Overview
Gawande, a surgeon and writer, examines how modern medicine handles ageing and dying — and argues that it handles both badly. The book draws on interviews with geriatricians, hospice workers, and Gawande's own father's decline and death.
Gawande is a surgeon at Brigham and Women's Hospital, a public-health researcher, and a longtime New Yorker writer. Being Mortal, published in 2014, grew out of his observation that neither his medical training nor the institutions he worked in had prepared him to help dying patients. The book was adapted into a PBS Frontline documentary and is widely used in medical school curricula.
Key Ideas
Medicine's mission drift
Modern medicine treats ageing and death as problems to be solved rather than conditions to be lived with.
The nursing home problem
Most institutions for the elderly are designed for safety and staff convenience, not for lives worth living.
Hard conversations
The willingness of doctors to have honest end-of-life conversations dramatically changes outcomes and satisfaction.
What matters most
When asked, dying patients typically name goals — a last holiday, a grandchild's wedding — that intensive intervention makes impossible.
Hospice over hospital
Hospice care often produces better quality of life and, in some cases, longer life than aggressive treatment.
Who should read this
Anyone with ageing parents, or anyone who expects to age themselves. The book is essential for doctors, nurses, and caregivers, but its audience is really everyone — Gawande's quiet argument is that a good death is not something medicine can provide alone; it requires choices we have to make ourselves.
Who might skip it
Skip if you are currently caring for a dying family member and do not have the capacity to sit with this material right now. The book is not consoling in the sentimental sense; its consolation comes through clarity.
The verdict
One of the most important books on medicine published this century. Gawande is a careful writer and an honest physician, and the chapters on his father's illness are some of the most moving writing about a parent's death I have ever read. The book will change how you talk to your doctor and to your family.
We've been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being.
— Atul Gawande, Being Mortal
If you liked this
The Checklist Manifesto for Gawande's book on procedural medicine. When Breath Becomes Air by Paul Kalanithi for a related memoir.