Alok Vaid-Menon's Reviews > Being Mortal: Medicine and What Matters in the End

In our anesthetic world sometimes melodrama can be a way to access what we feel. When grandpa died, I wept in the shower, I took long walks engulfed by the wind. One night I lay on the kitchen floor for hours. On those tiles I learned that there is no other side of grief — loss, it just perforates us. You begin to recognize the primordial poetry of an open mouth: absence and presence in one.

Growing up every time we drove by the nursing home my grandma would say a prayer. I never understood “never” like that look: her terror, her sympathy. After surrendering to it, my grief became gratitude. How lucky was I to be there? -- to witness the shaky elegance of his unbecoming? How fortunate was I to be the confidant he told about his desire to go?

In his book, Gawande exposes how modern medicine has erased traditions around morality that help us understand how there are some forms of living which can be more painful than dying. With the imposition of the nuclear family over more extensive community, elder care work is outsourced to sterile and isolating institutions. Gawande questions Western medicine’s salvific function -- its imperative on maintaining life -- without interrogating what quality of life, and what the patient wants in the first place. Doctors are trained in the technicalities of aging — accumulation of lipofuscin, DNA mutation — but not the affects of it. He encourages us to imagine another form of medicine: one in which we ask people what gives their lives meaning? It’s the distinction between living and existing. Health just can’t be about the body, it has to consider the psyche. Ultimately, I was able to accept my grandpa’s death because I knew that prolonging his life would mean incalculable suffering: the inability to speak, write, read, all very things that he loved.

Read this not for comfort, but for conviction. His book is less dynamic to read as it is to apply and propel conversations that have been put off. Occasionally his provocations outrun his prose and his compassion gets lost with so many case studies. But it’s important in the way confronting inconvenient things are: it’s less about the beauty, and more about the lesson.