|This quote is from page 259.|
"Research has shown that loss of bone density may be a better predictor of death from atherosclerotic disease than cholesterol levels" (p. 30).Montana. Another died in October. A friend who eats at my table in the dining room is in another hospital getting chemo, and a neighbor on my floor is in another hospital. I'll be 80 in April, so end of life is on my mind, too.
"The three primary risk factors for falling are poor balance, taking more than four prescription medications, and muscle weakness" (p. 40).
"Three Plagues of nursing home existence: boredom, loneliness, and helplessness" (p. 116).
"Four crucial questions. At this moment in your life ... :
1. Do you want to be resuscitated if your heart stops?
2. Do you want aggressive treatments such as intubation and mechanical ventilation?
3. Do you want antibiotics?
4. Do you want tube or intravenous feeding if you can't eat on your own?" (p. 179).
"What were her biggest fears and concerns? What goals were most important to her? What trade-offs was she willing to make, and what ones was she not?" (p. 234).
"For human beings, life is meaningful because it is a story. ... And in stories, endings matter" (pp. 238, 239).
"People want to share memories, pass on wisdoms and keepsakes, settle relationships, establish their legacies, make peace with God, and ensure that those who are left behind will be okay. They want to end their stories on their own terms" (p. 249).
The vital questions: "What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding?" (p. 259).
Yesterday, some of us took a survey about senior housing administered by Washington University students inquiring about what's offered, what's needed, whether we have those things here, and to what extent. The Crown Center is for independent living, but HOW independent are we? Do we need help dressing? taking medicine? cooking? bathing? shopping? cleaning our own apartments?
Being Mortal is a book for people ready and willing to face their own mortality, but I think it's equally important that physicians and medical people read it. As a doctor speaking to other doctors, Gawande says they've been focused on the wrong thing: keeping people alive, even if they are miserable and maybe tied into a wheelchair in the hallway of a nursing home. He advocates asking people what THEY want out of what's left of their lives. I agree wholeheartedly.
This single book is enough about nonfiction favorites for me today, but maybe I'll write about another book or two later.
If you click this link, you can read what others have written about nonfiction this week.