Being Mortal

#1 New York Times Bestseller 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.

This review of Being Mortal: Medicine and What Matters in the End by Atul Gawande provides a chapter by chapter detailed summary followed by an analysis and critique of the strengths and weaknesses of this book. Gawande draws on clinical studies, case histories and stories from his own experiences as a doctor and a son to illuminate the subject of mortality relative to modern medical systems. His treatment of the subject covers a broad range of institutions and individuals that shape the lives of the aged and terminally ill. The central thesis of the book is that the experience of the end of life has been problematized and addressed by medical models that place extending life over quality of life and institutional frameworks that place safety and efficiency over the ability for people to have autonomy over the last part of their lives. Gawande is a surgeon at Brigham and Women's Hospital and a professor at the Harvard Medical School. He is a writer at The New Yorker magazine and author of three New York Times bestselling books. Download your copy today! Available on PC, Mac, smart phone, tablet or Kindle device. (c) 2015 All Rights Reserved

The New York Times bestselling author of Being Mortal and Complications reveals the surprising power of the ordinary checklist We live in a world of great and increasing complexity, where even the most expert professionals struggle to master the tasks they face. Longer training, ever more advanced technologies—neither seems to prevent grievous errors. But in a hopeful turn, acclaimed surgeon and writer Atul Gawande finds a remedy in the humblest and simplest of techniques: the checklist. First introduced decades ago by the U.S. Air Force, checklists have enabled pilots to fly aircraft of mind-boggling sophistication. Now innovative checklists are being adopted in hospitals around the world, helping doctors and nurses respond to everything from flu epidemics to avalanches. Even in the immensely complex world of surgery, a simple ninety-second variant has cut the rate of fatalities by more than a third. In riveting stories, Gawande takes us from Austria, where an emergency checklist saved a drowning victim who had spent half an hour underwater, to Michigan, where a cleanliness checklist in intensive care units virtually eliminated a type of deadly hospital infection. He explains how checklists actually work to prompt striking and immediate improvements. And he follows the checklist revolution into fields well beyond medicine, from disaster response to investment banking, skyscraper construction, and businesses of all kinds. An intellectual adventure in which lives are lost and saved and one simple idea makes a tremendous difference, The Checklist Manifesto is essential reading for anyone working to get things right.

NATIONAL BESTSELLER The New York Times bestselling author of Being Mortal and Complications examines, in riveting accounts of medical failure and triumph, how success is achieved in a complex and risk-filled profession The struggle to perform well is universal: each one of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In this book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable. Gawande's gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors' participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable. At once unflinching and compassionate, Better is an exhilarating journey narrated by "arguably the best nonfiction doctor-writer around" (Salon). Gawande's investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.

A brilliant and courageous doctor reveals, in gripping accounts of true cases, the power and limits of modern medicine. Sometimes in medicine the only way to know what is truly going on in a patient is to operate, to look inside with one's own eyes. This book is exploratory surgery on medicine itself, laying bare a science not in its idealized form but as it actually is -- complicated, perplexing, and profoundly human. Atul Gawande offers an unflinching view from the scalpel's edge, where science is ambiguous, information is limited, the stakes are high, yet decisions must be made. In dramatic and revealing stories of patients and doctors, he explores how deadly mistakes occur and why good surgeons go bad. He also shows us what happens when medicine comes up against the inexplicable: an architect with incapacitating back pain for which there is no physical cause; a young woman with nausea that won't go away; a television newscaster whose blushing is so severe that she cannot do her job. Gawande offers a richly detailed portrait of the people and the science, even as he tackles the paradoxes and imperfections inherent in caring for human lives. At once tough-minded and humane, Complications is a new kind of medical writing, nuanced and lucid, unafraid to confront the conflicts and uncertainties that lie at the heart of modern medicine, yet always alive to the possibilities of wisdom in this extraordinary endeavor. Complications is a 2002 National Book Award Finalist for Nonfiction.

The Buddhist approach to death can be of great benefit to people of all backgrounds—as has been demonstrated time and again in Joan Halifax’s decades of work with the dying and their caregivers. Inspired by traditional Buddhist teachings, her work is a source of wisdom for all those who are charged with a dying person’s care, facing their own death, or wishing to explore and contemplate the transformative power of the dying process. Her teachings affirm that we can open and contact our inner strength, and that we can help others who are suffering to do the same.

In 1906 and 1907 I gave, as a part of my regular work at the Summer School of Harvard University, an “Introduction to Ethics, with Special. Reference to the Interests of Teachers” A few lectures, summing up the main principles that lay at the basis of this ethical course as it had been given in the summer of 1906, were delivered in January and February, 1907, before a general academic audience, during a brief visit of mine at the University of Illinois. In several other places, both in the West and in the East, I have also presented portions of my views upon ethics; and in the summer of 1907 four general lectures on the topic were repeated before the Summer School of Theology at Harvard. In November and December of 1907, the lectures that constitute the present book were delivered for the first time before the Lowell Institute in Boston. visiting lecturer, to give to undergraduate students at Yale University in weekly class meetings. The present book, although in this way related to present and past academic tasks, is, nevertheless, not a text-book, and does not mean to be elaborately technical philosophical research. It is simply an appeal to any reader who may be fond of ideals, and who may also be willing to review his own ideals in a somewhat new light and in a philosophical spirit. Loyalty is indeed an old word, and to my mind a precious one; and the general idea of loyalty is still far older than the word, and is immeasurably more precious. But this idea has nearly always been confused in men's minds by its chance social and traditional associations. Everybody has heard of loyalty; most prize it; but few perceive it to be what, in its inmost spirit, it really is, —the heart of all the virtues, the central duty amongst all duties. In order to be able to see that this is the true meaning of the idea of loyalty, one has to free this idea from its unessential if somewhat settled associations with this or that special social habit or circumstance. And in order to accomplish this latter end, one has indeed to give to the term a more exact meaning than popular usage defines. It is this freeing of the idea of loyalty from its chance and misleading associations; it is this vindication of the spirit of loyalty as the central spirit of the moral and reasonable life of man, —t is this that I believe to be somewhat new about my “Philosophy of Loyalty” The conception of “Loyalty to Loyalty”, as set forth in my third lecture, constitutes the most significant part of this ethical task. For the rest, if my philosophy is, as a theory, more or less new, I am still only trying to make articulate what I believe to be the true spirit and meaning of all the loyal, whoever they may be, and however they define their fidelity. The result of conceiving duty in terms of the conception of loyalty which is here expounded is, indeed, if I am right, somewhat deep-going and transforming, not only for ethics, but for most men's views of truth and reality, and of religion. My own general philosophical opinions have been set forth in various works some time since (most elaborately in the volumes entitled “The World and the Individual”). I have no change to report in my fundamental metaphysical theses. But I have not published any formulation of my ethical opinions since the brief review of ethical problems in the first part of my “Religious Aspect of Philosophy” (published in 1885). One learns a good deal about ethics as one matures. And I believe that this present statement of mine ought to help at least some readers to see that such philosophical idealism as I have long maintained is not a doctrine remote from life, but is in close touch with the most practical issues; and that religion, as well as daily life, has much to gain from the right union of ethics with a philosophical theory of the real world. At the moment there is much speech, in current philosophical literature, regarding the “nature of truth“ and regarding “pragmatism” An ethical treatise very naturally takes advantage of this situation to discuss the relation between the “practical” and —the Eternal. I have done so in my closing lectures. In order to do so, I have had to engage in a certain polemic regarding the problem of truth, —a polemic directed against certain opinions recently set forth by one of the “dearest of my friends, and by one of the most loyal of men; my teacher for a while in my youth; my honoured colleague for many years, —Professor William James. Such a polemic would be indeed much out of place in a book upon Loyalty, were it not that my friend and myself fully agree that, to both of us, truth indeed “is the greater friend” Had I not very early in my work as a student known Professor James, I doubt whether any poor book of mine would ever have been written, —least of all the present one. What I personally owe him, then, I most heartily and affectionately acknowledge. But if he and I do not see truth in the same light at present, we still do well, I think, as friends, each to speak his mind as we walk by the way, and then to wait until some other light shines for our eyes. I suppose that so to do is loyalty. Meanwhile, I am writing, in this book, not merely and not mainly for philosophers, but for all those who love, as I said, ideals, and also for those who love, as I may now add, their country, —a country so ripe at present for idealism, and so confused, nevertheless, by the vastness and the complication of its social and political problems. To simplify men's moral issues, to clear their vision for the sight of the eternal, to win hearts for loyalty, —this would be, in this land, a peculiarly precious mission, if indeed I could hope that this book could aid, however little, towards such an end. Amongst the numerous friends to whom (whether or no they agree with all my views) I am especially indebted for direct and indirect aid in preparing this book, and for criticisms and other suggestions, I must mention: first, my wife, who has constantly helped me with her counsel, and in the revision of my text; then, my sister, Miss Ruth Royce, of San José, California, with whom I discussed the plan of the work in the summer of 1907; then, Doctor and Mrs. R. C. Cabot of Boston; Doctor J. J. Putnam of Boston; and, finally, my honoured colleague, Professor George H. Palmer....FROM THE BOOKS.

#1 NEW YORK TIMES BESTSELLER • PULITZER PRIZE FINALIST • This inspiring, exquisitely observed memoir finds hope and beauty in the face of insurmountable odds as an idealistic young neurosurgeon attempts to answer the question What makes a life worth living? NAMED ONE OF PASTE’S BEST MEMOIRS OF THE DECADE • NAMED ONE OF THE BEST BOOKS OF THE YEAR BY The New York Times Book Review • People • NPR • The Washington Post • Slate • Harper’s Bazaar • Time Out New York • Publishers Weekly • BookPage Finalist for the PEN Center USA Literary Award in Creative Nonfiction and the Books for a Better Life Award in Inspirational Memoir At the age of thirty-six, on the verge of completing a decade’s worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor treating the dying, and the next he was a patient struggling to live. And just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air chronicles Kalanithi’s transformation from a naïve medical student “possessed,” as he wrote, “by the question of what, given that all organisms die, makes a virtuous and meaningful life” into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality. What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir. Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. “I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything,” he wrote. “Seven words from Samuel Beckett began to repeat in my head: ‘I can’t go on. I’ll go on.’” When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both.