Titled “Being Mortal,” the video from the “Frontline” series follows Dr. Atul Gawande as he explores the complex relationships between doctors and patients, as well as end-of-life decisions.
Based on his best-selling book Being Mortal, Gawande discusses how medical training is often insufficient to prepare doctors for the realities of death and dying. The documentary focuses on Gawande’s personal stories, including his own experiences with his father’s illness and death, and the challenges of balancing hope with realistic outcomes and living a quality life in the face of a terminal illness. shows the importance of
Overall, Being Mortal encourages a change in perspective within the medical community and society at large, encouraging a balance between curing disease and fostering a meaningful and dignified final day for patients. Gawande emphasizes the importance of individual choice and the value of life until its natural end.
He also emphasizes the futility of aggressive medical intervention when someone is nearing the end of life. In many cases, it does not improve the patient’s quality of life and may instead lead to long-term suffering.
This is often very difficult for doctors who are trained to do everything possible to help sick patients. But, as Gawande pointed out, “The two big problems that can’t be fixed are aging and dying. You can’t fix them.” So the question is, how do we let go? The question is, do we talk about death and dying with compassion?
duel story
This type of mind-based education may be particularly important given recent trends promoting euthanasia as a viable solution to the economic costs of caring for the elderly. As Dr. Matthias Desmet pointed out in his April 25, 2024 article,1
“A few weeks ago, the head of the government’s health insurance fund said in an article published on the website of Belgian state television that euthanasia should be considered as a solution to the rapidly aging population. That’s right. Old people cost too much. Let’s kill them.
These are the words of just one man. However, such words would not be published so innocently in newspapers if there was not a certain tolerance for such messages in society. To be honest, some people want to exclude the elderly.
And these people are suspiciously similar to those who accused you of being a ruthless criminal when you suggested that coronavirus measures would do more harm than good to the elderly. If you think about it, the sentimental “protection of the elderly” during the coronavirus pandemic was quite cruel and unreasonable.
For example, why were elderly people who died in hospitals not allowed to see their children and grandchildren? Was it because the virus could kill them while they were dying?
Just the opposite lurks beneath the surface of the nation’s concern for the elderly. In other words, the state wants to exclude the elderly. A consensus may soon emerge: everyone who wants to live past 75 is irresponsible and selfish…
Jacques Ellul taught us that for propaganda to be successful it must always resonate with the deep desires of the people. This is what I think: Society is full of suicides. That is why we are becoming more and more open to the propaganda that death is the best solution to our problems. ”
Being Mortal calls for improving the dignity and quality of life of older people through improved medical and social practices, but Desmet argues that current social and economic pressures and political discourse It warns that this could lead in the exact opposite direction, namely a decline in consideration and respect for the elderly. .
Essentially, these two sources highlight a potential ethical crisis in how modern society values the later stages of life. Which way would you like to go? Time will tell, but I hope we collectively decide to move forward in the direction Gawande has set out. As Frontline pointed out, “The ultimate goal, after all, is not a good death, but a good life to the end.”
when the person dying is young
It becomes even more complex and emotionally excruciating when dealing with a young person with a terminal illness. Gawande speaks with her husband, a 34-year-old female patient who was diagnosed with terminal lung cancer during pregnancy. A few months later, she was diagnosed with yet another cancer, this time in her thyroid.
He freely admits that even though he knew the situation was hopeless and that she would surely die, he couldn’t bring himself to suggest that the family spend what little time they could enjoy with each other. Instead, he acceded to their wishes by trying one experimental treatment after another.
“I thought a lot, what did that do to us?” says her husband. “What did we miss? What did we forget as we continued treatment after treatment, which made her sicker and worse? In the very last weeks of our lives. , she underwent brain radiation therapy. She was scheduled to undergo the experimental treatment the following Monday.”
I should have started making an effort to spend quality time together sooner. The chemotherapy made her very weak…it was exhausting and her last few months were not good. That’s not what we wanted.
We did very little in the last three months of her life. Radiation and chemotherapy probably didn’t do anything except make her worse. That may have shortened her life. ”
This incident was a turning point for Gawandi. He found it “interesting how uncomfortable I was and how poorly I handled her situation.” In the wake of her untimely death, and his inability to help her and her family make the most of the little time they had left, he decided to help other doctors manage this difficult situation. I started researching to find out how they are dealing with this.
Palliative care physicians specialize in end-of-life care
As mentioned in the film, talking about and planning for death is so difficult that there is a profession called palliative care physicians who specialize in these tasks. Many doctors simply ignore these conversations with patients and instead refer them to palliative care specialists.
Gawandi interviews palliative care physician Kathy Selvaggi about the best ways to discuss death with patients. “Her technique is as much about listening as speaking,” he says. When asked what her doctor would put on her checklist of things to do, she said:
“I think it’s important, first of all, to ask patients what their understanding of their disease is. I think that’s first and foremost, because what we as doctors say… is often different from what the patient is hearing.”
And if there is something you want to do, think about what it is and whether you can achieve it. As we know, people have priorities beyond simply living longer. You need to ask what those priorities are. Without these discussions, we won’t know…
These are very important conversations that should not wait until the last week of life to have between patients, families, physicians, and other health care professionals involved in that patient’s care. ”
difficult conversation
Gawandi goes on to talk about the final conversation he had with his parents and how important it turned out to be.
“There’s no natural moment to have these conversations, unless there’s a crisis, and then it’s too late. So I tried to start earlier, and I talked to my patients and even their fathers. I remember coming to visit, “My dad and I.” My mom and I sat in the living room and had this conversation, “What are your fears? What are your goals?” .
He cried, my mother cried, and I cried. He wanted to be able to be sociable. He didn’t want a situation where a quadriplegic person would end up on a ventilator. “If that happens, let me die,” he said. I didn’t know he felt that way.
This was a very important moment. These priorities would guide us in the years that followed, and they were born out of who he was. ”
He also talks about how upsetting it was to hear his father’s oncologist have unrealistic hopes, as he had in the past.
“As the tumor progressed slowly, we followed his priorities and we and he opted for aggressive surgery and radiation therapy. But eventually paralysis set in and… Then our options became chemotherapy, so our oncologist presented us with eight or nine different options, and we’re swimming through them all.
Then she started saying, “You should really think about getting chemotherapy.” I might be able to play tennis by the end of summer. ” I mean, that was crazy. That was very upsetting. This man could be paralyzed within weeks.
The oncologist was a completely human being, speaking to my father the same way I had spoken to my patients for 10 years, and had unrealistic hopes for him to undergo chemotherapy. ”
When patients are running out of time, they need to know the words of Gawandi so that they can plan what needs to be planned and make the most of the time they have left. “We were still thinking in the back of our minds, is there a way to get through this in 10 years?” Gawandi said. His father, himself a surgeon, ultimately said no, “and we needed to know that.”
“Medicine often offers deals. We sacrifice your time now for time available later. But my father realized later that time was running out. I was there.
He began to think seriously about what he could do and what he wanted to do to live the best life possible with the limited time he had. I think the lesson here is that doctors can’t always guide you. Sometimes patients have to do this. ”
Even if life ends, there is still joy
The film also features the case of Jeff Shields, whose story is a moving depiction of the end-of-life journey of a man committed to “dying well.” As treatment options dwindled and medical interventions became less effective, Jeff faced the reality of his condition with remarkable clarity and foresight.
As his physical world began to narrow to the confines of his home and eventually his bed, Jeff’s emotional and social world expanded significantly. He made a conscious decision to focus on quality of life rather than prolonging his life at all costs.
This decision marked a major change in his journey, moving from aggressive treatment to instead embracing moments of peace and connection with loved ones. Surrounded by his family and friends, Jeff’s home became a place filled with love, sharing, and support.
By discussing the future, accepting that the end was near, and making arrangements for his own care, he was able to take control of his journey in a way that aligned with his values and aspirations. This control and the presence of his loved ones helped him find peace in his final days.
Jeff’s story is a powerful demonstration of the idea that even as a person’s physical space decreases, their emotional and relational worlds can grow tremendously. His end-of-life journey, marked by deep connection and peaceful acceptance of fate, highlights the importance of focusing on what truly matters at the end of his life: comfort, love, and dignity. .
“Jeff Shields’ words that his last few weeks were his happiest were especially meaningful to me because they were one of his last words. He passed away hours later. Ta.” Gawandi says. “In the medical world, when we are faced with an unsolvable problem, we are often not ready to accept that it is unsolvable, but for people it is important to understand how their story ends. I learned that is important.
The questions we ask each other as humans are important. What are your fears and worries about the future? What are your priorities if you run out of time? What are you willing to sacrifice and what are you not willing to sacrifice? ”
https://articles.mercola.com/sites/articles/archive/2024/05/11/being-mortal-documentary.aspx
