they don't know what that person is feeling and they aren't taught to think of death as something that you might have to let happen if that is what the patient wants. They are taught that it is something you prolong, try to avoid from happening and for some people that just might not be what they want.

    This article also brings up the fact that when Gawande had to come to terms with his own fathers mortality he was at a loss for a decision. Even though he makes that same decision for people constantly. I think that shows that until a doctor has it happen to them they will never fully grasp the concept of mortality. They might on a biological level, but I don't think they will on an emotional level.

    On the other side this article shows that doctors truly do view this as a hard choice to make, they don't want to see someone suffering but they are taught to prolong life. I agree with what this review states that being mortal and medicine is what actually matters in the end. Medicine should be one thing and it should be used if it can be, but if it is just to prolong suffering, the doctor should be mortal enough to allow the patient to choose.


    ReplyDelete
  6. http://time.com/3485136/atul-gawande-being-mortal/

    The review article that I read was from TIME. Overall, I thought that the article was interesting and very well written. Quinn Cummings focused his review mainly on the point that the book is explaining and encouraging people to try and live their life to the fullest to make our final years of life meaningful. He commented on the book saying, "Being Mortal is a clear-eyed, informative exploration of what growing old means in the 21st century; it provides a useful roadmap of what we can and should be doing to make the last years of life meaningful for everyone experiencing the aging process up close."
    I definitely believe that it is important for people to try and live life to the fullest and make the most of it. From what his comment on the book says, I think he is trying to say also that dying knowing that you lived a quality life is important, because a quality of life is a life well lived.
    Quinn also took a quote from the book:
    "People with serious illnesses have priorities besides simply prolonging their lives. Surveys find that their top concerns include avoiding suffering, strengthening relationships with family and friends, being mentally aware, not being a burden on others and achieving a sense that their life is complete. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars. The question therefore is not how we can afford this system’s expense. It is how we can build a health care system that will actually help people achieve what’s most important to them at the end of their lives."
    I think from what he says at the end really hits the point that even though our healthcare system is trying to prolong the quantity of life, they should also focus on what the patient wants and try and help them having a meaningful life in their final days.
    So basically the review talks about how we should try and make the most of our life even during the dying and aging process.

    ReplyDelete
  7. http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/47971
    I read the MedPage Today review. I thought it was an interesting read and very friendly for a generic audience. Anyone would be able to benefit from this article. What I found particularly interesting was when the author says "One of the most striking features of Gawande's writing is his choice of pronoun throughout the book: we and us.". To me I understood this to mean that one day we will end up in declining health just like so many of the patients that Dr. Gawande describes. Our scenarios will all be different and there's no telling where our paths may lead, one thing if for certain though is that death awaits all of us. Sometimes it is just more patient that others.

    A point I found very valuable to myself was "Gawande's vulnerability is counterbalanced by his sense of optimism. He does not downplay hardships, but he does offer insights and solutions. The hope that surfaced throughout his book Better pervades his latest as well." With experiencing death within my own family, I fully understand how these families feel. I appreciate the view that Gawande has and feel like is it better for your own spiritual health to cope with this the way that Gawande suggests.

    ReplyDelete
  8. The article I read was “The best possible day”, I found this one to be very interesting. Within in the article Gawande proposes that we as people and health care providers have failed to recognize that people have priorities that they need us to serve besides just living longer. I completely agree with this, more often than not it seems we are always focused on the time frame in which death will come. Patients should be asked what their understanding of their health/condition is and if they have any goals for their future despite their condition or the amount of time they may have left. One of our first days in class we watched a video of a woman who’s only wish or goal for her future was to make it long enough to go on one last family vacation with her family to Disney world. Prolonging life shouldn’t always be about focusing on living as long as you possibly can. Maybe it’s just making it to your daughter’s graduation or your sons wedding or to one last “best day ever”. Regardless this article touched on making sure that patients are simply asked their thoughts and that they are completely informed about their condition. I thought it was very sweet that Peg got to choose to live the rest of her days at home, teaching, what she loved to do. If medicine can prolong someone to their last final goal on earth then who are we to take away from that?

    ReplyDelete
  9. I read the article called Testing, Testing. The article talks about the gaps in medical coverage and what will happen if we are unable to accommodate the amount of money needed to support Medicare and Medicaid. The reform for medical coverage is supposed to help lower cost however few believe it actually will. The problem is finding the funds to treat people while maintaining a budget due to the fact that health care cost have gone up but the money supply for the health care is being depleted very rapidly. The article then goes on to say that we might have a chance to see improvement if history is able to repeat itself. In 1900 the agriculture crisis was in deep frustration because the cost of food was so high. The U.S recognized this as an issue and tries an experiment that was very successful. They gave a farmer advice and technology to improve the way his crops would grow and sure enough he was successful. Eventually farmers were all taking the advice and were able to produce enough crops that the price of food was decreased by 50%. Furthermore the article goes on to say that the government was not the reason that agriculture was successful but the work of the famers guided by the government. The article says that we have so many problems with healthcare that we are not able to limit one area to compensate for another. If we are able to guide the healthcare system into better strategies then we might have a fighting chance to overcome the amount of money spent and accumulated for health care cost.

    ReplyDelete
  10. http://www.slate.com/articles/health_and_science/medical_examiner/1997/10/drowsy_docs.2.html

    The second article I found called Drowsy Docs suggest a study on people who are sleep deprived. A recent study shows that people who have lack of sleep are at risk for hurting others. The examples given are truck drivers, piolets and doctors. The study showed that doctor who are taking care of patients, are no different than a truck drivers and piolets driving drunk. A lack of sleep can cause people to become fatigued, think unclear, memory deficits, and be in a foul mood. Why is it ok for a doctor to be sleep deprived but not a truck driver? The answer in my opinion is that it is not. Looking at both situations people are still at risk of being hurt. Either truck drivers kill people by swerving on the road or doctors making mistakes because they are sleep deprived.

    ReplyDelete
    Replies
    1. I also read this article and found it to be very interesting and informative! A topic worth thinking about

      Delete
  11. http://time.com/3485136/atul-gawande-being-mortal/

    I read a review called “A Book about Dying Tells You How to Live” in TIME magazine by Quinn Cummings. The author feels that the work by Dr. Gawande should be mandatory for Americans to read at some time in their lives. The book is about the elder generation- how we care for them and the general process of getting old and dying. This book outlines what it means to ‘grow old’ in today’s world. The author expresses their liking of the book and shares several passages that are of meaning to them. One particular passage the reviewer points out is “People with serious illnesses have priorities besides simply prolonging their lives. Surveys find that their top concerns include avoiding suffering, strengthening relationships with family and friends, being mentally aware, not being a burden on others and achieving a sense that their life is complete. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars. The question therefore is not how we can afford this system’s expense. It is how we can build a health care system that will actually help people achieve what’s most important to them at the end of their lives”. This book is talked about regarding topics of aging and dying is more so a book about how to live. I thought this article to be very well written and informative. Gawande’s work seems to be very interesting and worth looking into.

    ReplyDelete
  12. I read the review from Live Mint. It was very well written and captured the novel well. The author spoke of the need for increased geriatric care in the healthcare system today because of the longer lifespan that most individuals have. He also spoke of Sara Thomas Monopoly, the woman diagnosed with lung cancer while pregnant and how the focus is often on living a "good life" rather than having a "good death." We often focus on what we are doing while we are alive but how often does that coincide with living a good life? The author also went into depth on Dr. Gawande's thoughts on teaching or learning morality as a healthcare professional. He expresses what Gawande said about being taught many things, but morality not being one of them and that doctors should have an understanding of morality in their practice.

    ReplyDelete