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Being Mortal: Medicine and What Matters in the End    by Atul Gawande order for
Being Mortal
by Atul Gawande
Order:  USA  Can
Metropolitan, 2014 (2014)
Hardcover, CD, e-Book
* * *   Reviewed by Hilary Williamson

Atul Gawande, a practicing surgeon is well known for his previous bestselling books on medical matters - Better: A Surgeon's Notes on Performance, Complications: A Surgeon's Notes on an Imperfect Science, and The Checklist Manifesto: How to Get Things Right. He brings the same common sense, sensibility and acquired wisdom to Being Mortal: Medicine and What Matters in the End.

Gawande tells us 'This is a book about the modern experience of mortality - about what it's like to be creatures who age and die, how medicine has changed the experience and how it hasn't, where our ideas about how to deal with our finitude have got the reality wrong.' What I really appreciate about him as both physician and author is that he's unafraid to admit uncertainty and doubt, and to delve into these issues with a journalistic depth, breadth and objectivity.

He uses examples throughout - including the personal experience of the decline and death of his previously very active father - to look at loss of independence and decision making as we age, and what that experience was like historically and in different cultures. He tells the story of aging in both medical and very human terms, and gives us the undervalued geriatrician's perspective, as well as clarifying the objectives of hospice care, where a simplification of medical interventions actually seems to extend life, rather than to hasten death.

He looks at the evolution of nursing homes and assisted living facilities and makes clear why our elders fear ending up in most of them. And he opens up some hope by telling us about fairly recent experiments that provide better alternatives in which professionals who offer them 'believe their job is not to confine people's choices, in the name of safety, but to expand them, in the name of living a worthwhile life.' And he addresses the controversial topic of assisted suicide, both pros and cons.

If you are nearing the last quarter of life or have a loved one with the probability of serious decline and/or death looming, then Being Mortal is a must read. While it brings out worrisome realities of treatment of the elderly (and others facing the end of life) it also lets us know that better options are being vigorously pursued, and gives guidance on how to handle the inevitable tough decisions that we and our families will all face - in time.

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