mapppy's review against another edition
5.0
Very interesting, makes you think about death differently
martynahanna's review against another edition
5.0
I have always had, for lack of a better word, a fascination with ageing, and this book has added another dimension to my understanding of the process, and a holistic, most humane approach to it.
What really matters in the end is the autonomy, the authorship of one's own life. A lot to think about still, but Gawande also gives some excellent references for further research.
What really matters in the end is the autonomy, the authorship of one's own life. A lot to think about still, but Gawande also gives some excellent references for further research.
shoelaceofdoom's review against another edition
5.0
If you are aging or know someone who is aging in America, you should read this book. Heck, you should read this book anyway. It is superb.
Gawande addresses what he points out to be medicine’s most financially and vitally costly failure— its inexorable focus on health over well-being. Modern medicine has, in his view, been dedicated to life-prolonging measures— treatments intended to push the brink of death further from where we stand now. But, he questions whether this is the appropriate goal of medicine in all cases, raising questions of medical futility and drawing the potent distinction between health and well-being. His arguments particularly concern our treatment of the elderly both societally and medically.
In more traditional societies, like the one where his own grandfather was aging, social structures revolve around the care of elders, enabling many elderly people to preserve their quality of life until their ends. Active until the very end, his grandfather died at 110 as the result of falling off a bus he was trying to ride into town for his business. While this is not necessarily the norm, one can appreciate the stark difference between this aging process and the one experienced by his wife’s grandmother, whose autonomy gradually diminished as she aged and fell multiple times in her home, was moved from her home into a care facility that did not provide for her psychosocial needs, and eventually died in a skilled nursing facility after less than a year of having lived there.
Ultimately if elder care facilities fail to cater to the needs of the population they intend to serve, it is because these institutions (as he says): “address any number of societal goals— from freeing up beds to taking burdens off families’ hands to coping with poverty among the elderly— but never the goal that matters to the people who reside in them: how to make life worth living when we’re weak and frail and can’t fend for ourselves anymore.” (p 77)
But an equally important problem he points to is that the medical profession does not train its constituents to face mortality. He describes the understandable discomfort he and his colleagues have felt in addressing mortality head-on with patients, particularly those who are young. Doctors feel pressured to understate the severity of a patient’s prognosis, perhaps for the simple reason that it is difficult to look at someone in distress and tell them that they will soon die. But the fortitude to be frank does not have to come at the expense of compassion, and in fact, he describes how often the compassionate thing to do is to recognize what truly matters to people in the end— being as comfortable as possible and surrounded by their loved ones.
Gawande addresses what he points out to be medicine’s most financially and vitally costly failure— its inexorable focus on health over well-being. Modern medicine has, in his view, been dedicated to life-prolonging measures— treatments intended to push the brink of death further from where we stand now. But, he questions whether this is the appropriate goal of medicine in all cases, raising questions of medical futility and drawing the potent distinction between health and well-being. His arguments particularly concern our treatment of the elderly both societally and medically.
In more traditional societies, like the one where his own grandfather was aging, social structures revolve around the care of elders, enabling many elderly people to preserve their quality of life until their ends. Active until the very end, his grandfather died at 110 as the result of falling off a bus he was trying to ride into town for his business. While this is not necessarily the norm, one can appreciate the stark difference between this aging process and the one experienced by his wife’s grandmother, whose autonomy gradually diminished as she aged and fell multiple times in her home, was moved from her home into a care facility that did not provide for her psychosocial needs, and eventually died in a skilled nursing facility after less than a year of having lived there.
Ultimately if elder care facilities fail to cater to the needs of the population they intend to serve, it is because these institutions (as he says): “address any number of societal goals— from freeing up beds to taking burdens off families’ hands to coping with poverty among the elderly— but never the goal that matters to the people who reside in them: how to make life worth living when we’re weak and frail and can’t fend for ourselves anymore.” (p 77)
But an equally important problem he points to is that the medical profession does not train its constituents to face mortality. He describes the understandable discomfort he and his colleagues have felt in addressing mortality head-on with patients, particularly those who are young. Doctors feel pressured to understate the severity of a patient’s prognosis, perhaps for the simple reason that it is difficult to look at someone in distress and tell them that they will soon die. But the fortitude to be frank does not have to come at the expense of compassion, and in fact, he describes how often the compassionate thing to do is to recognize what truly matters to people in the end— being as comfortable as possible and surrounded by their loved ones.
buthainna's review against another edition
2.0
this is not a bad book. I just personally did not enjoy it. It was not what I expected it to be. I thought it would be a lot more philosophical and self reflecting, and even though it was that way at times, it was mostly about palliative care, and nursing homes and caring for the elderly and what it is that matter is most to people at the end of their lives, and how we as medical professionals should deal with it.
it was almost mind numbingly boring at times, and if I hadn't had the audiobook then I probably would never have finished reading it.
it was almost mind numbingly boring at times, and if I hadn't had the audiobook then I probably would never have finished reading it.
asyaqub's review against another edition
informative
reflective
sad
medium-paced
5.0
I decided to finally read this book after my ICU rotation. It was a very difficult and emotional month for me as I watched patients die every day. Over and over again I heard from families how their loved one would not have wanted this, to be hooked up to ventilators and dialysis machines and dying in an ICU instead of at home with their families. That experience made me think about what I would want if I were in that situation and led to conversations with my parents about what they would want if it ever came to the point that I was the one making decisions about their medical care. I encourage people to read this book and think about what you would want for yourself and your loved ones before you are actively at the point of having to make those decisions. I truly hope we find a way in our system to care for the elderly and dying with dignity.
charlotte113's review against another edition
emotional
informative
slow-paced
3.5
Gawande gives an insight into how difficult balancing quality of life and length of life can be in palliative care and as a doctor. Through stories of care homes, assisted living and cancer patients, he illustrates how care is adapted for different patients, but how ultimately all care should move towards supporting the patient's wants and needs, even if it goes against the traditional means of medicine.
oniki3crimzen's review against another edition
dark
emotional
funny
informative
inspiring
reflective
medium-paced
4.5