Sunday, June 28, 2015

Atul Gawande

How we seek to spend our time may depend on how much time we perceive ourselves to have. . . . When horizons are measured in decades, most desire all that stuff at the top of Maslow's pyramid ─achievement, creativity, and other attributes of "self-actualization." But as your horizons contract ─when you see the future ahead of you as finite and uncertain─ your focus shifts to the here and now, to everyday pleasures and the people closest to you. (p 97)

The problem with medicine and the institutions it has spawned for the care of the sick and the old is not that they have had an incorrect view of what makes life significant. The problem is that they have had almost no view at all. Medicine's focus is narrow. Medical professionals concentrate on repair of health, not sustenance of the soul. Yet─and this is the painful paradox─we have decided that they should be the ones who largely define how we live in our waning days. For more than half a century now, we have treated the trials of sickness, aging, and mortality as medical concerns. It's been an experiment in social engineering, putting our fates in the hands of people valued more for their technical prowess than for their understanding of human needs.

That experiment has failed. If safety and protection were all we sought in life, perhaps we could conclude differently. But because we seek a life of worth and purpose, and yet are routinely denied the conditions that might make it possible, there is no other way to see what modern society has done. (p 128)

Gawande, Atul. Being Mortal: Medicine and What Matters in the End. New York: Metropolitan , Henry Holt, 2014. Print.