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Being Mortal: Medicine and What Matters in the End

por Atul Gawande

Outros autores: Ver a secção outros autores.

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3,5882332,551 (4.45)519
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.
Adicionado recentemente porPages_Aplenty, heringk, sabreader, ZeibFresh, biblioteca privada, lknicholson, giovannaz63, miriambaker, JenniferWu
  1. 10
    Final Exam: A Surgeon's Reflections on Mortality por 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.… (mais)
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Mostrando 1-5 de 229 (seguinte | mostrar todos)
I think anyone who who might have to help loved ones deal with their deaths in the future, or who may one day be faced with their own mortality, will find this book enormously interesting and helpful. You know who you are. ( )
  giovannaz63 | Jan 18, 2021 |
Everyone needs to read this book. ( )
  nhmyster | Jan 3, 2021 |
This is the ideal book for considering the details of aging, death and dealing with the medical system today. He began first by exploring different models of senior living - looking closely at nursing homes, assisted living facilities, other creative ways to grow old, and the histories behind them. Often the mandate of safety at these places undermines autonomy and even quality of life.

Gawande also writes to critique the way medicine is performed today - rather than a no-holds-bars fight for survival, the goal ought to "enable well-being." Life, it turns out, is often prolonged beyond what the elderly actually desire. He writes, "The debate is about what mistakes we fear most — the mistake of prolonging suffering or the mistake of shortening valued life.” Often having those hard conversations with your parents (or anyone who is actively dying) can be a blessing to know how to proceed, because when doctors are told to "do everything you can" in keeping someone alive, there's almost always something else they can try.

Toward the end, he highly praises hospice care work and the ways it makes the end of your life more tolerable and reduces unhelpful medical costs. I should note, Gawande is a wonderful story-teller and interweaves stories throughout to exemplify his points.

A closing favorite quote: “Arriving at an acceptance of one’s mortality and a clear understanding of the limits and the possibilities of medicine is a process, not an epiphany.” This was for me the reason to read it. ( )
  nrt43 | Dec 29, 2020 |
It took me 2-3 hours to really get into the book, but in the end I enjoyed it primarily because it made me think about issues I never before examined. What I took away from Gawande's discussion of the last months/weeks of our lives is that communication is key. The common thread that ran through all of the poor outcomes for people near death had to do with a failure by someone to have a difficult discussion -- that could be the aged individual themselves, their relatives and loved ones, or perhaps the doctors/nurses in charge of care. Usually it was a combination. But when people were willing to confront reality and examine what future they desired when life neared the end, the outcomes were far better.

I am grateful that I stumbled upon this before I was thrust into a situation where I would need the information. As Gawande writes, if you don't plan for eventualities at least a little in advance, your outcomes are likely to be much worse than if you had put even minimal effort in up front. This book is something I hope I will remember to come back to and re-read when I feel the information might be needed soon.

Below, I reproduce 5 questions Gawande encourages those with serious illness answer for themselves. Ideally, you will share this with those providing care as well as those that may be making life/death decisions for you if you become unable to do so yourself.

1. What is your understanding of where you are and of your illness?
2. What are your fears or worries for the future?
3. What are your goals and priorities?
4. What outcomes are unacceptable to you? What are you willing to sacrifice and not?
5. (later) What would a good day look like? ( )
  rsanek | Dec 26, 2020 |
I learned a lot from this book about things we don’t like to discuss. you can read more about my lessons learned from this book here: https://captivatedbycuriosity.com/2019/01/14/mortality-and-how-to-live-a-better-...

What is really best for your aging parent? How did dying in a nursing home come to be the norm? What key questions should you ask when looking death in the eye?

While answering these hard questions, he intertwines compelling and endearing stories of real people that show how things often end up and what happens when you don’t allow the medical system make decisions for you.

It’s a great read. Not an easy book to read in terms of facing the content and contemplating your and your loved ones future, but definitely helpful and calming with the only certainty we have in life. ( )
  pmichaud | Dec 21, 2020 |
Mostrando 1-5 de 229 (seguinte | mostrar todos)
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.”
adicionada por melmore | editarNew York Times, Sheri Fink (Nov 6, 2014)
 

» Adicionar outros autores (11 possíveis)

Nome do autorPapelTipo de autorObra?Estado
Atul Gawandeautor principaltodas as ediçõescalculated
Petkoff, RobertNarradorautor secundárioalgumas ediçõesconfirmado
Pradera, AlejandroTradutorautor secundárioalgumas ediçõesconfirmado
Röckel, SusanneÜbersetzerautor secundárioalgumas ediçõesconfirmado
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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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