Book Club Reflection: Being Mortal by Atul Gawande

My book group met to discuss Atul Gawande’s Being Mortal last week. We got off the topic of the book a bit because a lot of us wanted to discuss the same topic more than what Gawande had to say about it. Many of us have had loved ones go through end-of-life care so we all had a lot to share.

We did talk a bit about Gawande before we began. He’s a very impressive person. He was born in Brooklyn and earned his MA from Oxford and his MD from Harvard. He served as a health care advisor under Clinton during his campaign. He’s currently working on developing a new kind of health care company with major players in the business world called Haven. I’d love to get coffee with this guy, but I doubt he has the time.

We had a new member join us this month who works as a social worker with older adults and she had a lot of personal insight to share. She revealed to us that many older adults are afraid of death and how they will die. Some members of our group were surprised. They talk about death and dying with their families and friends openly. Of course, these are trusted loved ones, but the topic still comes up.

The social worker mentioned that she met Bill Thomas, the man who brought birds and plants into his retirement community to bring life back to it. She said he’s a little crazy, but most people with radical ideas are a bit out there. The idea of it is to make people feel useful. Sometimes, this is accomplished by having residents wash a dish or peel carrots for dinner. Thomas’s way was to have them take care of animals. Often, you see these ideas implemented incorrectly. A birdcage in the lobby where the staff care for the animals is in the right vein but doesn’t put the responsibility on the residents and defeats the purpose.

Suicide among the Baby Boomer generation is increasing (see this article). One of the reasons cited is the loss of power. We read a lot in Gawande’s book about how you lose your individualism as you grow older and the power to control what you do. This loss of power can fuel depression and it seems to be growing as the Baby Boomers age.

We talked at length about the difference between hospice and palliative care. I was still a bit unsure of the difference after reading the book. Palliative care is meant to keep someone who is ill out of the hospital and anticipate problems before they occur. It’s a bit of ‘comfort care,’ but it’s also on the preventative side as it mitigates side effects. Hospice means you are no longer being treated for the disease you are dying of. You won’t be rushed to the hospital for a symptom of your disease. This is the idea of ‘making every day as good as possible.’

These are hard topics for some people to talk about because they’re very personal. Our conversation got emotional but I’m proud of us and how much we trust each other to talk about these difficult issues. It was interesting how this book focused on keeping the elderly or sick person in control of their situation while the book we read about cadavers, Stiff by Mary Roach, focused on how what happens to our bodies after we die is completely out of our control. We can’t forget that the change should happen only at death and not before.

I can’t believe summer’s almost over but we’ll meet one more time in August before the fall picks up. Until next time, write on.

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