MASONIC BOOK REVIEW

“Being Mortal: Medicine and What Matters in the End”

By Dr. Atul Gawande

The drama of the human condition is fully encapsulated with the mystery of death and what lies beyond. Yet, how we approach the mystery itself is a question that requires a deeper and more intimate appraisal of our own mortality. And more deeply, our personal story leading to that point. It is these questions that the physician, Dr. Atul Gawande, approaches in his book, “Being Mortal: Medicine and What Matters in the End.”

Dr. Gawande’s book is a mixture of exposition and memoir delving into the development of our modern conception of death, the ethical considerations, and the many instiututional hurdles that often interfere or miss the true important. Among the topics explored, the discussion on the medicalization of dying reminded me of experiences I had during my medical training. In his work, Gawande criticizes the tendency to medicalize aging and dying, leading to unnecessary interventions that can sometimes prolong suffering instead of providing comfort and dignity. This preoccupation with treatment to avoid difficult conversations or what I call “treat to deflect” reduces patient autonomy, choice, and the ability to confront death in a meaningful way for themselves and those closest to the patient’s life. As a physician in training, this observation has taught me the value of stories and community in my own life as well as the patient’s I help. The greatest gift I can provide a patient facing death is the courage to embrace death and not seek after treatments that will only prolong their suffering. As one elderly patient taught me, the longing to live is built on a castle of hurt. This patient had a worsening clinical course complicated from his diabetes leading to several amputations and persistent bleeding. It was likely he would have his entire limb amputated and suffer additional infections and complications that would end his life. It was a conversation that I saw the surgical staff avoid addressing directly. The patient was visibly distraught and unsure how to proceed.
By creating a space to open up, my patient expressed feelings of regret, shame, and inadequacy. He felt robbed of the chance of having more time to ask the big questions in life. As he told me, to think about God and find the true meaning of living within. In our conversation, I realized that me engaging with him, listening, and being honest about not knowing opened his heart a bit more. I let myself be vulnerable by telling him that his life mattered because he was teaching me already to be a good doctor. Despite our differences, we both feared death and faced life’s most difficult questions each day we live. I was showing him and myself that we were simply human beings. Not patient and doctor. Two human beings trying to figure out this journey called life. I happen to have skills to help. He had the stories and experiences to share. After his sister and other relatives came to talk with him about his choice, he eventually agreed to go on hospice and palliative care. His face looked completely different. The man I saw this morning was replaced with someone who was alive, happy, and had his personality back. His unkempt hair showed more of his personality that I had overlooked before. And the patient was grateful that someone listened and spoke to his heart rather than his head. As Masons, the journey of finding harmony between the head and the heart comes from the confrontation of death described in the third degree. However, it is a journey that asks each of us the integrity and character by which we live. It asks us to engage with the difficult questions of life. Sometimes, for many years without a complete answer. But within that journey, the true meaning and expression of the divine we harbor comes forth through the way we act, live, and help those in need. It is expressed in ourselves and valuing this life that we live. The aforementioned patient reminds me that life’s biggest questions are a reflection of the divine exploration we are called to participate in. The human quest for truth and light is a reflection of the divine journey. It is a reminder that this life is one of a series of events and moments to come. What matters is looking beyond the physical and finding that purpose within that will carry us forth now and into the future. The promise of continued exploration and journey with the divine. To be both the answer and question to the divine journey that we have yet to fully understand.

Written by: Bro. Jonathan Kopel

 

Bro. Kopel is a MD PhD in his neurology residency in Washington DC. He is a member at Potomac Lodge #5 and Benjamin B. French Lodge #15 of the Grand Lodge of the District of Columbia, Washington, DC.

Samuel Lloyd Kinsey