Is mortality a subject you avoid?
Atul Gawande, the influential and clear-thinking American surgeon, wrote Being Mortal to think through those difficult decisions we all face if we are lucky to live a long life or unlucky and face an early but prolonged death. So yes, this might be a book some of us would instinctively avoid, yet I want to shout at everyone, young and old, READ THIS, because he shows you how to retake control.
If, as most of us do, we fear pain or prolonged weakness at time of our death, this book is a revelation. Gawande, with a curious and open mind, investigates current and historical end-of-life care and discusses what matters most and how it can be achieved. He learns from those quiet experts at the coal face, the dying, the relatives, the nurses and the carers, what questions to ask yourself and what questions to ask those you love. He emphasises the deep importance of asking those questions while in good health as well as when they need answering in extreme circumstances.
This book is not difficult to read because it is so well written and full of real examples. It does, however, need courage if these are questions you always avoid or if you find clearly-discussed medical matters uncomfortable to read. The magic is that facing fear makes you feel better. This book gives you tools to cope with that fear and a sense of control over your mortality.
So, what does it do for writers along the way? Gawande looks at research into the differences between our experience during events and our memory of that experience. Being human, these are often contradictory – at the time we experience ‘the peaks of joys and the valleys of misery’, but when we remember it is ‘how the stories works out as a whole’. So a really entertaining football match in which your team performs blissfully for hours can be ruined by some bad football at the end. Why? ‘Because a football game is a story. And in stories, endings matter.’ [my italics] The Peak-End moment is what matters to memory.
Last Tuesday night I read two poems from Paul Stephenson’s recent pamphlet, The Days That Followed Paris, at the Cambridge Speaker’s Club – our Toastmaster’s venue. Listeners found these as moving as I did; they convey the mood – strangeness, fear, pain and warmth – of those days. I read Safety Feature and Blindfold [about that brave muslim in the Place de la République]. 
Green Writing Room 
Thank you, Hilary. I’ve just been through an anniversary of the sudden deaths of two loved ones so yes, I do think about mortality. I have experienced both the shock of sudden youthful death and the prolonged, predicted aged death and to be honest, I’m not sure what I prefer. Well, obviously, I don’t want to die young (bit late for that now anyway) but sudden over foreseen? Hm. Not sure. I will look into this book.
Both are difficult as I, too, know. Believe me, although you may look back and wish as I do that you could have known more when these things hit you, you will find this book comforting, helpful and empowering for whatever the future holds.
That’s good to know. Thank you.
In times of grief we need a calm voice to sustain us.
A subject we all need to ponder at some point.
Indeed, calm is good. The wonder of this book is that, by looking into the whole subject before you are facing it perforce, you find dealing with death, when it comes, easier and grief does not contain regrets.
I think your right, read it before you may need it. How many really think about these things before we need to.
It was full of stuff I didn’t know I needed to know and I am so glad I read it.
It’s a tough subject and knowing one must face mortality doesn’t make it any easier TO face it. I’ve heard Atul Gawand interviewed on the radio and have thought I “should” read his book but…
Do it, really, it will make you feel better about the whole subject.
Interesting. I will be looking the book up….
You won’t regret it!
Great post and questions, Hilary. For me, I’m divided on the subject of mortality. I’m curious about it, and I write about it in a lot of [mostly fiction; sometimes bordering on NF] cases, but when it comes to facing the issue, it’s truly my biggest fear in life. It causes me panic attacks if I think too deeply about that point at which I will, inevitably, not exist or if someone I love will not exist, suddenly or not. I guess I’m able to split and compartmentalize my ‘creative mind’ from my, what, ‘everyday mind’? So, while I didn’t go to the ‘Bodies’ exhibit that was so provocative and ever-present here in the U.S. a few years ago, I’m fascinated by medicine and how the body (and mind) work(s), especially with my interest in infectious disease processes.
As to specifics, this sounds like a great book. I have Gawande’s Better and have started reading it; he’s a compelling story-teller for sure. It’s just whether I, as a reader (making another split here; between me as a writer and me as a reader), can handle the subject matter of death and dying. In college, when I took a D&D class (as I recall, it–or a class in the sociology vein), it didn’t affect me as much as now, when I feel more mortal than ever, I suppose.
Thanks for the mini-review. Lots of food for thought here!
Perhaps the answer is to read it as a writer, keeping a distance and thinking about whether you would have tackled the subject differently. I really do think reading it is an antidote to panic about mortality – but that is only my opinion. I can also understand the divided curiosity, I can view things as a scientist or as a writer or as a mother, and I feel and react differently depending on which persona I inhabit. Life is complex!
That looks like a very interesting read. I’m going to hunt for a copy.
Go for it. We will make life better for ourselves, our relatives and friends armed with Gawande’s research and insights.
I can’t say I fear my own death. I always take great comfort from a fact that after the event one won’t know or experience it again. Of course, the journey towards it, is what is life. Short or long, we make the best and enjoy whatever we make or be given by it. So far so good. If I have any fear it would have to be lingering on with misery and debilitating sickness in old age. One way for me is to avoid seeing doctors and keep medications to the minimum. Aspirin is about as far as I take drugs.
I will look up Gawande’s book and see what he makes of it all.
Yes, at least you only die once. The virtue of this book is that it gives you a chance to navigate the future and avoid the the wrong turns that so many people, sadly, end up taking – or get taken on their behalf. You can’t got wrong seeing what he says, it is only investigation and experience.
I don’t fear death. For reasons I won’t go into here, I wouldn’t mind knowing that one night, when I go to bed, I will not wake up again. What I am determined to avoid though, is ending up in an eventide home, trapped in too deep an armchair to get out of watching re-runs of the Black and White Minstrel Show or some such. I am using the current lunatic period searching for Black Friday deals on suicide kits. I will not let it happen. The underlying feeling is that unless I am productive I am nothing.
I feel exactly the same. Gawande’s book was very good for seeing how to avoid getting stuck in any of the above traps.
This is something I have thought about lately, as I lose friends and family members – but I’ve discovered no one wants to talk about it.
You are right, no one wants to talk about it. It becomes clear, in this book, that those who do talk about it, both the dying and their relatives, go easier and have fewer regrets than those who avoid thinking about or discussing it. It is a barrier well worth overcoming.
I just started reading this book and now I remember it got on my “to-read” list from this post. Thank you for the introduction.
I’m glad you found it. I do hope it proves as helpful to you as it was to me. (It is still sitting unread on my husband’s pile.)
Thank you for this recommendation, Hilary. After reading your post I reserved a copy at my local library, so I hope to read it soon. I think about mortality quite a bit, but mostly in terms of my parents dying. I fear a life without these wonderful people who’ve been with me since I came into this world, but it’s quite likely I will experience that at some point. My sister has nightmares about her parents and siblings dying in common calamity and leaving her alone as the sole survivor. I quite like the idea of dying at the same time as those I love, so that I wouldn’t have to face life without them, but I have no great desire to die. Death is so much a part of life and yet it remains almost a taboo. I would like to think I’ll be able to face my own death calmly and with acceptance, and by the sounds of things this book might well help me to do that.
I wish so much that I had read this book before my parents and parents-in-law died. I could have cared for them so much better in every way. Life would have been easier and happier for all of us. We did, by trial and error, manage better as our experience grew and my father died, pain-free, at his home, with family, but oh, it was a sad learning curve. Thinking and talking about such things is frightening, but I know, from long conversations with my father in the last months, that you feel better when you do. This book enable you to do this in a safe space, before you need to. When I mentioned it to my daughter, she said she knew what a wonderful man Atul Gawande was as she had listened to podcasts of his Reith Lectures!
I’m sorry you didn’t have this knowledge earlier in life but it’s great that your children are aware of it. Once I’ve got hold of a copy I think I’ll get my parents to read it as well.
I’ve just given my husband a copy, but I know that he is very reluctant and he may not be able to face it.
I read Being Mortal and then gave it to friends and family. And recommended it to my doctors– an important and well written book!!
I’m so glad to hear this. I have been recommending it left, right and centre and have not met anyone who has read it yet (I will next week at my reading group), so i have wondered if others will find it as important as I did. Thanks for hereassurance.
Thank you for recommending Gawande’s book. I am going to give it a read. Safety Feature sent chills up my spine as did the video of the muslim man receiving hugs.
I hope you find Gawande’s book as interesting and supportive as I did. Paul’s poetry is often comic with a sharp or tragic twist. I think this group of poems are a little different as he lived through the aftermath of the attacks.
Oh heck, my Grandad says he’s had a good life, no regrets, and I think oh no! Don’t talk like this you’ve got ages left you’re well. My friend called me this year and said he’d got Cancer, he had a terrible time and MRSA nearly polished him off and it scared me I was sure he’d be fine, he was so fit and well, I thought willing him well would be enough. Then my Mema died after a very short illness I feel like I need a book to help me to deal with this down side of growing up! I wish I knew better what to say in these situations.
It sounds as though you have had a stressful year on top of all the major new steps in your own life. It is admirable that with so much going on you take the time to send people like me a card! Thank you so much! I know what you mean about not knowing what to say in these situations, this is difficult for everyone because death is comparatively rare these days. You will find the Gawande book really positive and helpful – our girls will both be reading it. It is surprising, but talking about end of life choices makes individuals and family members happier and very sick people who consult palliative care specialists, as well as having treatment, live longer…
Have a fabulous Christmas with your wonderful family.
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