This one’s for you if you’re interested in how western medicine treats elderly patients, and approaches palliative care. But really this one is for everyone, because we all die, and we should all prepare for it as best we can.
“Being Mortal” was the most thought provoking book I have read in years. As an aspiring medic, it made me question the purpose and meaning of the profession. It will make you realise, or confirm your belief, that medicine shound not be about elongating life at all costs. Moreover, it presents fascinating alternatives to conventional care, such as bringing animals into nursing homes for the residents to take care of (p125 below) and combining the need for after school care for children and the need of the elderly for company and stimulation. I realise that I have included quite a lot of quotes here, but I think each and every one is important and it’s worth getting to the bottom of this post!
“In my grandfather’s pre modern world, how he wanted to live was his choice, and the family’s role was to make it possible.” p16
“Old age is a continuous series of losses.” p55
“He had one great solace…that she’d got to spend her last few weeks in peace at home in the warmth of their long love, instead of up on a nursing floor, a lost and disoriented patient.” p59
“As medicine became more powerful, the modern hospital brought a different idea…You checked in any gave over every part of your life to doctors and nurses: what you wore, what you ate, what went into the different parts of your body and when.” p70
“She woke when they told her, bathed and dressed when they told her, ate when they told her…like she was in prison for being old.” p73
“If there’s anything a decent nursing home is built for, it is safety…The trouble was that she expected more from life than safety.” p74
“Your chances of avoiding the nursing home are directly related to the number of children you have…having at least one daughter seems to be crucial to the amount of help you will receive.” p79
“As your horizons contract…your focus shifts to the here and now, to everyday pleasures and the people closest to you.” p97
“Many of the things that we want for those we care about are things that we would adamantly oppose for ourselves because they would infringe upon our sense of self” p106. This is written in the context of when children become in charge of their parent’s care. The top priority for the child when looking at nursing homes tends to be safety, and as above, safety is not what makes people happy.
“If place of boredom, they [living things] offer spontaneity. In place of loneliness, they offer companionship. If place of hopelessness, they offer a chance to take care of another being” p125
A systematic campaign to encourage doctors to discuss the end of life, involved the questions: “Do you want to be resuscitated if your heart stops? Do you want aggressive treatment like intubation and mechanical ventilation? Do you want antibiotics? Do you want intravenous feeding if you can’t eat?” p179
“People die only once. They have no experience to draw on. They need doctors and nurses…who will help people prepare for what is to come- and escape a warehoused oblivion few really want.” p188
“Instead of holding on to the lifelong identity that was slipping away from him, he managed to redefine it.” p210
“Technological society has forgotten what scholars call the “dying role”…people want to share memories, pass on wisdoms and keepsakes, settle relationships, establish their legacies, make peace with God, and ensure that those who are left behind will be okay. They want to end their stories on their own terms…the way we deny people this role, out of obtuseness and neglect, is cause for everlasting shame.” p249
“I have seen the damage we in medicine do when we fail to acknowledge such power is finite and always will be…We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being.” p259