Analysis of Being Mortal by Atul Gawande

According to Dr. Atul Gawande in his book Being Mortal, there are a few things wrong with how we are thinking of our end of life, or rather how we aren’t thinking about it at all. When you continuously avoid the thought of something as big as growing old and eventually dying, there can be a lot of wishes for your life that can be neglected. It is important that you and your loved ones talk about what you do and don’t want in the end. In the world of modern medicine, Atul explains, there are so many ways to preserve and treat illnesses in life, and oftentimes ‘last words’ are no longer happening; with ventilators and life support machines, people can keep a beating heart or working lungs, well after they are gone. In addition, the older you get, the more problems in your body need to be fixed, and there is only so much modern medicine can cure.

One of the more interesting things Atul describes in his book is the idea that modern medicine has advanced so far that we have gotten to the point of ending life sooner to try to cure terminal diseases. Many of these examples come from cancer patients Dr. Gawande has worked with and taking into account how damaging chemotherapy is, we see a detrimental slope rather than the results we want. We would rather give people experimental drugs, that for all we know will shorten their time left than stop treating something that even the medical personnel in charge have deemed incurable. This idea that we can cure the incurable, or change the course of a disease that is never predictable, is unimaginably insane. Yet, we do everything in our power to ‘treat’ these diseases. When in reality, the disease that is resistant to chemotherapy, unresponsive, and going to kill someone, is the one we keep fighting.

Atul describes many cases of elderly people slowly losing their ability to have complete independence. This switch from living on their own, to needing the help of those around them was a difficult thing for many of them. Eventually, everyone will have to give in to their deterioration. However, this does not mean that people should lose their autonomy, by any means. Autonomy is important to us in different ways, and especially when we live our lives in such a way for many years, it can be hard to give even a little of that autonomy and freedom away. In old age, however, oftentimes that full freedom is not possible. As your body falls apart with age, the people closest to us worry we are a danger to ourselves. As the younger generation, they don’t exactly know what to do, but they do know they want to keep you safe. One line from Atul’s Being Mortal (2014) stuck out to me in particular, “We want autonomy for ourselves and safety for those we love. . . Many of the things that we want for those we care about are things that we would adamantly oppose for ourselves because they would infringe upon our sense of self,” (p.106). This brings to mind a lot of what Atul covers in his book. We think about the safety of the people we love rather than what they would want. We tell ourselves they need the protection and we know how to give it to them, but in reality, we don’t consider if this protection is something they would even want. When we allow ourselves to make decisions based on others’ safety rather than their wishes, we risk them being miserable. This not only goes for the elderly but also adolescence developing into young adults. For many people, it is hard to let go of someone you love, you want to hold on tight and protect them from the world and all the pain, but eventually, they will be gone, either way, so we shouldn’t always prioritize safety as number one; happiness and mental wellbeing matter just as much as our physical bodies.

This is a big reason most nursing homes are so detrimental to mental wellbeing. Often, the nurses and doctors are only thinking about and measuring the physical wellbeing of individuals. As humans, though, we are much more complex than simply wanting to stay alive. We have values as well as passions, and oftentimes we get bored with the same routine every day. So why on earth would we be so medical about the way we treat our elderly people? We confine them to wheelchairs they don’t want to be in, make them eat, dress, and bathe on our time, and then expect them to be well and happy. Personally, it sounds like being in prison to me. People are not meant to live in institutions, we created them to make society as a whole easier for the healthy, middle class. When we don’t want to deal with someone’s issues, we feel we aren’t equipped to handle them, we send them somewhere which we believe will help them, but it only helps us. Often it is better for people with chronic, or terminal illnesses and elderly individuals to have assistance, as well as autonomy.