Courage - The Final Chapter in Being Mortal - Home Care Book Club

Chapter 8 (plus a brief Epilogue) bring us to the end of of Being Mortal. The chapter starts in what seems like a strange place. It talks about a painful surgery where the patient's pain is measured throughout the procedure but in the end their overall impression of the pain comes down to the ending. If the procedure ended well, patients say "that wasn't so bad."  The point he's making is that our lives are a story and the ending matters. A good ending is worth it.

He talks about a patient upon whom he is able to practice "palliative medicine." She has a tumor that's causing intestinal blockage and all kinds of fluid build up plus the inability for the patient to eat. They're able to temporarily relieve the situation but it's a temporary fix. Then they have "the talk" and decide to try a surgery but not to do things that are likely not to work. When the surgery is performed, Dr. Gawande finds that the blockage can't be fixed, so he installs "drains" and preserves the patient's quality of life for the time that she has left.

Then we return to the author's Dad...  This must have been really hard to write but it's something that you have to read. The key is that they try to give as much control as possible to the dying person. One setback occurs when Dr. Gawande Sr. doesn't wake up and his wife decides, against the plan, to take him to the emergency room. In the end, it seemed like a good decision because he was able to awaken and to go back home for the last days of his life and to enjoy those days with visits from friends and remembrances of a life well lived. The epilogue extends the story and talks about how Dr. Gawande senior wanted his remains to be treated and how this brought peace and closure to the family. 

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