This is an interesting book about the seemingly boring topic of medical care as you age. The author, Atul Gawande, is an American surgeon and writer for The New Yorker who also wrote the book The Checklist Manifesto, which I reviewed earlier this year here.
In this book, the author examines the various ways that current medical treatment may not work best for old people or people with terminal illnesses. He explains that doctors are trained to heal people and are not always prepared, to be blunt, to help people die gracefully.
He describes the three typical ways that a doctor is trained to treat patients. The first type is the type of doctor that always knows best and tells the patient what to do. The second type is the type of doctor that asks the patient what they want and does what the patient wants to do. The third type, and the type of doctor that everybody should have, is the type of doctor to find out what is most important to the patient and come to a decision on treatment in agreement with the patient. This third type of doctor may ask questions like “what are you most afraid of” or “what is most important to you”. He can then decide the best course of action along with the patient because he knows what motivates them. Doctors like this are particularly important for old or terminally sick patients because their lives are likely short and their motivations could be different.
The author also has first-hand experience with these issues when his father, also a doctor, developed a spinal tumor. He explains how his father picked his surgeon based on his willingness to answer questions and come to an agreement on a treatment plan along with his patient. They decided to delay any surgery for years because the patient was able to ask the surgeon the right questions about the positives and negatives of surgery and the surgeon discovered what motivated his patient.
The author of this book is of Indian decent, which is relevant only because he is able to compare and contrast how old people live in India and the USA. He explains that his grandfather in India lived to be over 100 and lived with his family until his death. His sons and grandsons took care of him on a daily basis and based their everyday activities around what their grandfather wanted to do that day. He compares this with the typical elderly person in the United States who was not able to live alone and had to move into an assisted living facility because the family members were either unwilling or unable to provide the assistance needed.
I placed this book on level 1. I suggest it for adults who take care of their elders and struggle with making decisions regarding healthcare. I liked this book and will probably read it again in the future but I must say that I read this book for a personal reason. Unfortunately my brother died unexpectedly in his sleep on October 1, 2017. The doctors did an autopsy and were unable to determine any cause of death.
I miss him more than anything but I do not have any regrets. He lived a good life and did the things he wanted to do and lived where he wanted to live. He is an inspiration to me. I wanted to share a photo of my brother. This photo was taken about a year before he died when he was 24 years old.
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