LibGuides: Islington Branch Book Club: "Being Mortal" by Atul Gawande

About the Author: Atul Gawande

Atul Gawande, born on November 5, 1965, in Brooklyn, New York, is an American surgeon, writer, and public health researcher. He is best known for his contributions to the fields of medicine, healthcare policy, and medical journalism.

Gawande graduated magna cum laude from Harvard University in 1987 with a Bachelor of Science degree in biology and political science. He then attended the University of Oxford as a Rhodes Scholar, earning a Master of Arts degree in philosophy, politics, and economics. He continued his education at Harvard Medical School, where he received his Doctor of Medicine (M.D.) degree in 1995.

Following medical school, Gawande completed his surgical residency at Brigham and Women's Hospital in Boston, Massachusetts. He also earned a Master of Public Health degree from the Harvard T.H. Chan School of Public Health.

Throughout his career, Gawande has held various roles in both clinical medicine and academia. He is a practicing general and endocrine surgeon at Brigham and Women's Hospital and is a professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health. He has also served as a staff writer for The New Yorker magazine since 1998, where he writes about healthcare, medicine, and public health issues.

Gawande is the author of several bestselling books, including "Complications: A Surgeon's Notes on an Imperfect Science" (2002), "Better: A Surgeon's Notes on Performance" (2007), "The Checklist Manifesto: How to Get Things Right" (2009), and "Being Mortal: Medicine and What Matters in the End" (2014). His books have received critical acclaim for their insightful exploration of the complexities of modern medicine and healthcare delivery.

In addition to his writing and clinical work, Gawande has been actively involved in healthcare policy and research. He has served as a consultant to the World Health Organization and the Clinton Health Access Initiative, and he was appointed by President Barack Obama as a member of the President's Council on Fitness, Sports, and Nutrition.

Gawande's contributions to medicine and public health have been widely recognized. He has received numerous awards and honors, including the MacArthur Fellowship (also known as the "Genius Grant") in 2006 and the Lewis Thomas Prize for Writing about Science in 2011.

Synopsis

In Being Mortal, bestselling author Atul Gawande tackles the hardest challenge of his profession: how medicine can not only improve life but also the process of its ending Medicine has triumphed in modern times, transforming birth, injury, and infectious disease from harrowing to manageable. But in the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit. Nursing homes, preoccupied with safety, pin patients into railed beds and wheelchairs. Hospitals isolate the dying, checking for vital signs long after the goals of cure have become moot. Doctors, committed to extending life, continue to carry out devastating procedures that in the end extend suffering. Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families. Gawande offers examples of freer, more socially fulfilling models for assisting the infirm and dependent elderly, and he explores the varieties of hospice care to demonstrate that a person's last weeks or months may be rich and dignified. Full of eye-opening research and riveting storytelling, Being Mortal asserts that medicine can comfort and enhance our experience even to the end, providing not only a good life but also a good end.

Discussion Questions

How does Atul Gawande redefine what it means to "be mortal" in the context of his book? How does this definition challenge traditional notions of aging and mortality?
Gawande discusses the medicalization of aging and dying in modern society. What are some examples of this medicalization, and what are its implications for the quality of life of elderly individuals?
One of the key themes in the book is the importance of autonomy and dignity in end-of-life care. How does Gawande illustrate the significance of these principles through personal stories and examples?
Gawande introduces the concept of the "end of life conversation" and emphasizes its importance in ensuring that patients' values and preferences are respected. Why are these conversations often difficult, and what strategies does Gawande propose for initiating them effectively?
The book explores various models of care for elderly and terminally ill individuals, including nursing homes, assisted living facilities, and hospice care. What are the strengths and weaknesses of each model, and how do they impact patients' quality of life?
Gawande discusses the role of technology and medical interventions in end-of-life care. How do advances in medicine sometimes conflict with patients' desires for autonomy and dignity, and how can these conflicts be addressed?
Throughout the book, Gawande shares personal anecdotes and experiences from his own medical practice. How do these stories contribute to the larger themes and arguments presented in "Being Mortal"?
Gawande examines the concept of "good death" and challenges traditional notions of what constitutes a "good death." How does he redefine this concept, and what factors does he argue are most important in achieving a good death?
The book raises questions about the role of family members and caregivers in end-of-life decision-making. How can family dynamics and relationships influence these decisions, and what support systems are necessary to ensure that patients' wishes are respected?
Gawande advocates for a shift in cultural attitudes toward aging and dying. What changes does he propose at the societal level to improve end-of-life care and support for elderly individuals?

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Modern Death by Haider Warraich
Call Number: 179.7 Warraich
There is no more universal truth in life than death. No matter who you are, it is certain that one day you will die, but the mechanics and understanding of that experience will differ greatly in today's modern age. Dr. Haider Warraich is a young and brilliant new voice in the conversation about death and dying started by Dr. Sherwin Nuland's classic How We Die: Reflections on Life's Final Chapter, and Atul Gawande's recent sensation, Being Mortal: Medicine and What Matters in the End. Dr. Warraich takes a broader look at how we die today, from the cellular level up to the very definition of death itself. The most basic aspects of dying--the whys, wheres, whens, and hows--are almost nothing like what they were mere decades ago. Beyond its ecology, epidemiology, and economics, the very ethos of death has changed. Modern Death, Dr. Warraich's debut book, will explore the rituals and language of dying that have developed in the last century, and how modern technology has not only changed the hows, whens, and wheres of death, but the what of death. Delving into the vast body of research on the evolving nature of death, Modern Death will provide readers with an enriched understanding of how death differs from the past, what our ancestors got right, and how trends and events have transformed this most final of human experiences.
Natural Causes by Barbara Ehrenreich
Call Number: 306.9 Ehrenreich
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Doctored: the Disillusionment of an American Physician by Sandeep Jauhar
Call Number: 610.92 Jauhar
In his acclaimed memoir Intern , Sandeep Jauhar chronicled the formative years of his residency at a prestigious New York City hospital. Doctored , his New York Times bestselling harrowing follow-up, observes the crisis of American medicine through the eyes of an attending cardiologist. Hoping for the stability he needs to start a family, Jauhar accepts a position at a massive teaching hospital on the outskirts of Queens. With a decade's worth of elite medical training behind him, he is eager to settle down and reap the rewards of countless sleepless nights. Instead, he is confronted with sobering truths. Doctors' morale is low and getting lower. Blatant cronyism determines patient referrals, corporate ties distort medical decisions, and unnecessary tests are routinely performed in order to generate income. Meanwhile, a single patient in Jauhar's hospital might see fifteen specialists in one stay and still fail to receive a full picture of his actual condition. Provoked by his unsettling experiences, Jauhar has written an introspective memoir that is also an impassioned plea for reform. With American medicine at a crossroads, Doctored is the important work of a writer unafraid to challenge the establishment and incite controversy.
Spring Chicken by Bill Gifford
Call Number: 613.2 Gifford
From acclaimed journalist Bill Gifford comes a roaring journey into the world of anti-aging science in search of answers to a universal obsession: what can be done about getting old? SPRING CHICKEN: Stay Young Forever (or Die Trying) SPRING CHICKEN is a full-throttle, high-energy ride through the latest research, popular mythology, and ancient wisdom on mankind's oldest obsession: How can we live longer? And better? In his funny, self-deprecating voice, veteran reporter Bill Gifford takes readers on a fascinating journey through the science of aging, from the obvious signs like wrinkles and baldness right down into the innermost workings of cells. We visit cutting-edge labs where scientists are working to "hack" the aging process, like purging "senescent" cells from mice to reverse the effects of aging. He'll reveal why some people live past 100 without even trying, what has happened with resveratrol, the "red wine pill" that made headlines a few years ago, how your fat tissue is trying to kill you, and how it's possible to unlock longevity-promoting pathways that are programmed into our very genes. Gifford separates the wheat from the chaff as he exposes hoaxes and scams foisted upon an aging society, and arms readers with the best possible advice on what to do, what not to do, and what life-changing treatments may be right around the corner. An intoxicating mixture of deep reporting, fascinating science, and prescriptive takeaway, SPRING CHICKEN will reveal the extraordinary breakthroughs that may yet bring us eternal youth, while exposing dangerous deceptions that prey on the innocent and ignorant.
Extreme Measures by Jessica Nutik Zitter
Call Number: 616.029 Zitter
An ICU and Palliative Care specialist featured in the Netflix documentary Extremis offers a framework for a better way to exit life that will change our medical culture at the deepest level In medical school, no one teaches you how to let a patient die. Jessica Zitter became a doctor because she wanted to be a hero. She elected to specialize in critical care--to become an ICU physician--and imagined herself swooping in to rescue patients from the brink of death. But then during her first code she found herself cracking the ribs of a patient so old and frail it was unimaginable he would ever come back to life. She began to question her choice. Extreme Measures charts Zitter's journey from wanting to be one kind of hero to becoming another--a doctor who prioritizes the patient's values and preferences in an environment where the default choice is the extreme use of technology. In our current medical culture, the old and the ill are put on what she terms the End-of-Life Conveyor belt. They are intubated, catheterized, and even shelved away in care facilities to suffer their final days alone, confused, and often in pain. In her work Zitter has learned what patients fear more than death itself : the prospect of dying badly. She builds bridges between patients and caregivers, formulates plans to allay patients' pain and anxiety, and enlists the support of loved ones so that life can end well, even beautifully. Filled with rich patient stories that make a compelling medical narrative, Extreme Measures enlarges the national conversation as it thoughtfully and compassionately examines an experience that defines being human.
Final Exam by Pauline W. Chen
Call Number: 617.092 Chen
A brilliant young transplant surgeon brings moral intensity and narrative drama to the most powerful and vexing questions of medicine and the human condition. When Pauline Chen began medical school twenty years ago, she dreamed of saving lives. What she did not count on was how much death would be a part of her work. Almost immediately, Chen found herself wrestling with medicine's most profound paradox, that a profession premised on caring for the ill also systematically depersonalizes dying. Final Exam follows Chen over the course of her education, training, and practice as she grapples at strikingly close range with the problem of mortality, and struggles to reconcile the lessons of her training with her innate knowledge of shared humanity, and to separate her ideas about healing from her fierce desire to cure. From her first dissection of a cadaver in gross anatomy to the moment she first puts a scalpel to a living person; from the first time she witnesses someone flatlining in the emergency room to the first time she pronounces a patient dead, Chen is struck by her own mortal fears: there was a dying friend she could not call; a young patient's tortured death she could not forget; even the sense of shared kinship with a corpse she could not cast aside when asked to saw its pelvis in two. Gradually, as she confronts the ways in which her fears have incapacitated her, she begins to reject what she has been taught about suppressing her feelings for her patients, and she begins to carve out a new role for herself as a physician and as human being. Chen's transfixing and beautiful rumination on how doctors negotiate the ineluctable fact of death becomes, in the end, a brilliant questioning of how we should live. Moving and provocative, motored equally by clinical expertise and extraordinary personal grace, this is a piercing and compassionate journey into the heart of a world that is hidden and yet touches all of our lives. A superb addition to the best medical literature of our time.