Tuesday, November 24, 2015

Book Club and Life Intersect

It's November.

And our book this month was:

It's about ageing. End of life discussions and circumstances. Care-giving. Housing options. Heath. Frailty. Questions you should ask. Being prepared. The role of doctors and hospitals. Family considerations.

Atul Gawande is an incredible author. This book is full of facts, statistics, history, and real stories that help you understand what all the options look like. And it's easy to read.

Everybody should. (Read it.) (And then talk to their parents and spouses about a few things...)

I highly, highly recommend it.
Just don't read it in November.
And probably don't read it a few months after your dad has passed away and you're living with your mom.

But seriously.
This is a must-read.


Random quotes:

“Your chances of avoiding the nursing home are directly related to the number of children you have,” and having at least one daughter seems crucial to the amount of care you'll receive."

“Life is choices, and they are relentless. No sooner have you made one choice than another is upon you.” 

“Our ultimate goal, after all, is not a good death but a good life to the very end.”

“The problem with medicine and the institutions it has spawned for the care of the sick and the old is not that they have had an incorrect view of what makes life significant. The problem is that they have had almost no view at all. Medicine’s focus is narrow. Medical professionals concentrate on repair of health, not sustenance of the soul. Yet—and this is the painful paradox—we have decided that they should be the ones who largely define how we live in our waning days.” 

“the purpose of medical schooling was to teach how to save lives, not how to tend to their demise.” 

“The simple view is that medicine exists to fight death and disease, and that is, of course, its most basic task. Death is the enemy. But the enemy has superior forces. Eventually, it wins. And, in a war that you cannot win, you don't want a general who fights to the point of total annihilation. You don't want Custer. You want Robert E. Lee, someone who knew how to fight for territory when he could and how to surrender when he couldn't, someone who understood that the damage is greatest if all you do is fight to the bitter end.” 

“Block has a list of questions that she aims to cover with sick patients in the time before decisions have to be made: What do they understand their prognosis to be, what are their concerns about what lies ahead, what kinds of trade-offs are they willing to make, how do they want to spend their time if their health worsens, who do they want to make decisions if they can’t?

“A family meeting is a procedure, and it requires no less skill than performing an operation.” One basic mistake is conceptual. To most doctors, the primary purpose of a discussion about terminal illness is to determine what people want—whether they want chemo or not, whether they want to be resuscitated or not, whether they want hospice or not. We focus on laying out the facts and the options. But that’s a mistake, Block said. “A large part of the task is helping people negotiate the overwhelming anxiety—anxiety about death, anxiety about suffering, anxiety about loved ones, anxiety about finances,” she explained. “There are many worries and real terrors.”

"...our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer..."

Three things I'm thankful for:

1. These two:

2. This one:

3. Our team.


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