Tag: Atul Gawande

Top 5 Non-Fiction Reads of 2016

These are my favourite non-fiction titles read or reviewed (not necessarily published) in 2016. Click the title for a link to the full review. See the previous post for my top five fiction reads of the year.

Being Mortal 

ISBN 978-0-8050-9515-9

Cover image for Being Mortal by Atul GawandeIn Being Mortal, Dr. Atul Gawande examines how society and the medical system can improve the treatment and care of elderly and terminally ill patients. He balances the personal and the professional, using stories from his own family–his wife’s grandmother, and then his own father–as well as case studies from his practice. The book provides an overview of different end of life care options, showcasing their benefits and short-comings. Particularly key to Gawande’s criticism is our failure to provide the sick and the elderly with as much control as possible over their own lives, even when the final outcome is beyond their control. Gawande demonstrates the price patients pay in quality of life when we over-emphasize safety. I truly want to make everyone read this book. Younger readers will be better prepared to navigate conversations about aging with their parents. And of course, anyone of any age can find themselves faced with an unexpected illness that catapults them into facing their own mortality sooner than they might have wished or planned.

Categories: Medicine

The Fire This Time

ISBN 978-1-5011-2634-5

Cover image for The Fire This Time, Edited by Jesamyn WardFollowing the death of Trayvon Martin, Jesmyn Ward turned to Twitter to raise her voice against the injustice. But while she found the medium powerful in the heat of the moment, its ephemerality left her wanting more. So she turned to the work of James Baldwin, and from there reached out to gather the voices of a new generation of writers on race in America today. The result is a collection of seventeen diverse pieces, largely essays, but with a poem or other more stylized piece opening each of the three sections. Many of the essays resurrect events that have long since slipped out of the news cycle, memorializing the victims, and decrying the injustice that cost them their lives. The tone ranges from humourous to angry to hopeful as the writers probe their experiences, and draw connections to America’s broader history and legacy. Each reader will undoubtedly have their own favourite pieces in this collection that speaks powerfully about continued racial tension in America today.

Categories: Essays

Just Mercy 

ISBN 978-0-8129-8496-5

Cover image for Just Mercy by Bryan StevensonAs a young law student at Harvard, Bryan Stevenson was unsure about his calling, but a summer internship at the Southern Prisoner’s Defence Committee led him to found the Equal Justice Initiative in 1994, defending indigent prisoners on Death Row in the South. The main thread of Just Mercy is Stevenson’s investigation into the conviction of Walter McMillian in the 1986 murder of Ronda Morrison, which is like something out of a television crime drama. The tenuousness of the evidence on which McMillian was convicted is scarcely believable, the racism poorly concealed, and the unwillingness to admit an error simply stunning. In the chapters between, Stevenson highlights other types of abuses that lead him to do this work, such as life without parole sentences for children, the incarceration of the mentally ill, and the prosecution of women who have suffered still births. While this results in a book that is less focused on a particular case, it ultimately proves to be a strength. These chapters serve to show that Walter McMillian is not isolated or even a particularly extreme case, and give a better idea of the breadth of the problem.Thus Stevenson paints a broad portrait of a problem that goes beyond any one wrongfully convicted prisoner, and serves to highlight a broken system in desperate need of reform.

Categories: African-American, Memoir, True Crime

Milk and Honey

ISBN 978-1-4494-7425-6

Cover image for Milk and Honey by Rupi KaurThis simple and stunning collection is the first book of poems by Canadian writer Rupi Kaur. The book is divided into four sections, entitled “the hurting,” “the loving,” “the breaking,” and “the healing.” Kaur describes it as “the blood sweat tears/ of twenty-one years,” and it does indeed feel like she has put her heart in your hands in paper form. Kaur’s style is short and to the point, but she can punch you in the gut with only a few words, as she explores first love and heart break, family dynamics, and sexual abuse. Her writing has a stripped-down feel, denuded of capital letters and most punctuation, relying on rhythm and visual formatting to do some of that work. The pieces are accompanied by simple black and white line drawings, many of which are really quite elegant, all clean lines and positive and negative space working together. I read this collection at least three times this year, and also listened to the audiobook performed by the author.

Categories: Canadian, Poetry

While the City Slept 

ISBN 978-0-6700-1571-9

Cover image for While the City SleptIn the early hours of July 19, 2009, a man entered the home of Teresa Butz, and her partner Jennifer Hopper in Seattle’s South Park neighbourhood. He raped both women, and slashed and stabbed them with a knife. Eventually they were able to escape screaming into the street, where neighbours came to their aid, and the police were called. Eli Sanders—who received the Pulitzer Prize for Feature Writing for his coverage of the South Park attacks in Seattle’s weekly newspaper, The Stranger—begins at this crucial moment, and then circles back to Jennifer and Teresa’s childhoods, and chronicles how they eventually met and fell in love. Sanders then turns to Isaiah Kalebu, the man accused of raping them and murdering Teresa. His story is an education in the results of deinstitutionalization, the conditions for involuntary commitment, and mental competency to stand trial. It is the story of one missed opportunity after another, of a young man who slipped repeatedly through the cracks in the system, despite his family’s best efforts to get him the help he so desperately needed. While the City Slept is a love story, a tragedy, and a gruesome murder mystery. But it is harrowing not merely because of the violence it recounts, but because of the way it methodically exposes the flaws and failures of both the mental health and criminal justice systems in Washington State.

Categories: LGBT+, True Crime

2016 was honestly a pretty great non-fiction year, thanks in part to my resolution to read more of it. There were a lot of great runners up that are worth checking out, too, including The Boys in the Boat, Hidden Figures, Lab Girl, Not Just Jane, and Where Am I Now.

What were your favourite non-fiction reads of 2016?

 

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Being Mortal

Cover image for Being Mortal by Atul Gawandeby Atul Gawande

ISBN 978-0-8050-9515-9

“Death, of course, is not a failure. Death is normal. Death may be the enemy, but it is also the natural order of things.”

In 1945, most Americans died at home. By the 1980s that number was down to 17%. Today it is trending back upwards as more people pursue options that allow them to live out their final days in the comfort of their own homes. Doctor and writer Atul Gawande explores how dying became medicalized in the intervening years, as science offered new innovations for beating back disease in the 20th century. Encompassing both the elderly and the terminally ill, Gawande examines how end of life care falls short of providing patients with the best possible quality of life in their final days, instead focusing on what else can be tried to fix the unfixable, and beat back the inevitable. From nursing homes to cancer wards to assisted living facilities to hospice care, Gawande reveals the shortcomings of the institutions we have created for the dying, and asks how we can be better prepared to face the question of mortality with clear eyes and compassion.

Atul Gawande’s previous books Better and The Checklist Manifesto both make it amply clear that he takes continuous professional improvement extremely seriously. In Being Mortal, he examines how society and the medical system can improve the treatment and care of elderly and terminally ill patients. Using the case of his wife’s grandmother, he shows how North American nursing homes commonly fall short, by focusing on safety rather than quality of life. Turning to his own grandfather in India, he shows some of the comparative advantages of multi-generational in-home care, but also highlights the inter-generational conflicts and tensions that can arise from this living situation. In the end, he concludes that both models fall short of providing the elderly with the level of control they need to have over their lives in order to be happy.

Gawande is wary of over-idealizing care provided by children in their homes for their elderly parents. In addition to his own grandfather, he uses the case of Shelley and her father Lou to show the stresses and tensions that this can result in. However, many people feel that this model is the ideal, and it is commonly argued that the decline of children caring for their parents indicates a lack of respect for elders in North American culture that comes from the veneration of youth. But Gawande has a slightly different take. He argues that what is being venerated is not youth, but the independent self, and both nursing homes and living with one’s children degrade that independence which is so central to the North American identity. But this way of thinking offers up a question that has been insufficiently answered: “if independence is what we live for, what do we do when it can no longer be sustained?”

Gawande talks about patients, both his own and those he meets in the course of his research, talking with geratiatricians and hospice care workers. He also draws on examples from his own life. Early in the book, he discusses the situation of his wife’s grandmother, Alice Hobson, who lived independently for many years, but eventually began having falls that made it too dangerous for her to continue living alone. She ultimately ending up in a nursing home she despised. Later, after he has explored the nuances of geriatric and hospice care, Gawande approaches the case of his own father, who was discovered to have a slow-growing tumour in his spine when he was in his seventies. His father’s case shows Gawande putting his new skills to use, but equally demonstrates that life is complicated and unpredictable, and that even with this knowledge, the end of life will not necessarily be ideal. Gawande is offering hope and help, not a magical solution that will make every difficult situation easy.

Being Mortal is a book that is important for young and old alike. For those facing choices about where and how they will live in their last years, Gawande offers food for thought about the different options available. Younger readers will be better prepared to navigate these conversations with their parents. And of course, anyone of any age can find themselves faced with an unexpected illness that catapults them into facing their own mortality sooner than they might have wished or planned. Readers will emerge with a better understanding of the warning signs of decline that can severely limit independence, the factors that most affect satisfaction with elder and hospice care for the patients, and questions to use in discussions with doctors and loved ones.

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