I would put this book on my top 20 books I've ever read list.
It matters not if a book is fiction or non-fiction, some books just make you feel elevated when you read them. This is one of those books.
For me, reading this book was an experience. I cried. I learned. I was inspired. I repeatedly wrote down quotes from the book because the way Dr. Gawande writes is so beautiful. His words resonate with me.
This book interested me because my mother is 92 years old, I'm a licensed nursing home administrator and, at age 56, I'm starting to realize that some day I'll be old. The book is about how people experience the end of their lives in America. Gwande draws on his own experience with terminal patients. He also relates the discouraging research regarding nursing homes and assisted living facilities; but he reports some encouraging programs that have arisen in these sectors over the past couple of decades. He relates some of the important things he's learned from hospice and palliative care providers.
Here are just a few of my favorite quotes from the book:
“At least two kinds of courage are required in aging and sickness. The first is the courage to confront the reality of mortality – the courage to seek out the truth of what is to be feared and what is to be hoped. Such courage is difficult enough. We have many reasons to shrink back from it. But even more daunting is the second kind of courage – the courage to act on the truth we find. The problem is that the wise course is so frequently unclear. For a long while, I thought that this was simply because of uncertainty. When it is hard to know what will happen, it is hard to know what to do. But the challenge, I’ve come to see, is more fundamental than that. One has to decide whether one’s fears or one’s hopes are what should matter most.”
“Technological society has forgotten what scholars call the “dying role” and its importance to people as life approaches its end. People want to share memories, pass on wisdoms and keepsakes, settle relationships, establish their legacies, make peace with ‘god, and ensure that those left behind will be okay. They want to end their stories on their own terms. This role is, observers argue, among life’s most important, for both the dying and those left behind. And if it is, the way we deny people this role, out of obtuseness and neglect, is cause for everlasting shame. Over and over, we in medicine inflict deep gouges at the end of people’s lives and then stand oblivious to the harm done.”
“If to be human is to be limited, then the role of caring professions and institutions – from surgeons to nursing homes-ought to be aiding people in their struggle with those limits. Sometimes we can offer a cure, sometimes only a salve, sometimes not even that. But whatever we can offer, our interventions, and the risks and sacrifices they entail, are justified only if they serve the larger aims of a person’s life. When we forget that, the suffering we inflict can be barbaric. When we remember it the good we do can be breathtaking.”