Author: Atul Gawande
Finished on: 25 May 2017
Where did I get this book: The wonderful Salt’s Mill bookshop
In May this year Ian Toothill from Sheffield climbed Mount Everest. An extraordinary achievement. But what made it even more extraordinary is that Toothill has terminal cancer. He said he wanted to “inspire anyone living with cancer to go and do that special thing they’ve always wanted to do. It could be finishing that book you’ve always said you would write, learning a new skill, or taking that dream trip.”
And, on closing the back cover of Being Mortal, I have a feeling Atul Gawande would heartily approve of Toothill’s incredible achievement.
The ageing, and death, of the people that we love, is one of the most frightening things we have to come to terms with in our lives. Not to mention the ageing, and death, of ourselves.
But it happens to everyone in the end. Everyone we love, and every one of us, will die. And if we’re lucky, we’ll get old, grey and probably doddery first.
So why don’t we talk about it more? Why are we reluctant to confront the reality of terminal illness, and the growing number of old people, with the deterioration of physical and mental health that comes with ageing, in the world today?
I used to work for a children’s hospice charity, so I was forced to confront the reality of death and dying on a daily basis at work. More recently, I volunteered as a befriender for Age UK, so would spend time every week with a wonderful lady in her 90s with severe dementia. Maybe I was drawn to these roles because I have always wanted to confront mortality, or maybe I am (almost… relatively… maybe…) comfortable with my own mortality because I have spent time in these roles. I don’t know.
Gawande is a surgeon who is professionally and personally interested in how we maintain and foster quality of life as we become unwell, get older, or both. He is concerned about the medicalisation of old age, and the prioritisation of ‘fixing’ physical illness, no matter the consequences for frail or vulnerable people.
At the heart of Gawande’s argument is the idea that everyone is an individual, and the things that make life living will be different for each of us. And that this information should inform decisions about whether various medical interventions are appropriate for us, or not, at different stages of illness.
He explores how our fixation on keeping people safe, no matter what, means that we are robbing many of their autonomy, and forcing our elderly or ill into conditions where, for many, life simply isn’t worth living.
This book feels very important. It feels like something everyone should read. Whether you’re ill or getting older, or people you love are ill or getting older, Gawande makes a convincing argument that conversations about what makes life living should be normal.
He is also clear that research shows these conversations should not happen ‘in the throes of crisis and fear.’ But the truth is that we often don’t have them until it is too late. Who wants to to pipe up at dinner with “Pass the pepper dad, and would you rather die than be left unable to talk? What about being able to walk?” But conversations like this mean we, and medical professionals, understand what risks are worth taking for each individual. One man wants to risk life-threatening surgery if it increases his chances of walking for a few more years, whereas another considers life worth living if he can eat ice cream and watch football. We are all different.
It’s not an easy read. But recommended. I now want everyone I love to read it, and to steel ourselves to have these conversations. We won’t all climb Everest, but we can give ourselves the best of doing our own equivalent, for as long as possible.