What is that elusive quality that elevates writing to an art? Fiction writers have it relatively easy: they can draw from a repertoire of elements to demonstrate the art: plot, characters, lyrical prose, metaphors etc. It is much harder for non-fiction writers. They cannot indulge in hyperbole, or create fantastic worlds or drop pithy aphorisms. Writing about a compelling subject is the easy way out...you might engage the reader, but credit may go to the subject matter and not the writing. If you take away the subject, the insights, the wisdom, will there still be something left? If so, that may be writing as an art.
Atul Gawande is one such writer and artist. Dr. Gawande is a Surgeon based in the US, and I had previously liked his 'Checklist Manifesto'. With his direct, economical and yet evocative turn of phrase, his books are enjoyable just for his writing. Being Mortal is the latest of his books, published a couple of years ago.
In this current book, he searches for an answer to the question: How does a doctor trained to fight disease and used to success, accept that he must ultimately lose? We are mortals and death is the inexorable victor...all prior efforts are sandbags and stopgaps, skirmishes and street fights that the doctor may win, but winner of the war is inevitably death. But doctors (specially in the US), are not prepared for that reality, he says. So they may offer options to patients that may extend life by a short period, but at the cost of great suffering, loss of dignity and the loneliness of the company of strangers. He thinks this is wrong and the book seeks other solutions.
This is a book focused on the US medical systems and culture, but his Indian links has him exploring these answers in India and other countries as well. In his search, he looks at alternatives to the attrition in the ICU: geriatric medicine, palliative care, hospices, nursing homes, assisted living, elderly communities etc. He traces the history of medicine and how it culminated in the current system when most people die in ICUs than at home.
The search is a personal one too. His elderly father, a successful doctor and leader of society, suffers a terminal disease, degeneration and death in his old age and Dr Gawande is forced to confront his own powerlessness in that process.
It is an enjoyable read, with compelling anecdotes that span the US and India. But the second half flags a bit, as he seems to run out of things to say and there is some repetition.
But I felt that he also missed seeing the big picture- confronting mortality is not just about the tactical options. The profundity of life, our relationship with our loved ones and with the Universe, who we are... these deep questions that have us playing blind man's buff for answers in such vulnerable moments seem to be addressed only peripherally in the book. Perhaps it is hard for a doctor to sound credible if he talks of things that are not concrete, subjects that are the focus of philosophy and religion. But nevertheless the book comes across as missing some pages.
But in summary, definitely worth a read!




















