Monday, October 22, 2012

At the End of Life: True Stories About How We Die, edited by Lee Gutkind

The book explores the processes by which this country’s medical system degrades patients’ dignity, how their lives are reduced from the accumulated experience of decades to lists of symptoms and medications. It makes you want to keep some chemical on hand, before the endless testing and treatments sap your strength to the point you can no longer open the bottle and swallow. Or find a remote shack with an open view of a forest or river, to kick around in until you can no longer feed yourself, and then starve to death quite naturally.

We can probably count on the Baby Boomers not to go quietly. The care and handling they denied their parents, who were accustomed to deprivation and bending before institutions, will become standard. They might bankrupt the country, but they might also force some changes in norms for the better. They did the same with education — right? Or did they make higher ed a consumer good,  a playground, and strip from a liberal education what hundreds of repressive governments before them could not? I can’t wait for the end of life as a dizzying rotation of consumer choices.

At the End of Life‘s authors argue for redefining what a doctor does — that  focusing exclusively on preserving life, regardless of its quality, ignores a lot of what makes us complex & sensitive. Doctors should save lives when possible, but when outcomes are discouraging, they should communicate openly with their patients and, when it makes sense, advocate palliative care or a hospice.