Author: Dariush – Year 12 Student
Peer Reviewers: Dorotea & Hannah – Year 12 Student Editors
Trigger Warning: death, bereavement.
Whilst I read this book, the nurses in the UK voted to strike – what could be a more fitting read than this? The author, Atul Gawande, is a very academically achieved man. Not only is he a general surgeon who graduated from the extremely prestigious Harvard medical school in 1995, but he is also in possession of several degrees, which he achieved prior to pursuing medicine. Gawande holds: a Bachelor’s in Biology and Political Science from Stanford University as well as being a Rhodes Scholar, earning an M.A. in PPE from Oxford University. This thorough and extensive education history, thus his accumulation of knowledge and skills, enabled him to write ‘Being mortal: Medicine and what matters in the End’.
The book initially explores nursing homes and previous social norms as well as diving into the complex topic of normativity in relation to geriatric health. He uses anecdotes of his father and his grandmother-in-law, and how their varying social backgrounds greatly impacted how much agency they had. He then delves into the assisted living movement, chaired by Keren Wilson, and the Eden alternative, led by Bill Thomas. Both movements were driven by the impetus that continuance in the nursing home was inadequate for most, and that life needed some greater purpose or power to work towards, that we need something that will last when our bones turn to ash and the sweat on our brows a tear in the ever-rising sea.
Gawande effortlessly considers ethical problems and debates, exploring the need for nursing homes, the reason why families’ hands are oftentimes tipped towards them. He uses personal cases to illustrate his points, which encouraged me to think deeply about what we as a society value most – age, or happiness? It is from this idea that the hospice movement was formed, and this for me was greatly inspiring for two important reasons. Firstly, I volunteer weekly at a charity shop where the proceedings go to St Gemma’s hospice, and this allows me to have a direct impact on how these hospices function. I feel empowered and lucky, but, secondly, also very grateful to have gotten the chance to recognise how much the hospice nurses and other staff do for these terminally ill patients. Through befriending the patient, they learn the ins and outs of their life – their goals in life, what their values are, and what they want during the waning span of their life. No two people are the same, and so being valued as your own, distinct person with your own fears and affections rather than an amalgamation of several medical cases means that your end-of-life care is suited to you and your family, allowing for a more dignified goodbye.
In conclusion, Gawande therefore highlights the importance of palliative care, and how its subsequent impact on all our lives means that the end is no longer something to dread, instead becoming a more peaceful affair in which the person has full autonomy over their death. In attaining our agency, we too can choose to ‘eat chocolate ice cream and watch football on TV’ if that is what our heart yearns for.
I fully urge you to read this book, as it not only educates about life’s inevitable, but also helps guide one on how to best help and offer support for when the cascade of events come to a loved one. Make sure you have the hard conversations, because that is where most of the impact comes into fruition – it is only by addressing these problems head-on that we can fully and best accomplish what is needed.
Finally, on the topic of nurses, support them in their struggle, they are worth infinitely more than the 17.6% they are asking for, and support their industrial action, as it will allow Britain to be safer, happier and more pooled. These nurses work tirelessly to ensure all patients get as much support as possible, but presently the nurses are being stretched so thin they can no longer provide an adequate continuum of care. We need to stop haemorrhaging nurses and make the job worthwhile. This can only be achieved by doing two things: improving working conditions for nurses (by addressing staff shortages), and increasing pay so nurses no longer leave in droves as the once extremely fulfilling vocation becomes financially unviable.
US website – https://www.edenalt.org/
News on nurse strike and their pay rise demands: https://www.theguardian.com/society/2022/nov/10/uk-nurses-pay-rise-strike-minister-chris-heaton-harris-nhs