How do we live a meaningful life when facing debilitating disease or a terminal condition? Gawande takes a very realistic look at our changed social circumstances in terms of life expectancy, movement of peoples and medical technologies/treatments. Through his own reflections, dialogues with colleagues, and study he examines his approach to patients facing difficult health situations. Is he truly dong the best he can?
When in medical school he was lectured on the differences between a patristic, knowledgeable practitioner and an information giver. Although he leaned towards the latter approach he was finding this did not seem to help his patients. Was there another approach? Perhaps guidance?
As he lives through and shares with us many patient stories, he realizes that he needs to listen and that what patients truly want is often unexpected and attainable. While families want health and safety, patients facing the reality of dying have different desires. So he becomes a guide who can offer information, discuss possible effects of treatments, and listen attentively….he learns to have the difficult conversations. The final ‘case’ he shares is the dying of his own father; his insights and new practices have a profound effect on how this passage takes place.
Hopefully he shares stories of different ways of assisting patients facing their own mortality. There are options if we are willing to creatively explore them.
Relevant to us as Canadians as we discuss the impending legislation about end-of-life, he cautions that countries who have embraced assisted end of life have not explored other options to help people with the limits that end-of-life situations find moments worth living for.
The book is readable, relevant and thought provoking with a most hopeful outlook.
Jackie Potter
CSJ Associate