Atul Gawande reflects on what people really need when they find death close at hand. Some thoughts from Being Mortal: Medicine and What Matters in the End in the New York Times:
First, in medicine and society, we have failed to recognize that people have priorities that they need us to serve besides just living longer. Second, the best way to learn those priorities is to ask about them. Hence the wide expert agreement that payment systems should enable health professionals to take sufficient time to have such discussions and tune care accordingly.
I also discovered that the discussions most successful clinicians had with patients involved just a few important questions that often unlocked transformative possibilities: (1) What is their understanding of their health or condition? (2) What are their goals if their health worsens? (3) What are their fears? and (4) What are the trade-offs they are willing to make and not willing to make? These discussions must be repeated over time, because people’s answers change. But people can and should insist that others know and respect their priorities.
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Peg, however, got to fulfill her final role. She lived six weeks after going on hospice. Hunter had lessons for four of those weeks, and two final concerts were played. One featured Peg’s current students, all younger children; the other, her former students from around the country. Gathered in her living room, they played Brahms, Chopin and Beethoven for their adored teacher. A week later, she fell into delirium and, a short time after that, died peacefully in her bed.
Hear an interview with Gawande today on the Diane Rehm show
What lessons does this have for clergy and pastoral care leaders in our churches?
A surgeon at Brigham and Women’s Hospital, a professor at Harvard, and a staff writer for The New Yorker. His newest book is “Being Mortal: Medicine and What Matters in the End,” from which this essay is adapted.