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Being Mortal: Illness, Medicine and What Matters in the End

von Atul Gawande

Weitere Autoren: Siehe Abschnitt Weitere Autoren.

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3,9412432,392 (4.46)529
Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families of the terminally ill.
  1. 10
    Final Exam: A Surgeon's Reflections on Mortality von Pauline W. Chen (BookshelfMonstrosity)
    BookshelfMonstrosity: Written by experienced and dedicated physicians, these compelling books question American health care's emphasis on management and technique to the detriment of human relationships between doctors and patients, especially when the patient's mortality is an important consideration.… (mehr)
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Important ( )
  dualmon | Nov 17, 2021 |
WONDERFUL! Kindle; read 2017
  18cran | Nov 7, 2021 |
The epilogue of Being Mortal sums itself by saying its about the struggle to cope with the constraints of our biology, with the limits set by genes and flesh and bone. Medical science has given us remarkable power to push against these limits.., but again and again I have seen the damage we in medicine do when we fail to acknowledge that such is finite and always will be. We think our job is to ensure health and survival, But is really to enable well being. What is your understanding of the situation and its potential outcomes? What are your fears and hopes? What are the trade-offs you are willing to make? What is the course of action that best serves this understanding? The epilogue is the best summation of the book. Dr Gawande uses his case studies to illustrate the challenges that both doctors and patients face as they deal with aging. The book covers impact of our industrialized urban culture on how we care for our aging parents. He takes the reader to origins of the nursing home industry, its evolution to the assisted living movement and finally the hospice movement. He does an excellent job in explaining what difficult discussions need to be done between both the patient and doctors and between the patient and their family. Finally he tackles end of life issues including assisted suicide. I found the book engaging and readable. Dr Gawande does not use medical jargon. The book reads like a biography of his father taking us from his initial illness to his death. During this journey Dr Gawande intersperses dissuasions of his other patients to further illustrate his points.
( )
  Cataloger623 | Oct 24, 2021 |
Incredible book about ourselves, medicine and how we live before we die. ( )
  auldhouse | Sep 30, 2021 |
I remember the Terri Schiavo case and feeling so surprised that people were arguing about her. Of course she should be kept alive, I thought. I was 10 or 11 at the time. My mom, however, was shocked that it was even a question -- like almost all doctors, she told me, she values quality of life more than life. This idea -- that people should determine for themselves what "quality of life" means and how much they value it over living for living's sake -- was kind of revolutionary to me.

Reading this, I couldn't help thinking about the people in my life who've gone through those final stages of life, and of the people who were growing older and closer to those stages. The power of this book stems from the drama that's so inherent in the universal human experience of dying, of suffering, of finding out for yourself what you think the meaning of your life is, what your priorities are. Priorities in life -- and in old age -- and in dying.

Perhaps what this book conveys most piercingly is that death's not a truly universal experience -- we all die, but differently. The stories Gawande tells are haunting, in the way that the climactic, the startling, the tragic is portrayed as so ordinary. I guess what ties all the people together is their autonomy, their need for autonomy. That's what surprised me the most -- people, as they lost their sharpness, amassed disabilities, drew closer to a fatal fall, valued the ability to do things for themselves and make decisions for themselves more than anything else. More than prolonging their own lives, it seemed at times.

I didn't like the writing at the sentence structure; it seemed a bit expository, a bit vanilla. Perhaps because I've read parts of it in the New Yorker. But of course, the value of this book is in the message. ( )
  Gadi_Cohen | Sep 22, 2021 |
His new book, “Being Mortal,” is a personal meditation on how we can better live with age-related frailty, serious illness and approaching death.

It is also a call for a change in the philosophy of health care. Gawande writes that members of the medical profession, himself included, have been wrong about what their job is. Rather than ensuring health and survival, it is “to enable well-being.”
hinzugefügt von melmore | bearbeitenNew York Times, Sheri Fink (Nov 6, 2014)
 

» Andere Autoren hinzufügen (8 möglich)

AutorennameRolleArt des AutorsWerk?Status
Gawande, AtulHauptautoralle Ausgabenbestätigt
Petkoff, RobertErzählerCo-Autoreinige Ausgabenbestätigt
Pradera, AlejandroÜbersetzerCo-Autoreinige Ausgabenbestätigt
Röckel, SusanneÜbersetzerCo-Autoreinige Ausgabenbestätigt
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I see it now—this world is swiftly passing.
—the warrior Karna, in the Mahabharata

They come to rest at any kerb:
All streets in time are visited.
—Philip Larkin, "Ambulances"
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I learned about a lot of things in medical school, but mortality wasn't one of them.
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Modern scientific capability has profoundly altered the course of human life. People live longer and better than at any other time in history. But scientific advances have turned the processes of aging and dying into medical experiences, matters to be managed by health care professionals. And we in the medical profession have proved alarmingly unprepared for it.
In other words, our decision making in medicine has failed so spectacularly that we have reached the point of actively inflicting harm on patients rather than confronting the subject of mortality. If end-of-life discussions were an experimental drug, the FDA would approve it.
The simple view is that medicine exists to fight death and disease, and that is, of course, its most basic task. Death is the enemy. But the enemy has superior forces. Eventually, it wins. And in a war that you cannot win, you don't want a general who fights to the point of total annihilation. You don't want Custer. You want Robert E. Lee, someone who knows how to fight for territory that can be won and how to surrender it when it can't, someone who understands that the damage is greatest if all you do is battle to the bitter end.
… our driving motivations in life, instead of remaining constant, change hugely over time and in ways that don’t quite fit Maslow’s classic hierarchy. In young adulthood, people seek a life of growth and self-fulfillment, just as Maslow suggested. Growing up involves opening outward. We search out new experiences, wider social connections, and ways of putting our stamp on the world. When people reach the latter part of adulthood, however, their priorities change markedly. Most reduce the amount of time they spend pursuing achievement and social networks. They narrow in. Given the choice, young people prefer meeting new people to spending time with, say, a sibling; old people prefer the opposite. Studies find that as people grow older they interact with fewer people and concentrate more on spending time with family and established friends. They focus on being rather than doing and on the present more than the future.
Life is choices, and they are relentless. No sooner have you made one choice than another is upon you.
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Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families of the terminally ill.

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