MLA Platinum Award Press Release

Excerpt from Being Mortal by Atul Gawande, plus links to reviews, author biography & more

Summary |  Excerpt |  Reading Guide |  Discuss |  Reviews |  Beyond the Book |  Readalikes |  Genres & Themes |  Author Bio

Being Mortal

Medicine and What Matters in the End

by Atul Gawande

Being Mortal by Atul Gawande X
Being Mortal by Atul Gawande
  • Critics' Opinion:

    Readers' Opinion:

  • First Published:
    Oct 2014, 304 pages
    Paperback:
    Sep 2017, 304 pages

    Genres

  • Rate this book


Book Reviewed by:
Kim Kovacs
Buy This Book

About this Book

Print Excerpt

Introduction

I learned about a lot of things in medical school, but mortality wasn't one of them. Although I was given a dry, leathery corpse to dissect in my first term, that was solely a way to learn about human anatomy. Our textbooks had almost nothing on aging or frailty or dying. How the process unfolds, how people experience the end of their lives, and how it affects those around them seemed beside the point. The way we saw it, and the way our professors saw it, the purpose of medical schooling was to teach how to save lives, not how to tend to their demise. The one time I remember discussing mortality was during an hour we spent on The Death of Ivan Ilyich, Tolstoy's classic novella. It was in a weekly seminar called Patient-Doctor—part of the school's effort to make us more rounded and humane physicians. Some weeks we would practice our physical examination etiquette; other weeks we'd learn about the effects of socioeconomics and race on health. And one afternoon we contemplated the suffering of Ivan Ilyich as he lay ill and worsening from some unnamed, untreatable disease. In the story, Ivan Ilyich is forty-five years old, a midlevel Saint Petersburg magistrate whose life revolves mostly around petty concerns of social status. One day, he falls off a stepladder and develops a pain in his side. Instead of abating, the pain gets worse, and he becomes unable to work. Formerly an "intelligent, polished, lively and agreeable man," he grows depressed and enfeebled. Friends and colleagues avoid him. His wife calls in a series of ever more expensive doctors. None of them can agree on a diagnosis, and the remedies they give him accomplish nothing. For Ilyich, it is all torture, and he simmers and rages at his situation.

"What tormented Ivan Ilyich most," Tolstoy writes, "was the deception, the lie, which for some reason they all accepted, that he was not dying but was simply ill, and he only need keep quiet and undergo a treatment and then something very good would result." Ivan Ilyich has flashes of hope that maybe things will turn around, but as he grows weaker and more emaciated he knows what is happening. He lives in mounting anguish and fear of death. But death is not a subject that his doctors, friends, or family can countenance. That is what causes him his most profound pain.

"No one pitied him as he wished to be pitied," writes Tolstoy. "At certain moments after prolonged suffering he wished most of all (though he would have been ashamed to confess it) for someone to pity him as a sick child is pitied. He longed to be petted and comforted. He knew he was an important functionary, that he had a beard turning grey, and that therefore what he longed for was impossible, but still he longed for it."

As we medical students saw it, the failure of those around Ivan Ilyich to offer comfort or to acknowledge what is happening to him was a failure of character and culture. The latenineteenth-century Russia of Tolstoy's story seemed harsh and almost primitive to us. Just as we believed that modern medicine could probably have cured Ivan Ilyich of whatever disease he had, so too we took for granted that honesty and kindness were basic responsibilities of a modern doctor. We were confident that in such a situation we would act compassionately.

What worried us was knowledge. While we knew how to sympathize, we weren't at all certain we would know how to properly diagnose and treat. We paid our medical tuition to learn about the inner process of the body, the intricate mechanisms of its pathologies, and the vast trove of discoveries and technologies that have accumulated to stop them. We didn't imagine we needed to think about much else. So we put Ivan Ilyich out of our heads.

Yet within a few years, when I came to experience surgical training and practice, I encountered patients forced to confront the realities of decline and mortality, and it did not take long to realize how unready I was to help them.

Excerpted from Being Mortal by Atul Gawande. Copyright © 2014 by Atul Gawande. Excerpted by permission of Metropolitan Books. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

Membership Advantages
  • Reviews
  • "Beyond the Book" articles
  • Free books to read and review (US only)
  • Find books by time period, setting & theme
  • Read-alike suggestions by book and author
  • Book club discussions
  • and much more!
  • Just $12 for 3 months or $39 for a year
  • More about membership!

Beyond the Book:
  Hospice Care

Support BookBrowse

Become a Member and discover books that entertain, engage & enlighten.

Join Now!

Editor's Choice

  • Book Jacket: Daughters Of Smoke & Fire
    Daughters Of Smoke & Fire
    by Ava Homa
    Ava Homa's debut novel begins with an epigraph by Sherko Bekas, a Kurdish poet, the last lines of ...
  • Book Jacket: The Book of V.
    The Book of V.
    by Anna Solomon
    In ancient Persia, Esther, a young Jewish woman, parades herself in front of the king in a desperate...
  • Book Jacket: How to Be an Antiracist
    How to Be an Antiracist
    by Ibram X. Kendi
    Ibram X. Kendi opens How to Be an Antiracist with a personal story he finds shameful in retrospect, ...
  • Book Jacket
    The Darwin Affair
    by Tim Mason
    Set in London in 1860, The Darwin Affair blends fact and fiction, imagining a string of murders ...

Readers Recommend

  • Book Jacket

    The Last Train to Key West
    by Chanel Cleeton

    Romance and danger are locked into Cleeton's suitcase for this journey to 1935 Key West.
    Reader Reviews

  • Book Jacket

    The Stone Girl
    by Dirk Wittenborn

    A riveting tale of deception, vengeance, and power set against the haunting beauty of the Adirondacks.
    Reader Reviews

Book Club Discussion
Book Jacket
The Beekeeper of Aleppo
by Christy Lefteri

This moving, intimate, and beautifully written novel puts human faces on the Syrian war.

About the book
Join the discussion!
Win this book!
Win Of Bears and Ballots

An Alaskan Adventure in Small-Town Politics

A charming account of holding local office with an entertaining, quirky cast of characters.

Enter

Wordplay

Solve this clue:

A S Louder T W

and be entered to win..

Books that     
entertain,
     engage

 & enlighten

Visitors can view some of BookBrowse for free. Full access is for members only.

Join Today!

Your guide toexceptional          books

BookBrowse seeks out and recommends the best in contemporary fiction and nonfiction—books that not only engage and entertain but also deepen our understanding of ourselves and the world around us.