It is rare that you chance upon a surgeon, who also runs a research centre and pens occasional long form pieces on medicine as staff writer for the New Yorker , besides having four bestsellers to his name.
For Atul Gawande, “Writing is a way of thinking out loud about issues that bother me and make me search for answers. I think I was lucky that people seem to like these thoughts as well. I started writing 15 years ago, when I started with surgery.”
On the sidelines of the Jaipur literature festival, Atul spoke about his latest book, Being Mortal: Medicine And What Matters In The End, that deals with the manner in which medicine can not only improve life but also the process of its ending.
Atul says, “In medical school, we were trained on finding ways to eliminate illnesses and fix people. We were not taught anything on how people die and what makes a good life and death.”
The idea for the book came when his father was diagnosed with terminal brain tumour.
“We started to think in terms of what would make him happy and drew up a list. My father was particular that if he was not able to joke with family and friends, we should give him painkillers and let him go. For almost two years, he managed to do just that and was at home the whole time. He lived with joy and purpose. Apart from this issue, I had been grappling with these limitations of medicine, especially with regard to patients who came to me with terminal illness.”
He adds, “In this book, I talk about the question of what people suffering from terminal illness need to lessen their suffering.
The book also talks about palliative medicine and the manner in which the collapse of the extended family system in urban India has bought about change in society. I have explored how my grandfather, who lived up to age of 108 in his village in India, was surrounded by his family and looked upon as a patriarch. He did have minor health issues, but the thought of spending his last days in a nursing home was unthinkable. He was active till the last day of his life. I have contrasted that experience with that of my wife’s grandmother, who was in a nursing centre in the United States and passed away, lonely and unhappy. I think our focus should be on what makes a person suffering from a terminal illness have a good day instead of using medicines in a last ditch effort to prolong their life. Most of us will have to deal with life-threatening illness at some point in our lives.
The key question is not about having a good death, but having a good life till the end. We need to ask is what the people’s priorities are when they have to deal with that.”
Atul contends, “These are questions urban India will soon grapple with. It is important to have a plan in place if someone has a terminal illness. It is important that people can provide the minimum quality of life to patients, instead of getting them into nursing homes, where their freedoms might be ruined."
He adds, “We tend to assume that survival matters the most, as people get older, even if it means losing your ability to choose for yourself. People often have priorities that extend beyond merely living longer. It is important that people have conversations about these issues with their loved ones.”
Talking about making time for writing, Atul quips, “I try and keep 10 hours a week for writing. I cut down on time with family and friends to keep up with my writing assignments.”
The author was at JLF on the invitation of Teamwork Arts
