Being Mortal: Illness, Medicine and What Matters in the End Atul Gawande 2014

Dr Atul Gawande’s fourth book is a poignant account of illness and death including that of his own father. He cites Ezakiel and Linda Emanuel’s study on the three different kinds of relationships that doctors have with their patients. The “paternalistic” doctor-knows-best relationship, the “informative” type with the doctor giving the facts and the patient deciding and the “interpretive” type where questions about the patient’s expectations are asked and decisions shared between doctor and patient. This book describes what patients go through when they become ill and the options available when they can no longer care for themselves. The traditional nursing home where residents live a regimented life is in stark contrast to assistedliving homes where residents live independently but have help available whenever needed. Given the option, patients interviewed in this book, do not want invasive procedures to be done towards the end of life and prefer to be with their families. The risks of chemotherapy and radiotherapy may far outweigh the benefits in patients with an incurable malignancy. The benefits of hospice care when patients return home to continue receiving palliative treatment are highlighted. This book is written with sensitivity and compassion. It challenges the reader to understand the needs of patients when facing a terminal illness and that palliative treatment is always an option.