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Being Mortal: Medicine and What matters in the End, Atul Gawande. M.D.

    In the summer of 2015, this book was chosen for the Dallas Morning News Points Summer Book Club. (www.dallasnews.com/bookclub)   This is one of the best books I've read in several years. Dr. Gawande is a surgeon. He describes how medical school training does not cover the process of dying in human terms. Doctors are trained to keep patients alive rather than help them make decisions about their death. The scope of this book is broad; I've written about his discussion about the history of Assisted Living in an eLetter. He discusses his own father's failing health and determination to remain in control even during the dying process. 
    Dr. Gawande believes that everyone should be informed of their medical choices when diagnosed with a critical or chronic condition. They should understand the consequences of radical treatment, ongoing treatment, or no treatment at all. Physicians should explain their prognosis and educate them as fully as possible about how they can live with their diagnosis, and how they can die in accordance with their beliefs.
   He explains managing the symptoms when the condition cannot be cured. He includes a discussion on the effects of medical decisions on the patient's family. He understands that today's patients and their families want to be 'fixed', cured, and the impatience with the doctor who admits their disease has no cure. He is a strong advocate of keeping in mind what is important for the patient, and believes that sickness, aging, and mortality are not only medical concerns. Swift, catastrophic death is a rarity in our society; death usually comes after a long struggle with an unstoppable disease. How much pain and inconvenience should the patient and the family endure of the sake of another day or week or year? Physicians are not comfortable with this kind of discussion, and so, in the majority of cases, medical decisions are made without the patient understanding the consequences.
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