They navigate difficult conversations with honesty and compassion, enabling his father to have a final phase of life that is worthwhile to him. Gawande also has difficult conversations with his own father, who learns he has a spinal cord tumor. After Douglass passes away, her daughter thanks Gawande for giving the family time with her. Knowing these priorities, Gawande suggests he begin the surgery by assessing how risky it looks-and if it looks too complicated, he will simply ease her pain instead, which is what he ends up doing. She wants to be able to eat again, but she doesn’t want to risk surgery that will cause more complications. He then treats a woman named Jewel Douglass, who has a tumor pressing on her bowels that causes her to vomit up everything she eats. Later, Gawande realizes that he needs to be more open with his patients and help them through difficult decisions so that they can prioritize what matters most to them. Knowing that Sara is likely to die, he recommends that they hold off on surgery for the thyroid cancer, but he isn’t fully honest with her about her short life expectancy. For example, he treats a woman named Sara Monopoli, who is terminally ill with stage IV lung cancer but who also has unrelated thyroid cancer. But as a result, he often simply presents treatment options to his patients without realistically helping them understand their disease or weighing the options adequately. For much of his time as a surgeon, Gawande feels ill-equipped to talk about death with his patients because it is an uncomfortable topic. The book not only makes a general argument for how medicine and end-of-life care should be improved, but it also chronicles Gawande’s personal struggle to help his terminally ill patients with the process of dying.
Atul Gawande is the author and narrator of Being Mortal.
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