An extremely insightful book by Dr. Gawande, talking about elderly & end-of-life care and humanity in medicine. It’s definitely uncomfortable and even sad to confront the reality of the fragile lives we all have, but it is an important conversation we all need to have at some point of our life journey.
Young people naturally think we have all the energy & time we want. On the day of our graduation ceremony, we told ourselves, “I will make a dent in the universe.” I absolutely love this energy and drive – this ambition is the embodiment of a young generation. It’s certainly important to live in the moment, but I do believe in the value to “begin with the end in mind” as Stephen Covey emphasized in his The Seven Habits of Highly Effective People. “If you carefully consider what you want to be said of you in the funeral experience, you will find your definition of success.” So what does beginning with end in mind mean to me in the context of Dr. Gawande’s Being Mortal?
1. Think about the deeper meaning behind whatever we do.
For me as an actuary, medical insurance product pricing means much more than crunching numbers and analyzing risks – I’m in a business that help people in their times of need. The U.S. healthcare system is far from perfect, but I’m glad I can be part of the solution to make it better. One of the important reasons I joined my current employer is that its mission resonates with my higher calling to make a difference in the lives of others around me.
“To improve the health, well-being, and sense of security of the people we serve.”
– Cigna’s mission statement
2. Life is beautiful because of the series of stories we write in the book of life.
- “In the end, people don’t view their life as merely the average of all its moments—which, after all, is mostly nothing much plus some sleep. For human beings, life is meaningful because it is a story. A story has a sense of a whole, and its arc is determined by the significant moments, the ones where something happens.”
- “You may not control life’s circumstances, but getting to be the author of your life means getting to control what you do with them.”
3. Medicine is much larger than prolonging lives; it enables well-being, which “is about the reasons one wishes to be alive.”
- “Being mortal is about the struggle to cope with the constraints of our biology, with the limits set by genes and cells and flesh and bone. Medical science has given us remarkable power to push against these limits, and the potential value of this power was a central reason I became a doctor. But again and again, I have seen the damage we in medicine do when we fail to acknowledge that such power is finite and always will be. We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. Those reasons matter not just at the end of life, or when debility comes, but all along the way. Whenever serious sickness or injury strikes and your body or mind breaks down, the vital questions are the same: What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding?”
Time to act – how this book can help you grow!
“Begin with the end in mind.” What’s your “end”? If you are not very clear yet, check out Stephen Covey’s funeral experience below and write down some takeaways. Ask yourself: “What are the stories I wish I have written before the conclusion of the last chapter?”
If you have aging parents/grandparents, how are they doing? Do you know how they would define “well-being”? Are they living that definition? If not, how can you help them?