A few things have happened recently to friends that remind me that we are mortal and life is transitory. I don't think people in their 40's, 50's think too much about the transitory part but when you get to be my age you think about it. I'm not saying that you spend your days worrying about dying but when you have lost a spouse and dear friends, you wonder about what is going to happen. About how you are going to get from living to being dead. I know that sounds weird. Still, I don't know anyone who wants to suffer or their families to suffer with them through a long illness where there is no chance of recovery.
I recently read Atul Gawande's book, On Being Mortal; Medicine and What Matters in the End. Gawande is a surgeon and has written several books about medicine. He also writes about medical issues in the NewYorker Magazine. Gawande apparently has struggled in his own medical practice on how to handle patients when he knows that medicine can not heal them. He wrote this book after his Father, also a surgeon, died from a rare form of cancer and as Gawande was with his Father through his illness, he saw medicine from the standpoint of the patient and his family.
The book is about the end of our lives and how to manage when our body begins to fail us. He writes about assisted living and nursing homes and why many elderly people are not happy living in these facilities. It is because they lose control of their lives in order that their families feel they are safe and the facility can operate efficiently. Losing control of when you want to get up in the morning, eat, take a bath, watch TV and giving up privacy is hard to accept no matter if you are old and your body is failing.
The last half of the book about medical care in the last part of life brought back memories of so many doctor visits with Ned as we negotiated his last months.
“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 knew how to fight for territory when he could and how to surrender when he couldn't, someone who understood that the damage is greatest if all you do is fight to the bitter end.”Fighting to the bitter end, Ned's last couple of months were overwhelming with visits to specialist who couldn't help, radiation that left him even more exhausted and more tests.
How do we find the right doctors that do not keep offering medical procedures that may prolong life but make it impossible for us to live our last days as we want, a doctor who can help us understand what is happening, ask us what is important and coach us through rational choices.
I think this is a great book for those of us who are in the "third age" as we call it here in Mexico but also it is a good book for our adult children to read as well.
The image of the bottles that once held medicines and potions is from the Port Aransas project.