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Debbie's Reviews> Being Mortal: Medicine and What Matters in the End
Being Mortal: Medicine and What Matters in the End
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Debbie's review
bookshelves: nonfict-not-memoir, death-and-illness, runners-up-2012-through-2019, almost-all-time-faves
Mar 23, 2015
bookshelves: nonfict-not-memoir, death-and-illness, runners-up-2012-through-2019, almost-all-time-faves
If you’re not afraid of dying, you’re either lucky or lying.
Meanwhile, this book gave me the heebee-jeebees! Did I really need to know that as I age my aorta will get crunchy and my shrinking brain will rattle around in my skull? Or did I need to know (and perhaps forever visualize) the disgusting details of the downhill spiral of my teeth and feet, and what I’ll have to show for them? Don't worry, the author does not dwell on these things, but I do! And, oh, how I hope I'm not one of the 40% (!) who is toothless by the time I'm 85, if, of course, I live that long. And do I even want to live that long after reading this depressing book???! Johnny Depp says he wants to be on a morphine drip and just drool and nod. I’m with him. So actually, this book did help me figure out how I want to go out, if I get the choice.
I guess going into this, I thought it would be a how-to book, how to not be scared of dying. Instead, I got a terrifying view of the horrors of nursing homes, terminal illness, aging, and deathbeds, and a blow-by-blow account of my bodily deterioration and decay. It is not a pretty picture. It is worse than my over-active imagination can even conjure up.
Informative? Yes, in spades. And this doctor can write! Clear, captivating prose. I learned so much about how doctors and other caregivers think of and handle the elderly and terminal patients. It talked about how people cling to hope even if their case is hopeless, and how doctors are often unable to tell it to them straight. And about how doctors, despite their knowledge about the facts, often hold out hope for a miracle too.
Other good stuff:
-Liked the many stories of people thriving in assisted living places. The people were real, their stories fascinating in a quiet way.
-The author is compassionate and has a conversational tone—very undoctor-like.
-Liked learning about what hospice does exactly and about how much they can help out.
-Liked that a provider had the bright idea to bring in other living things—plants, dogs, and kids—to assisted living places and loved hearing about how the residents responded so well.
Stuff I didn’t like:
-Too much history about assisted living, and too many pioneers mentioned by name. I get it that the author wants to give them credit, but we readers won’t remember a single one. Maybe some of this info would have better in an Acknowledgment section?
-The author claims that people get more mellow with age. What? Then why are so many old people on anti-depressants and anti-anxiety meds?
Stuff I wanted:
-Wanted it to be more psychological.
-Wanted more discussion about the fear of death, and a mention of how religion plays a part.
-Wanted talk about the cost of medical care. Does insurance always pay for chemo, for example? Do families go bankrupt? How much do finances affect the decision of whether to continue with treatment?
-Wanted a secret formula for shooing away the fear of death and dying.
Funny, I was way more comfortable reading about young people with terminal illnesses than about old people about to die. I can handle reading about suffering that can’t happen to me; I’m calmly empathetic. But tell me about someone my age (65) or older who has just been diagnosed as terminal, and I squirm and twitch out of sight. Just give me the clicker and let me watch Louis C.K., will you?
All fears and gripes aside, I know this is an important book, and it’s an amazing one. The doctor is talking about the elephant in the room, which is cathartic, depressing, and anxiety-producing all at once—you might want to have your valium handy. I do think this book will be scary to read if you're in your 60s or older. That is, unless you’re lucky or lying.
Meanwhile, this book gave me the heebee-jeebees! Did I really need to know that as I age my aorta will get crunchy and my shrinking brain will rattle around in my skull? Or did I need to know (and perhaps forever visualize) the disgusting details of the downhill spiral of my teeth and feet, and what I’ll have to show for them? Don't worry, the author does not dwell on these things, but I do! And, oh, how I hope I'm not one of the 40% (!) who is toothless by the time I'm 85, if, of course, I live that long. And do I even want to live that long after reading this depressing book???! Johnny Depp says he wants to be on a morphine drip and just drool and nod. I’m with him. So actually, this book did help me figure out how I want to go out, if I get the choice.
I guess going into this, I thought it would be a how-to book, how to not be scared of dying. Instead, I got a terrifying view of the horrors of nursing homes, terminal illness, aging, and deathbeds, and a blow-by-blow account of my bodily deterioration and decay. It is not a pretty picture. It is worse than my over-active imagination can even conjure up.
Informative? Yes, in spades. And this doctor can write! Clear, captivating prose. I learned so much about how doctors and other caregivers think of and handle the elderly and terminal patients. It talked about how people cling to hope even if their case is hopeless, and how doctors are often unable to tell it to them straight. And about how doctors, despite their knowledge about the facts, often hold out hope for a miracle too.
Other good stuff:
-Liked the many stories of people thriving in assisted living places. The people were real, their stories fascinating in a quiet way.
-The author is compassionate and has a conversational tone—very undoctor-like.
-Liked learning about what hospice does exactly and about how much they can help out.
-Liked that a provider had the bright idea to bring in other living things—plants, dogs, and kids—to assisted living places and loved hearing about how the residents responded so well.
Stuff I didn’t like:
-Too much history about assisted living, and too many pioneers mentioned by name. I get it that the author wants to give them credit, but we readers won’t remember a single one. Maybe some of this info would have better in an Acknowledgment section?
-The author claims that people get more mellow with age. What? Then why are so many old people on anti-depressants and anti-anxiety meds?
Stuff I wanted:
-Wanted it to be more psychological.
-Wanted more discussion about the fear of death, and a mention of how religion plays a part.
-Wanted talk about the cost of medical care. Does insurance always pay for chemo, for example? Do families go bankrupt? How much do finances affect the decision of whether to continue with treatment?
-Wanted a secret formula for shooing away the fear of death and dying.
Funny, I was way more comfortable reading about young people with terminal illnesses than about old people about to die. I can handle reading about suffering that can’t happen to me; I’m calmly empathetic. But tell me about someone my age (65) or older who has just been diagnosed as terminal, and I squirm and twitch out of sight. Just give me the clicker and let me watch Louis C.K., will you?
All fears and gripes aside, I know this is an important book, and it’s an amazing one. The doctor is talking about the elephant in the room, which is cathartic, depressing, and anxiety-producing all at once—you might want to have your valium handy. I do think this book will be scary to read if you're in your 60s or older. That is, unless you’re lucky or lying.
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Reading Progress
March 23, 2015
– Shelved
March 23, 2015
– Shelved as:
to-read
April 27, 2015
–
Started Reading
April 27, 2015
– Shelved as:
nonfict-not-memoir
May 19, 2015
–
Finished Reading
January 29, 2016
– Shelved as:
death-and-illness
February 11, 2020
– Shelved as:
runners-up-2012-through-2019
May 1, 2022
– Shelved as:
almost-all-time-faves
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Debbie "DJ"
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Apr 29, 2015 12:09AM
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Beautiful review, as always Debbie. Personally, I didn't find this book scary at all. But of course, I believe our bodies are just a shell of our spirit that never dies. I think the "stuff you wanted" wasn't included as Gawande had a lot of extremely valuable information to get across. Also, maybe no mention of medical costs were given as each state/employer provides different insurance. Still, loved your "good stuff," and review as a whole. Wonder what book is out there for fear of death? Is it just spiritual or religious beliefs? Dunno...
Great, convincing review, Debbie!
My mother recently passed away and she was in an awesome nursing home. Like a five-star hotel. (My older sister did lots of research and visits before she found it; the same sister visited several times a week; kept in constant touch with the staff; made 'friends' with the administrators. And it was no more expensive than the poorer-quality ones. Plus, once my mother's funds ran out - and she didn't have a lot - the state picked up the tab on the rest. But I'm in MA, so I don't know if that makes the difference. At any rate, the good homes are out there.)I've often heard to get a good idea of what your old age will be like, assuming you get there, look at the elderly in your own family, the ones you are genetically related to. In mine, we have dementia (Louie Body), as well as those who are hopping around and mentally aware/active into their late 90's. So it's a toss-up what'll happen to me.
But I loved your review and it's a conversation we all need to have at some point with the younger generation in the family. Difficult, yes, but we need to have it.
Terrific review, Debbie. I'm about your age and am no longer sure if I want to read this book, lol (sort of).
I'm close to sixty and I loved this book, but I have always been a very pragmatic person. I found comfort in the acknowledgment that we will ache and creak as we age, as I already do!! As I have both children and grandchildren I hope to live on in their memories. The circle of life!!
Debbie "DJ" wrote: "Beautiful review, as always Debbie. Personally, I didn't find this book scary at all. But of course, I believe our bodies are just a shell of our spirit that never dies. I think the" stuff you want... "Thanks, DJ. You are one of the lucky ones. Can you share your non-fear, please? Yeah, I'm thinking the only people who aren't scared of death are those who are spiritual or religious. Lucky bums! Even though it was a hard read for me, it was an awesome book.
Caroline wrote: "Great, convincing review, Debbie!"Thanks, Caroline. It's a book I will think about for a long time. I usually don't pick up nonfiction, so this was a gamble. It was an amazing book, despite the fact that it made me jumpy!
Jaksen wrote: "My mother recently passed away and she was in an awesome nursing home. Like a five-star hotel. (My older sister did lots of research and visits before she found it; the same sister visited several..."Thanks, Jaksen. My mom was in a great nursing home too. We probably need to thank the crusaders mentioned in Gawande's book; they worked hard to drastically improve nursing homes. And yes, I agree, it's a conversation we'll need to have with the young ones.
Ellie wrote: "Terrific review, Debbie. I'm about your age and am no longer sure if I want to read this book, lol (sort of)."Thanks so much, Ellie. Oh, don't let me dissuade you from reading it--it's an important book, one I'll be thinking about it for a long time. I'm just a chicken! Always have been, lol. A chicken with an over-active imagination!
Camie wrote: "I'm close to sixty and I loved this book, but I have always been a very pragmatic person. I found comfort in the acknowledgment that we will ache and creak as we age, as I already do!! As I have b..."I did like this book tremendously, despite the fact that it shook me up. I think a lot of people feel like you do--I'm probably the odd person out. I know we'll live on in people's memories, I just wish I could be there to appreciate it:)
Kelli wrote: "Scared & steering clear!"lol! Well, I'm definitely in the minority here. I think it's an important and well-written book. I can't help it if I'm a total chicken with no faith to comfort me!
I liked yourStuff I Wanted.Really gave me a good sense of what might be missing.
I really liked the book, not as much as his others, but still I got a lot from it.
Carol wrote: "I liked your Stuff I Wanted. Really gave me a good sense of what might be missing."Thanks Carol. I often have a wish list like that. It's probably not fair because what I want is often beyond the scope of the book and what the writer is intent on writing about. A gal can wish, though, huh?
Mummy wrote: "I really liked the book, not as much as his others, but still I got a lot from it."Hi Petra. I really have a love/hate relationship with the book, as you can tell. I didn't know the auth had other books. What are his other books and is there one you would recommend? He has an easy, straightforward style, and I love it that he doesn't talk down to us plebeians. I love it when people with so much knowledge are not arrogant or obtuse.
All his books are 5 star to me.The Checklist Manifesto: How to Get Things Rightchanged my way of doing business with it's imperative "count something".Complications: A Surgeon's Notes on an Imperfect ScienceandBetter: A Surgeon's Notes on Performancewere good reads that gave me plenty of ideas. I loved them all. I suppose I loved Complications least, just 4.75 stars worth:-)But all of those books were better with ideas and as a good read than this one. This is 'only' 4.5 stars to me. LOL. Thinking on it though, perhaps Better was the best read.
Thanks, Petra! I'll check these out!
I'm not afraid of death (or if I am, I'm lying to myself so convincingly, I don't realise), but dying is a different matter. And not just myself, but having a loved-one die in my presence.It sounds as if this is a book to read in middle age or not at all. I'm not sure how I feel about that.
I've already read Complications and just bought Better. Can't wait to get to them. I think this guy is a very brilliant guy who writes great books which most people can relate too ( or will someday) and can understand.
I'm not afraid of death either, though I don't think about it much. I've lost several ppl really close to me, too, grandparents, parents, best friend from childhood and many of my former students. (I'm a retired teacher.)As for talking about the subject, I have no issue with that either and have had 'the talk' with both my adult daughters and my husband. I'm an organ donor and my family knows my wishes if I should suddenly pass away. Also, my husband knows I intend for him to remarry, if he finds that this is something he wants to do. I WANT him to remarry if I am gone. My daughters know this, too.
I don't know why I am so matter-of-fact about this. I'm a New Englander, but I have seen how terrible it can be for people when a deceased person's wishes were not made known. My mother was widowed on her 60th birthday and for years couldn't date or go out with anyone because my father 'wouldn't have wanted her to.'
Damn it, you get one life. Live it to the fullest that you can.
Thanks, Debbie for the review. Excellent. I saw your post in Chrissie's review.I have this on my to read list but I suspect I know much of what's in in, and I don't like what's lacking, such as cost concerns.
And, yes, most personal bankruptcies in the U.S. are due to medical expenses, though not just old age ones. Young people with cancer and families of kids with cancer are often affected.
Medical condition and financial resources both make a huge difference in how we live elderly and how we die, as does the amount and quality of support we get from the people in our lives.
I'll leave the book on my to read shelf, for now, but I'm not convinced this particular book is for me. Leaving out costs and other things you mentioned are important to me. More psychological for sure, if that's lacking!
You nailed it with your opening line.And then you said"-Liked that a provider had the bright idea to bring in other living things—plants, dogs, and kids—to assisted living places and loved hearing about how the residents responded so well."
And what about those parakeets! Loved that.
I did note the names of those pioneering assisted living places as I would like to look more at them as models. When my mom needed this kind of living it became very important. She picked her own place but one thing that I would not have thought of was a point Gawande mentioned as to when we visit places for our parents if we are considering us or their true needs.
Great review.
Thanks for writing such an honest review for this book. I felt exactly the same way after reading it: it "gave me the heebee-jeebees!"
Well, I'm nearly to 70, and I'm not lying nor am I or have I been lucky. I've seen the long road past 95 up close and personal 3 times going on 4. I'm not at all scared of dying. I'm terrified of what happens before I die and the suffering of "not" dying. I've been this way since I was 26. I had Last Rites and was thought "over" twice before that last time. After that, I've considered the rest gravy. It's pain and suffering I fear, and not dying at all. We all die. My Mom was the same- not at all fearful- just sick of the hurting.
Jeanette wrote: "It's pain and suffering I fear, and not dying at all."Oh, same here! Since cancer runs in my family I've seen way too much suffering. Since age 12 I've wanted to have euthanasia if/when it gets bad. Dogs and cats get it and thankfully it's becoming legal for humans in some places. The drugs are expensive though so saving my pennies is necessary.
Lisa- exactly! You would not put an animal through what elders near to 100 go through in their "process".
Carol wrote: "You nailed it with your opening line.And then you said "-Liked that a provider had the bright idea to bring in other living things—plants, dogs, and kids—to assisted living places and loved heari..."
Thanks, Carol. (For some weird reason, I'm not seeing comments made on this thread--I guess I should just check it occasionally.)
I visited some places with my mom, and both of us said no way. She had already begun losing it, but her reaction to a bad facility was right on. My sibs and I found a great place, and she was happy there. I agree, it's so important that we pick something that fits their needs, not ours. I hope my kids think the same thing for me!
Scott wrote: "Thanks for writing such an honest review for this book. I felt exactly the same way after reading it: it" gave me the heebee-jeebees! ""Thank you, Scott! Beware of the heebee-jeebees! Don't you love that word?!
Jeanette wrote: "Well, I'm nearly to 70, and I'm not lying nor am I or have I been lucky. I've seen the long road past 95 up close and personal 3 times going on 4. I'm not at all scared of dying. I'm terrified of w..."Ha! Well, I still think you're lucky if you're not scared of dying. I'll take what you're having:) Illness and pain also scare me though. The whole subject gives me the shivers. So did you almost die when you were young? That's horrifying!
Lisa wrote: "Jeanette wrote:" It's pain and suffering I fear, and not dying at all. "Oh, same here! Since cancer runs in my family I've seen way too much suffering. Since age 12 I've wanted to have euthanasia... "
I'm with you. I live in Washington, and thankfully it's legal here. Did not know that it was expensive, though. So only the rich have the choice? Awful.
It's now legal in California too. In fact it was when CA made it legal that the cost for all went from about $1,500 to $3,000. I hope it stays legal! I am worried.
It's also tricky because not everyone can get it and some become too debilitated to take it. Scary!
Lisa wrote: "It's also tricky because not everyone can get it and some become to debilitated to take it. Scary!"Yes, very scary. Hope it stays legal too. Everything good might be taken away! I sure don't like it that some people don't qualify, and some become too debilitated. Just awful.
Yep. It needs to be available to anyone who wants it and has intractable suffering. Most still likely wouldn't want it but I would.
When you are VERY old or have physical organ failure, inability to swallow etc. etc. - you would not be in the position to access, IMHO. Unless you are within a system which I have never witnessed or had someone "help" you. For instance if you have had multiple strokes. I don't want to be macabre and explain more detail- but you are not in the position to swallow your hoard or "ask".That's why all of this supposition rather bothers me a little. Because it really doesn't connect to how end hours are handled in 95% of the cases, IMHO. Making it legal has little to do with making it accessible. Any hospice situations I have seen, just have a different goal. One of maintenance or pain relief or fluid support.
I was close to death twice before I was 26 and for completely different reasons. One time, the last, it was for 3 days- and I remember very little.
Personally, I do think euthanasia will be available for greater proportions of dying eventually, but not for a long time. But I could be wrong. I doubt it.
Well, once cancer patients can't keep anything down, the law doesn't help them. Also, the it has to be within 6 months of death thing some people never get there from doctors before they die. The law doesn't permit help. In fact, the person has to open and prepare the capsules themselves and swallow them themselves. And if they think you're depressed you don't get the meds. The law is of limited help but at least it's something.Of course doctors will give morphine as needed for suffering, sometimes in doses enough to cause death, because lower doses are ineffective, but not until what's the very end anyway.
I'll want something to end it as soon as the suffering becomes too much my MY opinion.
I hate that we don't have control over our own fates.
Re stroke and other debility, that's why it's important to let EVERYONE know what you want when you're still healthy. You wouldn't be eligible for mercy death then but at least your wishes would be known if you wanted comfort care but nothing to prolong life such as a ventilator or antibiotics, etc.
Yes, Lisa. But when you are VERY old, many times those who you would have told or were close to you for providing of legal help are gone. When and if you arrive at a very advanced age and are NOT equipped with an entourage? What I have seen is extremely problematic.Everyone thinks of the cancer patient, but more of us are living to great advanced ages. Yes, morphine overdose is a gradual solution, but in my observation- it comes only after months of extreme suffering. Or at least weeks of extreme suffering. That's what scares me the most.
Yes, that's why everything kept in writing and given to every single doctor as well as every single close friend and family member your trust. And keep talking as long as you can. And change it as you change your mind.Yes, everything is a huge problem. But if everyone you know knows that for decades you never wanted extraordinary measures taken it might help.
I'll rely on doctors and I don't trust them, so there you go. But many hospitals now have hospice programs.
I've seen horrible ends and okay ones. Cancer is rarely good except at the very, very end when some get enough drugs.
Your review and your feelings about the topic actually shed a lot of light on why doctors have such a difficult time having honest conversations with patients.
Valerie wrote: "Your review and your feelings about the topic actually shed a lot of light on why doctors have such a difficult time having honest conversations with patients."Thanks, Valerie. I can't imagine being a doctor and having to talk to terminally ill patients.
Thanks for this very honest review. I think I'll pick up this book now.
Dustin wrote: "Thanks for this very honest review. I think I'll pick up this book now."Thank you for taking the time to read and Like my review. This is such an excellent book! Hope you like it.
Lucky - just sad about who I will leave behind. I know where I'm going and I'm ready whenever He is.
Amy wrote: "Lucky - just sad about who I will leave behind. I know where I'm going and I'm ready whenever He is."I’m glad you have faith. Wish I did!
A lot of people, who haven't witnessed the gradual deterioration and death of a loved one, would do well to read a book like this Debbie. It might give them an idea of what might await them, so they can begin to prepare for it.Life is a video that suddenly fast forwards towards the end. So enjoy and appreciate each blessed day, folks!
Excellent review, Debbie! Don't hang up that pogo stick just yet!
Debbie, you know how you couldn't bear to read a treatise on a flat world, now that we know it is round? Western allopathic doctors treat symptoms. If they don't know how to cure a symptom or illness (which is not the actual problem any more than the red warning light in our cars); they call an ailment incurable and we helplessly leave it there. Please read, try, and tell everyone about "Energy Medicine" by Donna Eden. Naturally, bodies eventually die when they finish working but the thinking is wrong.Nuthshell: we are filled with circuit breakers so to speak, to send messages to our brains and clear up stagnant or blocked energy. If a floor flooded, would we keep scooping up the water until we ran out of pails, or look to a pipe that needs repairing?
This tutorial is logical, nothing mystical we imagine might be working. It is the most important thing I urge everyone to read and see for themselves and I am only a beginner. Just a reminder: I have to decline Goodreads messaging on rural internet speed. Reach me anytime in a profile comment or any other book update.:) Carolyn.
