Atul Gawande. 2014. Being Mortal: Medicine and What Matters in the End. New York: Metropolitan Books. $26.00. Hardback. Pp. 282. ISBN: 978–8050‐9515–9.

• Author: Bonnie Stabile
• DOI: http://doi.org/10.1002/wmh3.143
• Published date: 01 June 2015
• Date: 01 June 2015

Book Review

Atul Gawande. 2014. Being Mortal: Medicine and What Matters in the End. New

York: Metropolitan Books. $26.00. Hardback. Pp. 282. ISBN: 978–8050-9515–9.

“It beats the alternative,” is what my mother used to say whenever someone

complained about getting old. Whatever its attendant indignities or inf‌irmities,

she reasoned, being alive was still preferable to dying. In Being Mortal, Atul

Gawande, a surgeon and bestselling author, suggests that we have reached a

turning point for this way of thinking. Modern medical technology, which has

achieved some seemingly miraculous victories, has also reached certain limits

that Gawande urges us to acknowledge. “Decline remains our fate; death will

someday come” he tell us (p. 44). Despite its starkness, his message is ultimately

more soothing than disturbing, for he suggests a path forward to enhance quality

of life and alleviate the suffering caused by the pervasive practice of over-

medicalized death.

Gawande seeks to relieve suffering at the end of life by encouraging dialogue

among physicians, family members, and would-be patients about the role medical

interventions should play in end-of-life care. “What should medicine do when it

can’t save your life?” was the subtitle of Gawande’s 2010 New Yorker article,

“Letting Go,” and some of the stories introduced there are included in Being

Mortal. The f‌irst recounts his experience as one of the physicians participating in

the aggressive treatment of patient Sara Thomas Monopoli’s cancer, which left

him feeling complicit in offering her false hope, and guilty of contributing to a

diminished quality of life in her f‌inal days. The poignancy of her position is

underscored by the fact that her diagnosis and treatment came during her f‌irst

pregnancy and limited days as a new mother. When it became apparent that

Sara’s cancer could not be cured, Gawande ref‌lects that being honest with her

about the likely futility of treatment would have allowed her to spend her

inevitable f‌inal days enjoying time with her baby as best she could, rather than

with drainage tubes in her chest, “shortness of breath, dry heaves, coughing up

blood, [and] severe fatigue” brought on by chemotherapy and surgery (p. 169).

While Sara’s suffering was initially precipitated by the lung cancer ravaging her

body, and no one would have suggested forgoing treatment that could have

World Medical & Health Policy, Vol. 7, No. 2, 2015

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1948-4682 #2015 Policy Studies Organization

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