BEING MORTAL by Atul Gawande

 This book is the third written by Boston based surgeon about medical matters close to heart - the ethics and morality of what modern day medical practice is all about. He is also a staff writer for The New York Times and a professor at Harvard. It is a rare person who can take the scary science of medicine, humanise and demystify for us ignorant saps what really drives doctors and surgeons in their high pressure, high stakes work.

Three certainties in life - birth, death, and taxes.  We don't remember our births, and nothing really of the first two years of life. Taxes, well, we know all about them, and nothing we can do about those. Death and with it getting old - we don't want to face all that ickiness, losing our memories, eyesight, hearing, mobility, senility, bodily functions. And what about disease and sickness? All far too scary. And who wants to go and live in a rest home - visions of old people shrivelled up in wheelchairs, sitting zombie like in front of tele, dinner at 5pm. Is this what our active, interesting and stimulating lives have been reduced to? And is getting old, and the process of dying something we can have some control of, something we can do about?

Well, we can't prevent it happening, but we can certainly make it easier for ourselves and our families, which is the author's focus in this book. As a doctor, he has been trained in the physical care of the elderly. But his experiences in dealing with elderly people, including his own grandmother and father, have shown him that good care is about so much more than prescribing medication, four walls and three meals a day. He identifies the three enemies of successfully managing old age - boredom, loneliness and helplessness. Any of these three have an immediate negative impact on one's quality of life. We already know this of course as it may affect us when we aren't elderly. But up until recently the options available for elderly care have been fairly limited - primarily rest/nursing homes - where these three afflictions have plenty of opportunity to flourish. So he advocates for community based care, retirement villages, pets both furry and feathered, and being active for as long as possible.

He then addresses terminal illness and the process of dying - not nearly as awful as one might think. Again, it is all about helping people maintain their dignity, giving them control over how their pain and illness is to be managed, having those 'conversations' that none of us want to have with our own selves, let alone with others we care about.

There is plenty of the personal memoir in this book, not only in his writing about patients and families he has dealt with, but also his own family. Which for the ignorant reader is really quite wonderful. Not only is the doctor showing how human he is too, just like the rest of us, but with enormous grace and humility is showing us how we can make old age different, better, happier, more productive. Compulsory reading for everyone, I loved it so much I bought my own copy.

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