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Atul Gawande, the doctor author with a list of books that have been runaway successes, is out with one that looks set to be his best so far.
The title Being Mortal: Medicine and What Matters in the End suggests that the book would be for those in their sunset years or are on its threshold.
But anyone who has read the book would know better than to judge it by the title. Drawing from history, sociology, anthropology and all the sciences, and from scientific researches, Gawande reminds us that "for most of our hundred-thousand-year existence all but the past couple of hundred years the average life span of human beings had been thirty years or less."
Living beyond 30 years was seen as rare and extraordinary, in fact unnatural. Every day beyond 30 years is a gift of modern medical science. And so, the implication is we all have a life span that we were not naturally programmed for.
But what do we choose when things look bleak? An extension? How? In a hospital, with tubes and injections and a depressing regimen? Or simply stay put at home or a homely place and spend the sunset time with family and friends, doing all that you like? And, what should your choices be based on? Through the lives of young and not-so-young, Gawande takes us through what we may want to consider for ourselves. His only advice is that we must give these choices a consideration.
It is a very timely book on excessive medication, hospitalisation, treatment and experimenting with treatment. It also refers to the inability or reluctance of doctors to help patients take that final call.
Gawande's book does not, even remotely, hint at anything like voluntary euthanasia. Quite the contrary, he talks of living the way one wants to against all odds. Yet, it reminds me of what Dr P.N. Chuttani, then director of the Postgraduate Institute of Medical Education & Research in Chandigarh, once said when we spoke on euthanasia."It is not enough to have a biology. It is important to have biography." How to ensure that biography during treatment is either a problem or a positive is the focus of the book.
Gawande has written it like a beautiful human interest story, stringing all the stories he has heard from all kinds of people¯healthy, not so healthy, young, old, patient, attendant, neighbour, doctor, nurse and social worker. He has culled the best of authentic research, taken a bit from history, and, above all, real stories. One may have a subjective view on what matters in the end. But read the book, objectively.
(Arrangement with THE WEEK)
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