One of the best signs of a good book is its unplanned lessons. While its title might profess how to fix this or do better at that, a high-quality book also will lead the reader to enlightenment for reasons a PR agent might not promote. Such is my personal experience with Atul Gawande’s “Being Mortal.”
In this 2014 book, the surgeon-author tackles the medical establishment’s often poor way of dealing with impending death. This can mean dragging out pain or suffering, if only because we have the technology to extend life. The author also gives an illuminating history of various kinds of eldercare and delves into end-of-life-care.
Tracing the roots of the assisted living profession, for example, proves enlightening even for long-time long-term care stakeholders. Gawande, a surgeon by trade and New Yorker staff writer by avocation, also traces the roots and philosophy of long-term care alternatives such as The Eden Alternative, The Green House model, and others. You don’t know all of this already, trust me.
This makes “Being Mortal” worth the price of purchase, or even just a drive to the library, for long-term care professionals.
Perhaps the main thrust of this New York Times best-seller is that the medical profession does not often enough take the dying individual’s wishes into account. To rephrase that, Gawande believes that more should be done to put quality into a person’s final days — rather than trying to put more days into a life no matter what the cost. And the costs can mean much more than dollars. There’s also suffering, disorientation and perhaps most significantly, lost opportunity to do what one most wants to do. This could mean teaching piano, communicating with grandchildren or simply watching football on TV while eating chocolate ice cream, as Gawande illustrates.
This fine book is filled with connective anecdotes that make it excellent reading for healthcare professionals and civilians alike. It doesn’t need another fawning review or sales pitch.
But I couldn’t help thinking about it Sunday because of a largely unintended lesson. It comes under Gawande’s argument for the importance of good palliative care for the terminally ill.
Sunday afternoon, I learned of the death of a very dear friend. Doug Kimsey was just 56. He had learned of his pancreatic cancer diagnosis less than six months earlier. We met as newspaper writers 27 years ago and had kept in touch even after he moved out of state. A fun-loving, good-natured baseball enthusiast, he stood up for me at my wedding, and while our visits were all too infrequent, our families formed strong bonds.
His final hours were peaceful and pain-free, one of his sons told me from their small town in central Ohio. The final days were a frustrating mix of consciousness and lack of coherency, but there was comfort in the fact that at least he was receiving hospice care.
The end was always coming. Pancreatic cancer, as I unwillingly learned through recent research, does not lose to anyone, ever, yet alone slowly.
But Doug — Naval veteran, journalist and long-time teacher of the disabled — was living proof that putting life into one’s days trumps merely putting days into one’s life. As bitter as his passing is — and make no mistake, this will always be bitter — I am grateful he at least had good doctors and was able to decide how to live most of his remaining months.
There were sickening, debilitating days for my once-strapping friend. I was not there to witness those. But he also found the fortitude, and his body apparently made good use of chemo treatments for at least a while, to wring some more pleasures out of life.
He remained involved with the athletics program at the school where he taught; visited with his sons, and infant grandson; had periodic dinners with a social group of retired friends; and with the help of his loving wife, made numerous drives to his beloved hometown of Portsmouth, OH, with its local brewery and famous floodwall murals.
The outpouring of affection for my genial, homespun friend knew no bounds, his wife told me last week. My own recent visit, which included an eight-hour drive home after a snowstorm, pales in comparison to the efforts of others who visited from near and far. Take, for example, the pair of buddies who drove in on a Friday, spent Saturday watching NCAA tournament basketball on TV with Doug, and then drove home on Sunday. And, oh yeah, they live in Massachusetts. That’s a 15-hour drive each way.
“Unfair” is the word I want to sob the most when I think of what happened to Doug. But there are memories that bring a smile here and there, and that, I believe, is a core message of “Being Mortal.”
We are all mortal, and that confers upon us an obligation. No, a duty. It is to do everything we can to put the most quality in the days we have — whether they are our own days or those of someone we care for. It can be said this is important at any stage of life, but especially so if we know the end is nearing.
I miss you, Doug, but you did it right. You always did.
James M. Berklan is McKnight’s Editor. Follow him @JimBerklan.