Being Mortal – book review and farewell by Joyce Fagel, pre-health adviser in the Center for Undergradaute Advising, Diversity and Student Success.
Atul Gawande is a surgeon, and a professor at Harvard Medical School and School of Public Health. His third book “Being Mortal: Medicine and What Matters in the End” is a great read for anyone, and especially those who plan to work in health care.
Health care providers are generally trained to provide treatment to patients; that is disagnose and/or engage in procedures aimed to improve or cure the medical issues of the patients or lengthen their life. And modern medicine has many procedures available. Even when the patient is near the end of life, there are experimental medications, surgeries, etc that can be tried. Dr. Gawande writes in a straightforward manner about his journey from action packed health care to an approach that considers what really matters to people at the end of their lives and making this integral to treatment decisions.
Talking with and observing elderly living communities, palliative and hospice care experts, patients in the end phase of their life, as well as his own family experiences, leads Dr. Gawande to learn what is important in the end. He observes that less treatment may mean more life enjoyment, sometimes even more time, for the patient, yet these decisions must be guided by the patient’s wishes. This can only be done when difficult conversation are part of the medical discussion.
This includes questions such as: What are your biggest fears and concerns? What goals are most important to you? What trade-offs are you willing to make, and what ones are you not? Currently few health professionals outside of palliative and hospice care are accustomed to think this way or trained to have such conversations. Dr. Gawande proposes that we will be a better health care system and society if we do engage with one another at this level.
Such questions are not pertinent only during the last phase of life. We will live a better life when we consider them throughout, and especially as we make choices in life that are likely to effect us deeply and in a lasting way. Such as choosing one’s career. Such as choosing where to employ one’s energy and passion.
Today is my last day working at the University of Washington. I have been an academic adviser here for 26 years, starting in the Biology Department and for the last 17 years in a position shared by UW and Shoreline Community College. As of Monday August 17, I will work full-time at Shoreline Community College in academic advising. Leaving the UW is difficult because I care deeply about students and staff here and the endeavor that is higher education. Students: I wish you all many wonderful and challenging and inspiring experiences here at the U. of Washington and beyond! Joyce Fagel
